Obese Type Research Articles

INVESTIGATING INTERACTIONS OF PATHOGENETIC FACTORS IN THE DEVELOPMENT OF ARTERIAL HYPERTENSION AND OBESITY

This review is devoted to investigating the clinical, pathogenetic, and molecular mechanisms underlying the development of arterial hypertension and obesity, as well as their mutual impact on the progression of comorbidity. The literature review uncovers the mechanisms contributing to the emergence of various forms of cardioremodelling, taking into account the role of gender-specific factors. The article also presents current theoretical results and findings of clinical studies regarding how pathogenetic factors of arterial hypertension and obesity interact and influence on the progression of both diseases in case of their comorbidity. The influence of the gender, age, race, and seasonal variations in the course of arterial hypertension and obesity was highlighted as well. Special attention was paid to the issues considering the development of these diseases worldwide, age-related characteristics in the progression of this variant of comorbidity. When studying the problem of cardioremodeling in patients with arterial hypertension and in patients with comorbid arterial hypertension and obesity, two types of this pathological process (concentric and eccentric) were established. It has been shown that their development in men and women is significantly influenced by the type of obesity. This process is a gradually progressive disrupt of the structure and function of all parts of the heart, which lead to the development of structural and functional irreversible changes. This is especially clearly observed in patients with arterial hypertension and obesity, including those with type 2 diabetes.

Metformin: An Oral Anti-Hyperglycaemic Agent for the Treatment of Type 2 Diabetes

Metformin is one of the safest and most effective first-line glucose-lowering oral drug therapies for overweight and obese type 2 diabetes (T2D) patients, and those with normal kidney function. It is one of the drugs of Biguanide class of anti-diabetic compounds. It prevents the production of hepatic glucose, increases fatty acid oxidation, enhances insulin sensitivity, decreases lipid synthesis, and impedes gluconeogenesis. Sometimes it is used in combination with insulin or other oral medications. It should be used very carefully who have surgery, trauma, heart failure, severe kidney disease, and impaired liver functions. Some patients face side effects of Metformin and they should take it considering possible side effects of it. In this study aspect of Metformin is discussed as a guideline for the proper treatment T2D patients.

The Effects of Obesity on Bone Turnover Markers in Diabetic Patients with Diabetic Ketosis or Ketoacidosis.

Despite the fact that diabetes individuals are often associated with a higher risk of bone fracture, our previous research demonstrated that Diabetic ketosis (DK) or ketoacidosis (DKA) induced significant alterations in bone biomarkers. It is unknown whether there is a difference in bone metabolism between obese and non-obese diabetic populations while they are in DK or DKA; hence the current study will investigate this further to aid in the prognosis and prediction of bone fracture risk in patients with different BMIs. We categorized patients into four groups based on their BMI utilizing data from our hospital's medical record system from 2018 to 2020 in the Department of Endocrinology: obese DK or DKA patients (OB+DK/DKA, n=41), non-obese DK or DKA patients (DK/DKA, n=201), obese type 2 diabetes patients without DK or DKA (OB+T2D, n=93), and patients with type 2 diabetes only (T2D only, n=304). The comparisons were made on glycosylated hemoglobin (HbA1c), body mass index (BMI), fasting plasma C-peptide (FPCP), and plasma lipids, in addition to bone metabolism indicators such as total 25-OH-VitD3 (25-OH-VitD3), N-terminal middle molecular fragment of osteocalcin (NMID), -C terminal cross-linking telopeptide of type 1 collagen (-CTX), parathyroid hormone (PTH), and blood calcium (Ca2+). The OB+DK/DKA group had a lower average age (p<0.05) than the DK/DKA group, while the DK/DKA group had a significantly lower FPCP (p<0.05). The 25-OH-VitD3 levels of DK/DKA patients were considerably lower than those of the T2D-only group (p< 0.05). In contrast, NMID and Ca2+ levels were significantly lower than those of non-ketosis or acidosis patients (p<0.05), and PTH levels in the DK/DKA group were significantly lower than those of OB+ T2D patients (p<0.05). In contrast, the β-CTX of the DK or DKA group (OB+DK/DKA and DK+DKA) was significantly greater than that of the non-DK or DKA group (p<0.05), although there was no significant difference in blood phosphorus between OB+DK/DKA and DK/ DKA (p>0.05). The levels of thyroid-stimulating hormone (TSH) and free T4 (FT4) did not differ significantly among the four groups (p>0.05); however, the levels of total T3 (TT3), T4 (TT4), and free T3 (FT3) were significantly lower in the DK/DKA group (p<0.05); the ratio of TT3 to TT4 (TT3/TT4) was significantly decreased in the DK/DKA group, whereas the ratio of FT3/FT4 was significantly lower (p<0.05). Obese patients with DK or DKA have a younger onset age, superior pancreatic function, and better blood glucose management than non-obese patients with DK/DKA. Despite having higher bone absorption signals than non-DK/DKA patients, OB+DK/DKA patients have stronger bone formation markers than non-obese DK/DKA patients, according to a recent study. Changes in markers of bone metabolism may be linked to non-thyroidal illness syndrome in cases of DK or DKA.

Milestones in the journey towards addressing obesity; Past trials and triumphs, recent breakthroughs, and an exciting future in the era of emerging effective medical therapies and integration of effective medical therapies with metabolic surgery.

The 21st century is characterized by an increasing incidence and prevalence of obesity and the burden of its associated comorbidities, especially cardiometabolic diseases, which are reaching pandemic proportions. In the late '90s, the "black box" of adipose tissue and energy homeostasis was opened with the discovery of leptin, transforming the adipose tissue from an "inert fat-storage organ" to the largest human endocrine organ and creating the basis on which more intensified research efforts to elucidate the pathogenesis of obesity and develop novel treatments were based upon. Even though leptin was eventually not proven to be the "standalone magic bullet" for the treatment of common/polygenic obesity, it has been successful in the treatment of monogenic obesity syndromes. Additionally, it shifted the paradigm of treating obesity from a condition due to "lack of willpower" to a disease due to distinct underlying biological mechanisms for which specific pharmacotherapies would be needed in addition to lifestyle modification. Subsequently, the melanocortin pathway proved to be an equally valuable pathway for the pharmacotherapy of obesity. Melanocortin receptor agonists have recently been approved for treating certain types of syndromic obesity. Other molecules- such as incretins, implicated in energy and glucose homeostasis- are secreted by the gastrointestinal tract. Glucagon-like peptide 1 (GLP-1) is the most prominent one, with GLP-1 analogs approved for common/polygenic obesity. Unimolecular combinations with other incretins, e.g., GLP-1 with gastric inhibitory polypeptide and/or glucagon, are expected to be approved soon as more effective pharmacotherapies for obesity and its comorbidities. Unimolecular combinations with other compounds and small molecules activating the receptors of these molecules are currently under investigation as promising future pharmacotherapies. Moreover, metabolic and bariatric surgery has also demonstrated impressive results, especially in the case of morbid obesity. Consequently, this broadening therapeutic armamentarium calls for a well-thought-after and well-coordinated multidisciplinary approach, for instance, through cardiometabolic expertise centers, that would ideally address effectively and cost-effectively obesity and its comorbidities, providing tangible benefits to large segments of the population.

The Role of Childhood Obesity in Early-Onset Type 2 Diabetes Mellitus: A Scoping Review.

Childhood obesity is a growing concern worldwide, with significant implications for public health. Of particular interest is its association with the early onset of type 2 diabetes mellitus in children. Exploringthis relationship and identifying contributing factors may help strengthen understanding of this complex relationship. Factors such as family history, gender, and sedentary lifestyle, and poor dietary habits, insulin resistance in adipose tissue have been identified as significant contributors to early-onset type 2 diabetes. The rising prevalence of childhood obesity and its association with diabetes necessitates early interventions to mitigate this concerning trend and ensure a lasting impact on public health. This scoping review aims to investigate the relationship between childhood obesity and early-onset type 2 diabetes mellitus while also exploring other contributing factors. We employed a standardized framework for reviews to analyze relevant literature published in English between 2000 and 2021. Only primary research, systematic reviews, and meta-analyses addressing the association between childhood obesity and early-onset type 2 diabetes mellitus were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format. Out of the 3614 articles assessed, 17 were ultimately incorporated into this scoping review as they met the inclusion criteria. The majority of the literature primarily represented North American studies, with no inclusion of studies from South America.The findings from these studies have highlighted several factors contributing to type 2 diabetes mellitus development. Most of the studies associated obesity development with hypertension and unfavorable lipid profiles.It is important to acknowledge that these findings are derived from the available literature and may not encompass the entirety of research on childhood obesity and early-onset type 2 diabetes mellitus. Furthermore, the limited regional diversity in the selected studies may restrict the generalizability of these findings to other geographic regions. Additional research involving diverse populations is imperative for a comprehensive understanding of the link between childhood obesity and early-onset type 2 diabetes mellitus.Insulin resistance in adipose tissue among obese individuals contributes to the transition from obesity to type 2 diabetes mellitus. Notably, this transition occurs at approximately half the duration in obese youths compared to obese adults, where it typically takes around a decade. The increasing prevalence of childhood obesity and diabetes mellitus in high-income, low-income, and middle-income countries necessitate collective efforts to reduce the increasing rates of early-onset type 2 diabetes in children. This scoping review, therefore, seeks to underscore the importance of early interventions with regard to ensuring a lasting impact capable of extending into adulthood.

Recent Advances in Psychotherapeutic Treatment and Understanding of Alexithymia in Patients with Obesity and Diabetes Mellitus Type 2

Alexithymia is the inability to describe one’s own feelings and is being increasingly researched. According to contemporary psychodynamic theories, negative emotions cannot be adequately named and externalized, but remain trapped in the body. Recent research shows the connection of alexithymia with numerous somatic diseases. Diabetes mellitus type 2 and obesity represent great challenges in treatment, and the psychological profiles in these diseases are being studied more and more often. Therefore, alexithymia enters the focus of some research as a factor that could play a significant role in these diseases, namely as the one that makes a difference. The aim of this paper is a review of the literature with the purpose of understanding the current knowledge about the interconnection between alexithymia, obesity and type 2 diabetes mellitus.

Abdominal obesity in Chinese patients undergoing hemodialysis and its association with all-cause mortality.

Obesity in patients undergoing hemodialysis is common. However, there is limited information on the relationship between obesity types defined by the combined body mass index (BMI) and waist circumference (WC) classification criteria and all-cause mortality in Chinese hemodialysis patients. Our objective was to determine the association between obesity types and all-cause mortality in hemodialysis patients. We conducted a prospective cohort study including patients from 11 hemodialysis centers in Beijing. According to the World Health Organization's standards, patients were classified into 2 categories with WC and 4 categories with BMI and then followed up for 1 year. Kaplan-Meier survival analysis was used to compare the difference in the cumulative survival rate in different BMI and WC groups. A multivariate Cox regression analysis was used to determine the association between different types of obesity and all-cause mortality. A total of 613 patients were enrolled, the mean age was 63.8 ± 7.1 years old, and 42.1% were women. Based on the baseline BMI, there were 303 (49.4%) patients with normal weight, 227 (37.0%) with overweight, 37(6.0%) with obesity, and 46 (7.5%) with underweight. Based on the baseline WC, 346 (56.4%) patients had abdominal obesity. During a median follow-up of 52 weeks, 69 deaths occurred. Kaplan-Meier plots demonstrated a significant association of BMI categories (log-rank χ2 = 18.574, p<0.001) and WC categories (log-rank χ2 = 5.698, p=0.017) with all-cause death. With normal BMI and non-abdominal obesity as a reference, multivariate Cox regression analysis results showed that obesity (HR 5.36, 95% CI, 2.09-13.76, p<0.001), underweight (HR, 5.29, 95% CI, 2.32-12.07, p<0.001), normal weight combined with abdominal obesity (HR 2.61, 95% CI, 1.20-5.66, p=0.016), and overweight combined with abdominal obesity (HR 1.79, 95% CI, 1.03-3.73, p=0.031, respectively) were significantly associated with higher risks of all-cause mortality. Our study indicated that abdominal obesity is common and associated with all-cause mortality among Chinese hemodialysis patients.

The Prevalence of Multidrug-Resistant Organisms in Patients with Surgical Site Infections in Riyadh, Saudi Arabia: A Cross-sectional Study at a Tertiary Care Hospital

Background: Multidrug-resistant (MDR) infections are a threat in patients undergoing surgery. This study was undertaken to determine the prevalence and possible predictors of MDR infections over a two-year period in patients with surgical site infection (SSI) at a tertiary care hospital in Riyadh, Saudi Arabia. Methods: We conducted a cross-sectional study from April 2016 to April 2018 by reviewing hospital records of patients with a diagnosis of SSI based on a physician report and laboratory findings. The isolation of MDR organisms (MDRO) from SSI was the primary outcome variable as well as other risk factors. Results: SSI was diagnosed in 55 out of 77 patients under study, with MDRO prevalence rate of 44%. Previous antibiotic use and hospitalization in the last 90 days were strongly associated with developing MDRO infection often due to ESBL producing Gram-negative bacterial pathogens. Superficial and deep incisional SSI were more frequent in patients compared to organ/space SSI. History of diabetes mellitus, duration of surgery and bacterial colonization at other body site also increased the likelihood of MDRO. Factors such as trauma, obesity, general anesthesia, and wound types were not found to increase the risk for MDRO. Conclusions: Our study identified recent antibiotic use and hospitalization as major risk factors for MDRO surgical site infections. Other predisposing factors include diabetes mellitus, duration of surgery and bacterial colonization. MDRO isolated include E. coli and Pseudomonas aeruginosa. Bacterial pathogens harboring multiple resistant mechanisms can complicate SSI adversely affecting clinical outcomes following routine surgical procedures.

The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis

Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent. Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis. From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis. There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096). General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.

Associations of 10 trace element levels in the whole blood with risk of three types of obesity in the elderly.

Currently, over 2 billion people worldwide suffer from obesity, which poses a serious health risk. More and more attention is being given to the effects of trace elements on obesity in recent years. Synergistic or antagonistic interactions among these elements can adversely or positively impact human health. However, epidemiological evidence on the relationship between trace element exposure levels and obesity has been inconclusive. Baseline data of 994 participants from the Cohort of Elderly Health and Environment Controllable Factors were used in the present study. ICP-MS was used to measure the concentrations of 10 trace elements in the whole blood of the older population. Binary logistic regression, restricted cubic splines (RCS) models, and Bayesian kernel machine regression (BKMR) models were employed to assess single, nonlinear, and mixed relationships between 10 trace element levels and three types of obesity based on body mass index (BMI), waist circumference (WC), and body fat percentage (BFP) in the elderly. Based on BMI, WC and BFP, 51.8% of the included old population were defined as general overweight/obesity, 67.1% as abdominal obesity, and 36.2% as having slightly high/high BFP. After multivariable adjustment, compared with the lowest tertile, the highest tertile of blood selenium (Se) concentration was associated with an increased risk of all three types of obesity. Additionally, compared with the lowest tertile, higher tertiles of strontium (Sr) concentrations were associated with a lower risk of general overweight/obesity and having slightly high/high BFP, and the highest tertile of barium (Ba) was associated with a lower risk of having slightly high BFP, while higher tertiles of arsenic (As) concentrations were associated with an increased risk of having slightly high/high BFP, and the highest tertile of manganese (Mn) was associated with a higher risk of abdominal obesity. BKMR analyses showed a strong linear positive association between Se and three types of obesity. Higher blood levels of trace element mixture were associated with increased obesity risks in a dose-response pattern, with Se having the highest value of the posterior inclusion probability (PIP) within the mixture. In this study, we found higher Se levels were associated with an elevated risk of obesity and high levels of Ba, Pb and Cr were associated with a decreased risk of obesity. Studies with larger samples are needed to confirm these findings.

The Southern European Atlantic Diet and Its Supplements: The Chemical Bases of Its Anticancer Properties.

Scientific evidence increasingly supports the strong link between diet and health, acknowledging that a well-balanced diet plays a crucial role in preventing chronic diseases such as obesity, diabetes, cardiovascular issues, and certain types of cancer. This perspective opens the door to developing precision diets, particularly tailored for individuals at risk of developing cancer. It encompasses a vast research area and involves the study of an expanding array of compounds with multilevel "omics" compositions, including genomics, transcriptomics, proteomics, epigenomics, miRNomics, and metabolomics. We review here the components of the Southern European Atlantic Diet (SEAD) from both a chemical and pharmacological standpoint. The information sources consulted, complemented by crystallographic data from the Protein Data Bank, establish a direct link between the SEAD and its anticancer properties. The data collected strongly suggest that SEAD offers an exceptionally healthy profile, particularly due to the presence of beneficial biomolecules in its foods. The inclusion of olive oil and paprika in this diet provides numerous health benefits, and scientific evidence supports the anticancer properties of dietary supplements with biomolecules sourced from vegetables of the brassica genus. Nonetheless, further research is warranted in this field to gain deeper insights into the potential benefits of the SEAD's bioactive compounds against cancer.

FRI251 A Combination Of Klinefelter Syndrome And The Classic Form Of Congenital Dysfunction Of The Adrenal Cortex: Clinical Case

Abstract Disclosure: N.I. Volkova: None. Introduction: Congenital adrenal hyperplasia (CAH) is a defect in one of the enzymes or transport proteins involved in the synthesis of cortisol in the adrenal cortex. Virile form of CAH is characterized by cortisol deficiency and hyperandrogenism. Klinefelter syndrome is one of the most frequent chromosomal diseases leading to the development of primary hypogonadism. The manifestation of these two diseases in one patient causes difficulties in diagnosis and medical treatment that leads to adverse consequences. Clinical Case: A 43-years-old patient consulted a physician complaining about the lack of erections for 4 years, breast enlargement. From anamnesis, it is known: that the patient at the age of 2 years and 8 months based on experienced growth of pubic hair, decreased level of 17-ketosteroids in the urine and genetic analysis diagnosis of CAH, virile form was suspected. Prednisone 5 mg daily was prescribed. At the age of 5, based on phenotypic features and karyotyping Klinefelter Syndrome (XXY) was diagnosed. At the age of 13, stimulating hormonal chorionic gonadotropin drug with only one course of 10 injections was prescribed. At the age of 18, the patient independently canceled the use of prednisone. Further, he did not receive medication therapy for CAH and Klinefelter syndrome. At the age of 42, adrenal CT revealed formation of the left adrenal gland. High levels of aldosterone and renin were detected. A diagnosis of left adrenal aldosteroma was made and a left-sided adrenalectomy was performed. Histological examination diagnosis of aldosteroma did not confirmed. On physical examination, BMI 30 kg/m2, genoid type of obesity, right testicle is not palpated, left testicle is dense, reduced in size. Small penis size.Laboratory examination revesled decreased level of total testosterone, normal level of SHBG, LH and FSH. Ultrasound of the scrotum organs revealed as well decrease in the size of the testicles and appendages, a volumetric formation of the right testicle, suspicious of tumor. Thus, diagnosis of CAH, virile form and Klinefelter syndrome, primary hypogonadism, right-sided cryptorchidism was confirmed. Hydrocortisone 30 mg daily was prescribed. Hormone replacement therapy with testosterone preparations was not prescribed until surgical treatment of neoplasm of the right testicle will be performed. Conclusion: We have demonstrated a combination of two endocrine pathologies and serious mistakes were made in the management of this patient that requires a multidisciplinary approach, which improves the prognosis and quality of life of these patients. Presentation: Friday, June 16, 2023

Bo's abdominal acupuncture improves disordered metabolism in obese type 2 diabetic rats through regulating fibroblast growth factor 21 and its related adipokines.

To investigate the effect of Bo's abdominal acupuncture (BOAA) on fibroblast growth factor 21 (FGF21) and its related adipokines in type 2 diabetes mellitus (T2DM) rats. This study established obese T2DM rat model by high-fat diet (HFD) with a dose of streptozotocin (STZ, 30 mg/kg). Obese T2DM rats were randomly subdivided into four groups (n = 10): negative, BOAA, conventional acupuncture (COA group) and metformin group (Met group) groups. The biochemical parameters, mRNAs, and proteins were analyzed using enzyme-lined immunoassays kits, quantitative polymerase chain reaction and Western blot. Treatment with BOAA attenuated the histopathological changes in visceral fat and restored the alterations in the levels of body weight, fasting blood glucose (FBG), homeostasis model assessment for insulin resistance (HOMA-IR). BOAA treatment significantly decreased the levels of triglyceride, total cholesterol, low density lipoprotein cholesterol, leptin, and increased the serum levels of high-density lipoprotein cholesterol, fibroblast growth factor 21 (FGF21), adiponectin (ADP), peroxisome proliferator-activated receptor γ (PPAR-γ), C-peptide (C-P) in obese T2DM rats. Furthermore, BOAA treatment significantly increased the mRNA expressions of FGF21, ADP, leptin, PPAR-γ, PPAR-α and adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK). Besides, BOAA treatment upregulated the protein expressions of fibroblast growth factor receptors3 (FGFR3), PPAR-α, extracellular signal-regulated kinase (ERK), phosphorylated ERK (p-ERK), AMPK, p-AMPK, Liver kinase B1 (LKB1), phosphorylated LKB1 (p-LKB1), acetyl-CoA carboxylase (ACC) and phosphorylated ACC (p-ACC), while downregulated the protein expressions of FGF21 and PPAR-γ in visceral fat. BOAA treatment reduced FBG and body weight, and improved insulin sensitivity through regulating FGF21 signaling pathway and its related adipokine in obese T2DM rats.

Effects of Obesity Type on Diabetes and Hypertension in Obese Korean Adults

Obesity is a major cause of diabetes and hypertension. Previous studies have analyzed the effects of obesity on diabetes and hypertension by comparing non-obese and obese groups. Here, we investigated the effects of obesity type through comparison between obesity types in obese adults.The sample comprised 8,914 adults, classified as obese according to body mass index criteria or waist circumference criteria, selected from the Korean National Health and Nutrition Examination Survey (2016-2020). Obesity was classified as abdominal obesity-only, general obesity-only, and abdominal and general obesity. The effects of obesity type on diabetes and hypertension were analyzed using logistic regression model.12.78% of participants exhibited abdominal obesity-only, 22.35% had general obesity-only, and 64.78% had both types. The proportion of patients aged ≥60 years was 57.52% in the abdominal obesity-only group, while 17.12% in the general obesity-only group. The general obesity-only group had a lower incidence of diabetes than the abdominal obesity-only group (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.47-0.77), and the abdominal and general obesity group had a higher incidence of hypertension than the abdominal obesity-only group (OR, 1.82; 95% CI, 1.54-2.15).Abdominal obesity has a stronger association with diabetes than general obesity, and the risk of hypertension is greatest when both obesity types coexist. Individuals with abdominal obesity-only are likely to be excluded from obesity management, especially when aged ≥60 years. The risk of hypertension is much greater when abdominal and general obesity coexist, emphasizing the need to use both body mass index and waist circumference to define obesity.

Obesity and sarcopenic obesity characterized by low-grade inflammation are associated with increased risk for major depression in women.

We aimed to determine women's risk of major depressive disorder (MDD) in relation to obesity phenotypes characterized by levels of circulating high-sensitivity C-reactive protein (hsCRP). This population-based retrospective cohort study comprised 808 women (ages 20-84 y) recruited 1994-1997 and followed for a median 16.1 y (IQR 11.9-16.8). At baseline, body fat and lean tissue mass were measured by whole body dual-energy x-ray absorptiometry (DXA). Obesity was identified as high fat mass index (>12.9 kg/m2), body fat percentage (≥35%) and body mass index (≥30 kg/m2); sarcopenic obesity referred to a high ratio fat mass/fat-free mass (≥0.80). Systemic inflammation was operationalized as serum hsCRP concentration in the upper tertile (>2.99 mg/L). Obesity phenotypes were: non-obese + lowCRP, non-obese + highCRP, obese + lowCRP, and obese + highCRP. During follow-up, the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) was used to identify lifetime history of MDD and age of onset. Poisson regression models were used to estimate the MDD rate for each obesity phenotype during follow-up. Demographic, health and lifestyle factors were tested as potential confounders. During 11,869 p-y of follow-up, 161 (19.9%) women experienced an MDD episode. For obesity phenotypes based on fat mass index, models adjusted for baseline age and prior MDD, and non-obese + lowCRP as reference, RR for non-obese + highCRP was 1.21 (95% CI 0.80, 1.82), obese + lowCRP 1.46 (0.86, 2.47) and obese + highCRP 1.56 (1.03, 2.37). Patterns were similar for obesity by body fat percentage, body mass index and sarcopenic obesity. Consistently across different obesity definitions, this longitudinal study reports that women with both obesity and systemic inflammation are at increased risk of subsequent MDD. Future research should examine whether tackling this metabolically unhealthy obesity type - through, for example, lifestyle or medication approaches - can reduce depression risk.

Normal-weight central obesity: implications for diabetes mellitus.

Current guidelines for obesity prevention and control focus on body mass index (BMI) and rarely address central obesity. Few studies have been conducted on the association between normal-weight central obesity and the risk of diabetes mellitus (DM). 26,825 participants from the National Health and Nutrition Examination Survey (NHANES) were included in our study. A weighted multivariate logistic regression model was used to analyze the relationship between different obesity patterns and the risk of DM. Our results suggest that normal-weight central obesity is associated with an increased risk of DM (OR: 2.37, 95% CI: 1.75-3.23) compared with normal-weight participants without central obesity. When stratified by sex, men with normal-weight central obesity, obesity and central obesity were found to have a similar risk of DM (OR: 3.83, 95% CI: 2.10-5.97; OR: 4.20, 95% CI: 3.48-5.08, respectively) and a higher risk than all other types of obesity, including men who were overweight with no central obesity (OR: 1.21, 95% CI: 0.96-1.51) and obese with no central obesity (OR: 0.53, 95% CI: 0.30-0.91). Our results highlight the need for more attention in people with central obesity, even if they have a normal BMI.

Impact of diet modification on body mass and kidney function in patients with diabetic nephropathy: a pilot study.

The increasing trend in chronic kidney disease (CKD) has occurred in parallel with the increased prevalence of obesity and diabetes type 2. The relationship between a reduction in body mass and protein intake in diabetic nephropathy (DN) has not been adequately understood. This study aimed to determine whether dietary intervention in an adult with DN is associated with decreasing proteinuria or changes in kidney function over six months. The study included 120 patients with DN, consecutively admitted to a dietitian from a Kidney Disease Clinic. Patients were classified into two groups: a reduction diet or a normal calorie diet, both with 0.8 g of protein/kg of ideal body weight/day. Anthropometric and laboratory assessments were done before and after observation. After six months, in the study group of patients on a reducing diet, a decrease in body mass, body mass index (BMI) and stabilization of estimated glomerular filtration rate (eGFR) were observed. There was also a significant correlation between the time of diabetes diagnosis and eGFR and creatinine (R Spearman=-0.24 and 0.3, respectively; p=0.05). There were no other significant associations between body mass, BMI, albuminuria, eGFR, or creatinine. The study shows that obesity is a common comorbid disease in patients with DN and that dietary intervention is associated with a significant reduction in body mass and stabilization of eGFR in these patients.

Effect of chronic disease on racial difference in COVID-19-associated hospitalization among cancer patients.

Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19-associated hospitalization among cancer patients. We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19-associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19-associated hospitalization (27.2% vs 17.2%). The odds of COVID-19-associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19-associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. Chronic diseases played a substantial role in the racial disparity in COVID-19-associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.

Comprehensive Search for GPCR Compounds which Can Enhance MafA and/or PDX-1 Expression Levels Using a Small Molecule Compound Library.

It has been shown that chronic hyperglycemia gradually decreases insulin biosynthesis and secretion which is accompanied by reduced expression of very important insulin gene transcription factors MafA and PDX-1. Such phenomena are well known as β-cell glucose toxicity. It has been shown that the downregulation of MafA and/or PDX-1 expression considerably explains the molecular mechanism for glucose toxicity. However, it remained unknown which molecules can enhance MafA and/or PDX-1 expression levels. In this study, we comprehensively searched for G protein-coupled receptor (GPCR) compounds which can enhance MafA and/or PDX-1 expression levels using a small molecule compound library in pancreatic β-cell line MIN6 cells and islets isolated from nondiabetic C57BL/6 J mice and obese type 2 diabetic C57BL/KsJ-db/db mice. We found that fulvestrant and dexmedetomidine hydrochloride increased MafA, PDX-1, or insulin expression levels in MIN6 cells. We confirmed that fulvestrant and dexmedetomidine hydrochloride increased MafA, PDX-1, or insulin expression levels in islets from nondiabetic mice as well. Furthermore, these reagents more clearly enhanced MafA, PDX-1, or insulin expression levels in islets from obese type 2 diabetic db/db mice in which MafA and PDX-1 expression levels are reduced due to glucose toxicity. In conclusion, fulvestrant and dexmedetomidine hydrochloride increased MafA, PDX-1, or insulin expression levels in MIN6 cells and islets from nondiabetic mice and obese type 2 diabetic db/db mice. To the best of our knowledge, this is the first report showing some molecule which can enhance MafA and/or PDX-1 expression levels. Therefore, although further extensive study is necessary, we think that the information in this study could be, at least in part, useful at some point such as in the development of new antidiabetes medicine based on the molecular mechanism of β-cell glucose toxicity in the future.

Overweight and obesity in children and adolescents with endocrine disorders.

Obesity has become a serious medical condition where many factors can contribute to excess weight gain. The most common type of childhood obesity is simple obesity, which is due to gene-obesogenic environment interaction. Only a minority are due to pathological causes. Secondary causes of obesity, while less common, include these: genetic syndromes, drug-related obesity, as well as endocrine disorders (hypothyroidism, Cushing's syndrome, growth hormone deficiency, hypogonadism, pseudohypoparathyroidism type Ia, insulinoma, hypothalamic obesity and polycystic ovary syndrome). Given that some conditions may be treatable, physicians must be aware of obesity due to endocrinopathies and distinguish them from simple obesity, and treat them properly. Although rare among children, early detection of the endocrine cause of obesity leads to reduced morbidity and, in some cases, reduced mortality in these individuals. The aim of this review is to summarize the current findings on obesity-related endocrinopathies in children (illustrated by clinical examples), highlighting aspects of pathogenetic mechanisms, genetics, the clinical diagnosis, growth, body mass index and possible therapeutic approaches. Early detection and correction of endocrine obesity is of paramount importance for obese children who could benefit from timely diagnosis and an improved management of obesity as many disturbances related to obesity can be reversed at the early stage, if weight loss is achieved.