Obese Volunteers Research Articles

The Influence of Red Cabbage Extract Nanoencapsulated with Brassica Plasma Membrane Vesicles on the Gut Microbiome of Obese Volunteers.

The aim of the study was to evaluate the influence of the red cabbage extracts on the bioaccessibility of their isothiocyanates, and their effect on the intestinal microbiota using a dynamic model of human digestion treated with the gut microbiome of obese adults. The elicitation of red cabbage plants with methyl jasmonate (MeJA) duplicated the content of glucosinolates (GSLs) in the plant organs used for elaborating the encapsulated formula. The use of plasma membrane vesicles, according to a proper methodology and technology, showed a high retention of sulforaphane (SFN) and indol-3-carbinol (I3C) over the course of the 14-day digestion study. The microbiome was scarcely affected by the treatments in terms of microbiota composition or the Bacteroidetes/Firmicutes ratio, but a 3 to 4-fold increase was observed in the production of butyric acid with the encapsulated extract treatment. Based on our pilot red cabbage extract study, the consumption of this extract, mainly encapsulated, may play a potential role in the management of obesity in adults.

Sixteen Weeks of Supplementation with a Nutritional Quantity of a Diversity of Polyphenols from Foodstuff Extracts Improves the Health-Related Quality of Life of Overweight and Obese Volunteers: A Randomized, Double-Blind, Parallel Clinical Trial

Overweight and obesity adversely affect health-related quality of life (HRQOL) through day-to-day impairments of both mental and physical functioning. It is assumed that polyphenols within the Mediterranean diet may contribute to improving HRQOL. This investigation aimed at studying the effects of a polyphenol-rich ingredient on HRQOL in overweight and obese but otherwise healthy individuals. A randomized, double-blind, placebo-controlled study including 72 volunteers was conducted. Subjects were randomly assigned to receive for a 16-week period either 900 mg/day of the supplement or a placebo. Dietary recommendations were individually determined and intakes were recorded. Daily physical mobility was also monitored. Improvement of HRQOL was set as the primary outcome and assessed at baseline and at the end of the investigation using the Short-Form 36 (SF-36) health survey. Body composition was analyzed using dual-energy X-ray absorptiometry (DXA). Physical activity was calculated using the International Physical Activity Questionnaire (IPAQ). After 16 weeks, despite there being no adherence to the Mediterranean Diet Serving Score (MDSS), supplemented individuals experienced significant HRQOL improvement (+5.3%; p = 0.001), including enhanced perceived physical (+11.2%; p = 0.002) and mental health (+4.1%; p = 0.021) components, with bodily pain, vitality, and general health being the greatest contributors. Body fat mass significantly decreased (−1.2 kg; p = 0.033), mainly within the trunk area (−1.0 kg; p = 0.002). Engagement in physical activity significantly increased (+1308 Met-min (Metabolic Equivalent Task minutes)/week; p = 0.050). Hence, chronic supplementation with nutritional diversity and dosing of a Mediterranean diet-inspired, polyphenol-rich ingredient resulted in significant amelioration in both perceived physical and mental health, concomitant with the improvement of body composition, in healthy subjects with excessive adiposity.

Evaluation of Serum Ischemia Modified Albumin Level in Male Patients with Androgenetic Alopecia

Male pattern androgenetic alopecia (AGA) is associated with oxidative stress. Ischemia modified albumin (IMA) is albumin due to albumin modification caused by reactive oxygen species which occur during ischemia.to evaluate IMA levels in AGA patients and compare their levels in healthy control. The four study groups were group (A) included thirty obese patients with AGA, (B) included thirty non-obese patients with AGA, group (C) included ten obese normal volunteer and group (D) ten non obese normal volunteer. The AGA severity was calculated according to the modified Norwood Hamilton classification and serum IMA was measured by ELISA in all participants.The patients and control groups showed a non-significant difference as regards age, smoking and BMI. There was a significant difference between patients and control groups as regards the IMA levels (P= <0.0001). The IMA level showed a significant difference between obese patients and obese control (P= <0.0001), between non-obese patients and non-obese control (P <0.0001), between obese patients and non-obese patients (P < 0.0001), while it showed a non-significant difference between obese and non-obese control (P= 0.7776).The current study suggested that IMA levels were increased by the effect of obesity, but the AGA has an adding effect. The IMA levels showed a positive correlation with AGA duration and AGA severity. The IMA approved as diagnostic indicator of myocardial ischemia and elevated IMA were reported in metabolic syndrome, cardiovascular risk and obesity, and IMA might confirm the link between AGA and these metabolic disorders.

Stratification of Volunteers According to Flavanone Metabolite Excretion and Phase II Metabolism Profile after Single Doses of 'Pera' Orange and 'Moro' Blood Orange Juices.

Large interindividual variations in the biological response to citrus flavanones have been observed, and this could be associated with high variations in their bioavailability. The aim of this study was to identify the main determinants underlying interindividual differences in citrus flavanone metabolism and excretion. In a randomized cross-over study, non-obese and obese volunteers, aged 19–40 years, ingested single doses of Pera and Moro orange juices, and urine was collected for 24 h. A large difference in the recovery of the urinary flavanone phase II metabolites was observed, with hesperetin-sulfate and hesperetin-sulfo-O-glucuronide being the major metabolites. Subjects were stratified according to their total excretion of flavanone metabolites as high, medium, and low excretors, but the expected correlation with the microbiome was not observed at the genus level. A second stratification was proposed according to phase II flavanone metabolism, whereby participants were divided into two excretion groups: Profiles A and B. Profile B individuals showed greater biotransformation of hesperetin-sulfate to hesperetin-sulfo-O-glucuronide, as well as transformation of flavanone-monoglucuronide to the respective diglucuronides, suggestive of an influence of polymorphisms on UDP-glucuronosyltransferase. In conclusion, this study proposes a new stratification of volunteers based on their metabolic profiles. Gut microbiota composition and polymorphisms of phase II enzymes may be related to the interindividual variability of metabolism.

GLP-1 and hunger modulate incentive motivation depending on insulin sensitivity in humans

ObjectiveTo regulate food intake, our brain constantly integrates external cues, such as the incentive value of a potential food reward, with internal state signals, such as hunger feelings. Incentive motivation refers to the processes that translate an expected reward into the effort spent to obtain the reward; the magnitude and probability of a reward involved in prompting motivated behaviour are encoded by the dopaminergic (DA) midbrain and its mesoaccumbens DA projections. This type of reward circuity is particularly sensitive to the metabolic state signalled by peripheral mediators, such as insulin or glucagon-like peptide 1 (GLP-1). While in rodents the modulatory effect of metabolic state signals on motivated behaviour is well documented, evidence of state-dependent modulation and the role of incentive motivation underlying overeating in humans is lacking. MethodsIn a randomised, placebo-controlled, crossover design, 21 lean (body mass index [BMI] < 25 kg/m2) and 16 obese (BMI³ 30 kg/m2) volunteer participants received either liraglutide as a GLP-1 analogue or placebo on two separate testing days. Incentive motivation was measured using a behavioural task in which participants were required to exert physical effort using a handgrip to win different amounts of food and monetary rewards. Hunger levels were measured using visual analogue scales; insulin, glucose, and systemic insulin resistance as assessed by the homeostasis model assessment of insulin resistance (HOMA-IR) were quantified at baseline. ResultsIn this report, we demonstrate that incentive motivation increases with hunger in lean humans (F(1,42) = 5.31, p = 0.026, β = 0.19) independently of incentive type (food and non-food reward). This effect of hunger is not evident in obese humans (F(1,62) = 1.93, p = 0.17, β = −0.12). Motivational drive related to hunger is affected by peripheral insulin sensitivity (two-way interaction, F(1, 35) = 6.23, p = 0.017, β = −0.281). In humans with higher insulin sensitivity, hunger increases motivation, while poorer insulin sensitivity dampens the motivational effect of hunger. The GLP-1 analogue application blunts the interaction effect of hunger on motivation depending on insulin sensitivity (three-way interaction, F(1, 127) = 5.11, p = 0.026); no difference in motivated behaviour could be found between humans with normal or impaired insulin sensitivity under GLP-1 administration. ConclusionWe report a differential effect of hunger on motivation depending on insulin sensitivity. We further revealed the modulatory role of GLP-1 in adaptive, motivated behaviour in humans and its interaction with peripheral insulin sensitivity and hunger. Our results suggest that GLP-1 might restore dysregulated processes of midbrain DA function and hence motivational behaviour in insulin-resistant humans.

Oxidative Stress in Association with Metabolic Health and Obesity in Young Adults

Introduction Obesity is one of the most important public health problems in the world. Among obese people, there are those who, apart from excessive body weight, do not exhibit other metabolic dysfunctions, have a lower risk of developing cardiovascular diseases (CVDs), and show lower mortality. According to the theory, they are referred as metabolically healthy obese (MHO), in contrast to metabolically unhealthy obese (MUO). Metabolic disturbances occurring with obesity have been well established to be associated with oxidative stress. Aim The purpose of this study was to analyse the association between selected anthropometric and biochemical parameters with oxidative stress in MHO, MUO, and normal weight young adults. Material and Methods. Individuals with age between 18 and 36 years with no history of chronic diseases and use of medicaments, with or without obesity, participated in the study. Complete blood counts, biochemical measurements, and parameters of oxidative stress such as total antioxidant capacity (TAC), total oxidative status (TOS), oxidative stress index (OSI), serum concentration of malondialdehyde (MDA), ceruloplasmin, thiol groups and lipid hydroperoxides (LPH), concentration of lipofuscin (LPS) in erythrocytes, and the activity of superoxide dismutase (SOD) were measured. Results 422 patients who met the inclusion criteria were enrolled in the study. Among the study participants, 208 people (49.29%) were offspring of patients with angiographically confirmed coronary artery disease. Among the participants, 16 patients have been included in the group of metabolically healthy obese (MHO) people and 61 patients in the group of metabolically unhealthy obese (MUO) people and 345 patients had normal body weight. Significant differences between metabolically unhealthy obese and normal weight patients, as well as between women and men, have been found. Conclusions We showed significant differences in the selected parameters of oxidative stress between metabolically unhealthy obese (MUO) individuals and young volunteers with normal body weight as well as without significant medical history.

Effect of intermittent fasting on various health parameters in obese type 2 diabetics: A pilot study

Background: Diabetes mellitus type 2 is fast becoming a cause of concern for governments world over and people at large as it has immense socio-economic impact. A diabetic patient usually goes through phases of being overweight, obese, and insulin-resistant before being classified as a patient of type 2 diabetes. Fasting, though practiced for centuries, is a novel approach for delaying progression and possibly reversing diabetes mellitus. Aim and Objectives: The aim of the study is to look for the effect of intermittent fasting on various health parameters in obese type 2 diabetics. Materials and Methods: The study was conducted at a tertiary care facility in Amritsar. Twelve obese volunteers in the age group of 20–60 years with type 2 diabetes mellitus not controlled with metformin alone were included in the study. All the participants were told to follow intermittent fasting protocol of 16:8 for a period of 4 weeks. At the beginning of the study, weight, height, body mass index, waist circumference, waist-hip ratio, fasting blood sugar, and serum insulin, were recorded in each participant. At the end of the 4 weeks period, all the measurements were repeated and compared with baseline values using the student t-test. Results: There was a highly significant decrease in the anthropometric indices and fasting blood sugar as compared to baseline values at the end of the 4-week period without any change in fasting serum insulin levels. Conclusion: There is a favorable effect of intermittent fasting on anthropometric indices and fasting blood sugar levels without any improvement in fasting serum insulin.

Alteration in cardiac function by extreme dieting in obesity

Background: There is rekindled interest in extreme diet control after recent demonstration of reversion of diabetes mellitus by extreme diet control as it improves insulin sensitivity. Weight loss in long run is good for cardiovascular functions but increase in fatty acids associated with extreme diet control may be detrimental to cardiac metabolism and function. Aim and Objective: In this study, we tried to find out the effect of extreme diet control on cardiac functions during a period of 8 weeks and its anticipated beneficial effect on metabolism. Materials and Methods: Thirty obese volunteers (body mass index [BMI] = 35.8 ± 6) were subjected to biochemical profiling and echocardiography at 1 and 8 weeks following extreme diet control (800 Kcal/day). Results were compared to parameters at the start of study. Results: There was weight loss at 1 week of extreme diet control (BMI=34.1 ± 5.8 at 1 week as compared to 35.8 ± 6.0 at baseline, P < 0.01) associated with improvement in biochemical parameters, however, there was impairment in both systolic (LVEF by 3%, P = 0.04) and diastolic myocardial functions (E/e’8.5 ± 1.3 to 9.2 ± 1.6, P = 0.01). Biochemical parameters were found to improve along with decrease in BMI at 8 weeks as compared to 1 week along with improvement in systolic myocardial functions (LVEF improved from 62 ± 5 at 1 week to 64 ± 5 at 8 weeks). Diastolic myocardial functions also improved (E/e’ from 9.2 ± 1.6 at 1 week to 7.1 ± 1.5 at 8 weeks). Conclusion: Extreme diet control results in continuing significant improvement as regards weight loss and biochemical parameters but is linked to temporary but significant cardiovascular impairment at 1 week which may have deleterious effect on coexisting cardiac comorbidity or already compromised cardiac functions. Whereas 8 weeks of extreme dieting resulted in reversion to normal cardiac systolic functions and diastolic functions improved even from their baseline values, thereby signifying its possible therapeutic value in cardiac parameters in obese people in long run.

Insulin-Stimulated Muscle Glucose Uptake and Insulin Signaling in Lean and Obese Humans.

Skeletal muscle is the primary site for insulin-stimulated glucose disposal, and muscle insulin resistance is central to abnormal glucose metabolism in obesity. Whether muscle insulin signaling to the level of Akt/AS160 is intact in insulin-resistant obese humans is controversial. We defined a linear range of insulin-stimulated systemic and leg glucose uptake in 14 obese and 14 nonobese volunteers using a 2-step insulin clamp (Protocol 1) and then examined the obesity-related defects in muscle insulin action in 16 nonobese and 25 obese male and female volunteers matched for fitness using a 1-step, hyperinsulinemic, euglycemic clamp coupled with muscle biopsies (Protocol 2). Insulin-stimulated glucose disposal (Si) was reduced by > 60% (P < 0.0001) in the obese group in Protocol 2; however, the phosphorylation of Akt and its downstream effector AS160 were not different between nonobese and obese groups. The increase in phosphorylation of Akt2 in response to insulin was positively correlated with Si for both the nonobese (r = 0.53, P = 0.03) and the obese (r = 0.55, P = 0.01) groups. Total muscle GLUT4 protein was 17% less (P < 0.05) in obese subjects. We suggest that reduced muscle glucose uptake in obesity is not due to defects in the insulin signaling pathway at the level of Akt/AS160, which suggests there remain significant gaps in our knowledge of muscle insulin resistance in obesity. Our data imply that models of acute lipotoxicity do not replicate the pathophysiology of obesity.

Pranayama, a simple counterattack on obesity, via its impact on the serum leptin levels

Overweight (i.e. BMI of 25- 29.9) and Obesity (BMI ?30) continues to be one of the neglected global health problems. Leptin is one of the chief adipokines in the body that is basically involved in maintaining a balanced appetite in association with the various other adipokines like the adiponectin, ghrelin etc., Pranayama is the simplest and the ancient, dateless, venerable, non- pharmacological intervention that could be potentially used to maintain a healthy life. To determine how the regular practice of pranayama could significantly alter the deranged serum leptin levels in the obese. The correlative study was carried out in Sree Balaji Medical College &amp; Hospital. The subjects included were 60 obese student volunteers of 17-19 years with no other known complications. We measured their serum leptin levels using ELISA method in the central laboratory, both before and after the pranayama training for 6 months. After 6 months of regular pranayama practice, there was a significant decrease in both their serum leptin levels and their BMI as well. Thus, it was concluded that we can potentially turn off our fat switch by beneficially reducing the serum leptin levels and enhancing the leptin receptor sensitivity in the obese with the regular practice of pranayama.&#x0D;

A body weight loss- and health-promoting gut microbiota is established after bariatric surgery in individuals with severe obesity

Obesity has reached an epidemic level worldwide, and bariatric surgery (BS) has been proven to be the most efficient therapy to reduce severe obesity-related comorbidities. Given that the gut microbiota plays a causal role in obesity development and that surgery may alter the gut environment, investigating the impact of BS on the microbiota in the context of severe obesity is important. Although, alterations at the level of total gut bacteria, total gene content and total metabolite content have started to be disentangled, a clear deficit exists regarding the analysis of the active fraction of the microbiota, which is the fraction that is most reactive to the BS. Here, active gut microbiota and associated metabolic functions were evaluated using shotgun proteomics and metabolomics in 40 severely obese volunteers. Samples from each volunteer were obtained under basal conditions, after a short high protein and calorie-restricted diet, and 1 and 3 months after BS, including laparoscopic surgery through Roux-en-Y Gastric Bypass or Sleeve Gastrectomy. The results revealed for the first time the most active microbes and metabolic flux distribution pre- and post-surgery and deciphered main differences in the way sugars and short-fatty acids are metabolized, demonstrating that less energy-generating and anaerobic metabolism and detoxification mechanisms are promoted post-surgery. A comparison with non-obese proteome data further signified different ways to metabolize sugars and produce short chain fatty acids and deficiencies in proteins involved in iron transport and metabolism in severely obese individuals compared to lean individuals.

Role of ceramide-to-dihydroceramide ratios for insulin resistance and non-alcoholic fatty liver disease in humans

IntroductionSphingolipid accumulation has been linked to obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). A recent study showed that depletion of dihydroceramide desaturase-1 (DES-1) in adipose and/or liver...

The PNPLA3-I148M Variant Confers an Antiatherogenic Lipid Profile in Insulin-resistant Patients.

The I148M (rs738409-G) variant in PNPLA3 increases liver fat content but may be protective against cardiovascular disease. Insulin resistance (IR) amplifies the effect of PNPLA3-I148M on liver fat. To study whether PNPLA3-I148M confers an antihyperlipidemic effect in insulin-resistant patients. Cross-sectional study comparing the impact of PNPLA3-I148M on plasma lipids and lipoproteins in 2 cohorts, both divided into groups based on rs738409-G allele carrier status and median HOMA-IR. Tertiary referral center. A total of 298 obese patients who underwent a liver biopsy during bariatric surgery (bariatric cohort: age 49 ± 9 years, body mass index [BMI] 43.2 ± 6.8 kg/m2), and 345 less obese volunteers in whom liver fat was measured by proton magnetic resonance spectroscopy (nonbariatric cohort: age 45 ± 14 years, BMI 29.7 ± 5.7 kg/m2). Nuclear magnetic resonance profiling of plasma lipids, lipoprotein particle subclasses and their composition. In both cohorts, individuals carrying the PNPLA3-I148M variant had significantly higher liver fat content than noncarriers. In insulin-resistant and homozygous carriers, PNPLA3-I148M exerted a distinct antihyperlipidemic effect with decreased very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) particles and their constituents, and increased high-density lipoprotein particles and their constituents, compared with noncarriers. VLDL particles were smaller and LDL particles larger in PNPLA3-I148M carriers. These changes were geometrically opposite to those due to IR. PNPLA3-I148M did not have a measurable effect in patients with lower IR, and its effect was smaller albeit still significant in the less obese than in the obese cohort. PNPLA3-I148M confers an antiatherogenic plasma lipid profile particularly in insulin-resistant individuals.

The Impact of Time-Restricted Diet on Sleep and Metabolism in Obese Volunteers.

Background and objectives: A time-restricted diet is one of the various ways to improve metabolic condition and weight control. However, until now, there have been few pieces of evidence and research to verify the methods and effectiveness of time-restricted diets on metabolic improvement and health promoting. We designed this study to make a healthy diet program and to verify the effectiveness of a time-restricted diet on general health, including sleep and metabolism, in healthy volunteers. Materials and Methods: This study was conducted in healthy adults who are obese but do not have related metabolic disease. Fifteen participants were recruited. Before and after this program, serologic tests including ketone level, questionnaires—daytime sleepiness evaluation such as the Epworth sleepiness scale and the Stanford sleepiness scale, the Korean version of the Pittsburgh sleep questionnaire index, STOP BANG to evaluate sleep apnea, the Hospital Anxiety and Depression Scale for emotion/sleep—and polysomnography (PSG) were conducted to evaluate the effects on sleep of the program. They were divided into two groups based on ketone levels that could reflect the constancy of participation in this study. We analyzed the before and after results of each group. Results: Fifteen participants (nine males and six females) completed this program without significant adverse events. Body weight after this program decreased to 78.2 ± 14.1 from 82.0 ± 15.6 kg (p = 0.539), and BMI decreased to 27.9 ± 3.8 from 29.3 ± 4.6 kg/m2 (p = 0.233). Weight loss was observed in 14 subjects except 1 participant. The results from questionnaires before and after this were not significant changes. They were classified into high/low-ketone groups according to the ketone level of the participants. In the results of the PSG, the apnea hypopnea index (25.27 ± 12.67→15.11 ± 11.50/hr, p = 0.25) and oxygen desaturation (18.43 ± 12.79→10.69 ± 10.0/hr, p = 0.004), which are indicators of sleep apnea, also improved in the high-ketone group, compared with the low-ketone group. Satisfaction interviews for this restricted diet program showed that 86% of the participants were willing to participate in the same program again. Conclusion: The time-restricted diet was successful in weight loss for a period of 4 weeks in obese participants, which did not affect the efficiency and architecture of sleep. In addition, successful weight loss and significant improvement of sleep apnea were showed in the high-ketone group. Further research is needed to demonstrate mechanisms for weight loss, sleep apnea, and time-restricted diets.

The correlation between dietary fat quality indices and lipid profile with Atherogenic index of plasma in obese and non-obese volunteers: a cross-sectional descriptive-analytic case-control study

Background and aimAbnormalities in lipid metabolism are commonly observed in patients who were obese. Alongside dyslipidemia, one of the markers in predicting the risk of cardiovascular disease is the Atherogenic Index of Plasma (AIP), which is related to dietary intake. Healthy fat quality indices might affect on AIP. The purpose of this study is to find the possible relationship between dietary fat quality, and AIP and comparison of these indices among obese and non-obese volunteers.MethodsThis study was a cross-sectional descriptive-analytic case-control study with 157 normal and overweight and obese volunteers (n = 71 normal, Age: 38.90 ± 10.976 vs n = 86 overweight/obese, Age: 38.60 ± 9.394) in the age range of 18–65 years. Food intake was measured using FFQ, anthropometric indices (weight, height, body mass index and waist to hip ratio), body composition (visceral fat level, total body water, body fat mass), and lipid profile were measured.ResultsBased on the present results, comparable biochemical parameters including TC (P = 0.580), TG (P = 0.362), LDL (P = 0.687) and HDL (P = 0.151) among overweight/obese volunteers as compared to normal ones were noticed. Effects of dietary fat quality, including Atherogenicity (AI) and Thrombogenicity (TI) hypo/hypercholesterolemic ratio (h/H), the Cholesterol-Saturated Fat Index (CSI) showed significantly higher AI (P = 0.012) in the overweight/obese group as compared to the normal group. Whereas, h/H (P = 0.034) and ω-6/ω-3 ratio (P = 0.004) were significantly higher in normal-weight volunteers. There was a positive correlation between AI, TI, CSI, SFA, MUFA, PUFA and ω-6/ω-3 ratio with AIP and negative correlation between h/H with AIP in both groups. Despite the significances of these correlations no strong relation was observed by doing multiple regression among normal and overweight/obese groups (R2 = 0.210, R2 = 0.387).ConclusionsIn summary, the present work proposes a direct relationship between dietary fat quality, increased BMI, and lipid abnormalities with AIP. Nevertheless, further large-scale studies are required to sustain a clear conclusion in this wish.

Significantly Elevated Levels of Plasma Nicotinamide, Pyridoxal, and Pyridoxamine Phosphate Levels in Obese Emirati Population: A Cross-Sectional Study.

Water-soluble vitamins like B3 (nicotinamide), B6 (pyridoxine), and B9 (folic acid) are of utmost importance in human health and disease, as they are involved in numerous critical metabolic reactions. Not surprisingly, deficiencies of these vitamins have been linked to various disease states. Unfortunately, not much is known about the physiological levels of B6 vitamers and vitamin B3 in an ethnically isolated group (such as an Emirati population), as well as their relationship with obesity. The aim of the present study was to quantify various B6 vitamers, as well as B3, in the plasma of obese and healthy Emirati populations and to examine their correlation with obesity. A sensitive and robust HPLC-MS/MS-based method was developed for the simultaneous quantitation of five physiologically relevant forms of vitamin B6, namely pyridoxal, pyridoxine, pyridoxamine, pyridoxamine phosphate, and pyridoxal phosphate, as well as nicotinamide, in human plasma. This method was used to quantify the concentrations of these vitamers in the plasma of 57 healthy and 57 obese Emirati volunteers. Our analysis showed that the plasma concentrations of nicotinamide, pyridoxal, and pyridoxamine phosphate in the obese Emirati population were significantly higher than those in healthy volunteers (p < 0.0001, p = 0.0006, and p = 0.002, respectively). No significant differences were observed for the plasma concentrations of pyridoxine and pyridoxal phosphate. Furthermore, the concentrations of some of these vitamers in healthy Emirati volunteers were significantly different than those published in the literature for Western populations, such as American and European volunteers. This initial study underscores the need to quantify micronutrients in distinct ethnic groups, as well as people suffering from chronic metabolic disorders.

The Pharmacology, Efficacy, and Safety of Rivaroxaban in Obese Patient Populations.

Cardiovascular disease (CVD) remains the leading cause of death in the USA. Several risk factors have been identified, and obesity has become one of prominent concern. Excessive weight is considered a risk factor for CVD based on evidence linking it to a hypercoagulable state. Considering the prevalence of CVD and obesity in the USA, along with the increased risk for thrombus-related events, anticoagulation plays a significant role in prevention and treatment. Direct oral anticoagulants have taken the place of many traditional anticoagulants. Considering the recently approved indications and continued postmarketing studies conducted with rivaroxaban, this updated review provides data on the overall impact of obesity on this compound. This includes data obtained from both healthy obese volunteers and obese patients with various CVD conditions enrolled in rivaroxaban clinical trials, along with data obtained from postmarketing real-world evidence studies. Assessment of the clinical pharmacology and population pharmacokinetics in obese individuals revealed no clinically relevant effects of increased weight. Additionally, subgroup analyses from each of the pivotal phase III trials supporting the current approved labeling also demonstrated consistent efficacy and safety results in obese patients. Lastly, these findings are further supported by several recent real-world evidence studies assessing the continued effectiveness and safety of rivaroxaban. In conclusion, rivaroxaban’s overall pharmacological and clinical profile remained consistent in obese adults when assessed in both drug development and postmarketing studies, supporting the premise that higher weight does not necessitate adjustment in either dose strength or regimen.

Comparison of Intraocular Pressure and Central Corneal Thickness Measurements of Obese, Overweight, and Healthy Volunteers

Comparison of Intraocular Pressure and Central Corneal Thickness Measurements of Obese, Overweight, and Healthy Volunteers

Predictive anatomical factors of lung aerosol deposition in obese individuals. Would modified mallampati score be relevant? Clinical trial

BackgroundObesity is a highly prevalent condition worldwide that aggravates symptoms of already existing conditions such as asthma and COPD. The limited effectiveness of inhaled medications in these individuals may be related to anatomic characteristics of their upper airways, mainly due to compressive factors. MethodsControlled clinical trial with obese and nonobese individuals. The following variables were evaluated: anthropometric characteristics, Lung and airway deposition of radiolabeled aerosol (pulmonary scintigraphy), upper airways anatomy (CT scans), and modified Mallampati score. Results29 subjects (17 nonobese and 12 obese) participated. Obese volunteers presented 30% lower aerosol lung deposition compared to nonobese. Moreover, obese subjects Mallampati classification of 4 presented an aerosol lung deposition two times lower than nonobese subjects (p = 0.021). The cross-sectional area of the retropalatal region and retroglossal region were lower in obese patients (p < 0.05), but no correlation to aerosol lung deposition was observed. BMI was associated with 32% of the variance of lung deposition (p < 0.001; β −0.28; 95% CI -0.43 to −0.11). ConclusionHigh BMI correlated to reduced percentage lung deposition. Also, modified Mallampati class 4 was even more detrimental to aerosol delivery into the lungs. Obese subjects have narrower upper airways, compared to nonobese, but this is not reflected in higher radiolabeled aerosol impaction into their oropharynx and does not predict the percentage of lung deposition in this group. Clinical trial registrationNCT03031093 (clinicaltrials.org)

Declared and real physical activity in obese individuals as assessed by the questionnaire and accelerometer.

Due to the lack of precise research data related to the evaluation of the physical activity level (PAL) among obese individuals, the aims of the study were to evaluate declared and real volume of physical activity, and to assess the correlations between these methods. The study consisted of 30 female (M<inf>age</inf>=32.9±7.3 years) and 16 male (M<inf>age</inf>=36.4±8.4 years) a total of 46 obese volunteer individuals were included (M<inf>bmi</inf>: 37.6±6.6 kg/m2, M<inf>bmi</inf>: 34.2±4.3 kg/m2; body fat percentage: 42.1% and 35.2%, respectively). A cross-sectional study was conducted on the obese people. The information form was prepared for obese individuals who applied the Health Institutions and body composition measurements were performed with Tanita BC-1000. PAL was assessed objectively by a Sense Wear Armband (SWA) for 7 consecutive days- and seven day later the participants fill out the International Physical Activity Questionnaire - Short Form (IPAQ-SF). For statistical analysis, the data were presented as mean values, Standard deviations (SD), frequency (f), and percentage (%). Spearman's Rho Correlation were used, and the significant level was P<0.05. According to IPAQ and SWA, 69.6% (10.9% plus 58.7%) of the participants (N.=32) estimated activity levels as "correct." The PAL of 30.4% (N.=14) of the participants does not seem to be consistent. According to the IPAQ and SWA, the rates of moderate-vigorous physical activity (MVPA) were 80.4%, 67.4% respectively. Weak correlation was found-between IPAQ-MET and SWA-step/day and SWA-MET respectively (r<inf>(</inf>s)=0.381; 0.410 (P<0.01). Physical activity level being assessed by a subjective method was different from the objective method in obese individuals. In addition to this, sample groups and limitations should be taken into consideration when determining suitable methods.