Obese Type Research Articles

Functional state of the liver and endothelium in patients with menopausal metabolic syndrome

Aim. To assess the functional state of the liver and endothelium in patients with menopausal metabolic syndrome, depending on the degree of obesity. Materials and methods. 70 patients with menopausal metabolic syndrome and obesity of varying degrees with an average age of 49.9±1.1 years and 30 practically healthy women without obesity and liver pathology with an average age of 47.3±2.6 years (comparison group) who were in the early postmenopausal period were examined. All women underwent biometric and laboratory-instrumental examination, including assessment of biometric indicators, determination of estradiol levels in the blood, biochemical markers of cytolysis and cholestasis, markers of endothelial dysfunction, assessment of microvascular tone reaction with calculation of the thermal vasodilation index, ultrasound examination of the liver and calculation of the Hepatic steatosis index (HSI). Results. All patients with menopausal metabolic syndrome had a genoid type of obesity and hypoestrogenism. The level of estradiol decreased more significantly during the transition to the 1st degree of obesity (p=0.001). According to ultrasound and the HSI index, signs of liver steatosis were found in all patients with menopausal metabolic syndrome. Functional liver tests were within the reference values, 13% had an increase in the level of alkaline phosphatase, more significant in the group with grade 3 obesity (p=0.034). Laboratory markers of endothelial dysfunction were significantly higher in patients with menopausal metabolic syndrome than in the comparison group. The muscular and neurogenic index of thermal vasodilation significantly decreased in women with grade 1 obesity compared to the group with “pre-obesity“ (p=0.041 and 0.047). The lowest endothelial response was observed at the transition to the 1st degree of obesity in comparison with women with excess body weight. Conclusion. For patients with menopausal metabolic syndrome to assess the condition of the liver, it is recommended to conduct a comprehensive instrumental laboratory examination, including ultrasound examination of the liver, biochemical parameters and calculation of the steatosis index.

Central obesity may affect bone development in adolescents: association between abdominal obesity index ABSI and adolescent bone mineral density

PurposePrevious studies have suggested that obesity defined by body mass index(BMI) is a protective factor for bone mineral density(BMD), but have overlooked the potential influence of different types of obesity. This study aims to evaluate the correlation between abdominal obesity index A Body Shape Index(ABSI) and adolescent bone density, and analyze the relationship between abdominal obesity and bone metabolism.MethodsA total of 1557 adolescent participants were included in NHANES from 2007 to 2018. Calculate the ABSI using a specific formula that takes into account waist circumference and BMI. A weighted multiple linear regression model is used to evaluate the linear correlation between ABSI and BMD. Forest plots are used to analyze the correlations between subgroups, and cubic splines are limited to evaluate the nonlinear correlations and saturation effects between ABSI and BMD.ResultsAfter adjusting for confounding factors, there was a significant linear correlation (P < 0.01) between ABSI and femoral BMD, both as a continuous variable and an ordered categorical variable. The restrictive cubic spline curve indicates a significant nonlinear correlation and saturation effect between adolescent ABSI and BMD.ConclusionResearch has shown a significant negative correlation between ABSI and BMD at the four detection sites of the femur, and this correlation may vary slightly due to age, race, family income, and different detection sites. The research results indicate that compared to overall body weight, fat distribution and content may be more closely related to bone metabolism.

Native dynamics and allosteric responses in PTP1B probed by high-resolution HDX-MS.

Protein tyrosine phosphatase 1B (PTP1B) is a validated therapeutic target for obesity, diabetes, and certain types of cancer. In particular, allosteric inhibitors hold potential for therapeutic use, but an incomplete understanding of conformational dynamics and allostery in this protein has hindered their development. Here, we interrogate solution dynamics and allosteric responses in PTP1B using high-resolution hydrogen-deuterium exchange mass spectrometry (HDX-MS), an emerging and powerful biophysical technique. Using HDX-MS, we obtain a detailed map of backbone amide exchange that serves as a proxy for the solution dynamics of apo PTP1B, revealing several flexible loops interspersed among more constrained and rigid regions within the protein structure, as well as local regions that exchange faster than expected from their secondary structure and solvent accessibility. We demonstrate that our HDX rate data obtained in solution adds value to estimates of conformational heterogeneity derived from a pseudo-ensemble constructed from ~200 crystal structures of PTP1B. Furthermore, we report HDX-MS maps for PTP1B with active-site versus allosteric small-molecule inhibitors. These maps suggest distinct and widespread effects on protein dynamics relative to the apo form, including changes in locations distal (>35 Å) from the respective ligand binding sites. These results illuminate that allosteric inhibitors of PTP1B can induce unexpected changes in dynamics that extend beyond the previously understood allosteric network. Together, our data suggest a model of BB3 allostery in PTP1B that combines conformational restriction of active-site residues with compensatory liberation of distal residues that aid in entropic balancing. Overall, our work showcases the potential of HDX-MS for elucidating aspects of protein conformational dynamics and allosteric effects of small-molecule ligands and highlights the potential of integrating HDX-MS alongside other complementary methods, such as room-temperature X-ray crystallography, NMR spectroscopy, and molecular dynamics simulations, to guide the development of new therapeutics.

Association between obesity and the prevalence of dyslipidemia in middle-aged and older people: an observational study

This study aimed to explore the link between various forms of obesity, including body mass index (BMI) and waist circumference (WC), and the risk of dyslipidemia among Chinese residents. We selected the study population through a multi-stage random sampling method from permanent residents aged 35 and older in Ganzhou. Obesity was categorized as non-obesity, general obesity, central obesity, or compound obesity according to established diagnostic criteria. We employed a logistic regression model to assess the relationship between different types of obesity and the risk of dyslipidemia. Additionally, we used the restricted cubic spline model to analyze the association between BMI, WC, and the risk of dyslipidemia. The study included 2030 residents aged 35 or older from Ganzhou, China. The prevalence of dyslipidemia was found to be 39.31%, with an age-standardized prevalence of 36.51%. The highest prevalence of dyslipidemia, 58.79%, was observed among those with compound obesity. After adjusting for confounding factors, we found that the risk of dyslipidemia in those with central and compound obesity was respectively 2.00 (95% CI 1.62–2.46) and 2.86 (95% CI 2.03–4.03) times higher than in the non-obese population. Moreover, the analysis using the restricted cubic spline model indicated a nearly linear association between BMI, WC, and the risk of dyslipidemia. The findings emphasize the significant prevalence of both dyslipidemia and obesity among adults aged 35 and above in Ganzhou, China. Notably, individuals with compound obesity are at a substantially increased risk of dyslipidemia. Therefore, it is crucial to prioritize the use of BMI and WC as screening and preventive measures for related health conditions.

#1870 Uninephrectomized diabetic rats delay onset of hyperglycemia via down-regulation of SGLT2 mRNA

Abstract Background and Aims The kidney is essential for glucose metabolism. Reabsorption of almost all the glucose filtered by the glomerulus is performed by the sodium-glucose cotransporters (the SGLTs) in the proximal tubules, with SGLT2 responsible for about 90%. In addition, the kidney, along with the liver, plays an important role in gluconeogenesis, especially in the long fasting state. SGLT2 inhibitors originally developed for the treatment of type 2 diabetes mellitus (DM) are clinically very effective drugs halting chronic kidney disease progression. The underlying mechanisms are, however, not fully understood. Furthermore, SGLT2 expression in diabetic patients has been reported to increase and decrease but remains unclear. Therefore, this study aimed to evaluate how uninephrectomy (UNx) and SGLT2 inhibitor treatment affects the dynamics of blood glucose and SGLTs in SDT fatty rats with obese type 2 DM (leptin receptor mutation), which is hyperglycemic from an early stage. Method 24 male SDT fatty rats were divided into four groups: sham + placebo group (n=6); sham + dapagliflozin (dapa, 1.5 mg/kg/day) group (n=6); UNx + placebo group (n=6); UNx + dapa group (n=6). UNx or sham operations were undergone at week 6. Measurements included body weight, food intake, water consumption, urine output, blood pressure, serum creatinine, and blood glucose in the experiment. At week 12, the rats were sacrificed, and the kidneys were sampled to measure SGLT1 and SGLT2 mRNA in the renal cortex by real-time PCR quantification. Results Blood glucose levels continued to rise from week 7 in the sham + placebo group, but the rate of increase was still slower in the UNx + placebo group, and the increase in blood glucose levels was mostly suppressed with dapa administration (Fig. 1). Only the Sham + placebo group showed increased urinary volume and weight loss after week 10 due to hyperglycemia. There were no significant differences in serum creatinine or blood pressure during the study. Real-time PCR results showed that SGLT2 mRNA in the renal cortex was significantly decreased by 26% in the UNx group (P=0.0386), but SGLT1 mRNA was not significantly different. Conclusion Uninephrectomized diabetic rats delayed onset of hyperglycemia and reduced SGLT2 mRNA; SGLT2 inhibitor treatment further delayed the onset of hyperglycemia but did not alter SGLT2 mRNA expression. In animal models of diabetes, renal glucose reabsorption appeared to be a major contributor to the development of hyperglycemia.

Visceral Fat-associated Adipokines and Metabolic Variables in Central Obese Type 2 Diabetic Patients

Background:: The association between visceral obesity and insulin resistance establishes an alternative risk for the onset of type 2 diabetes mellitus. The infiltration of macrophages in the visceral fatty tissue and the unreliable generation of adipokines are associated with mechanisms directing the progress of insulin resistance. Objective:: The objective of the study was to observe the relationship between visceral fat-associated adipokines and biochemical variables in central obese type 2 diabetic patients. Methods:: This study included 100 central obese subjects (both genders) aged 30-60 years newly diagnosed with type 2 diabetes mellitus. Out of the 100 participants, 73 were male and 27 were female. Serum adipokines were analyzed using an enzyme-linked immunosorbent assay. Biochemical parameters were assessed using the Cobas® 6000 analyzer, while HbA1c levels were determined through high-performance liquid chromatography. Results:: The results showed a significant relationship (p &lt; 0.05) between the adipokines and HbA1c, fasting, and postprandial blood glucose levels. The results indicated a significant association (p &lt; 0.05) between the adipokines and lipid profile with varying degrees in central obese type 2 diabetic subjects. Conclusion:: The relationship between visceral fat-associated adipokines and metabolic variables may influence the metabolic pathways in central obese type 2 diabetic patients. The adipokines are strong predictors for the intensification of diabetic risk and can be used as a diagnostic tool for risk assessment in the central obese population.

Efficacy and Safety of Injectable Dulaglutide 1.5 mg Among Type 2 Diabetes Patients in Clinics at King Saud Medical City, Riyadh, Saudi Arabia

IntroductionType 2 diabetes mellitus is the most common type of diabetes, characterized by varying degrees of insulin resistance and diminishing beta-cell function, which increases the risk of macrovascular and microvascular complications. Dulaglutide is a long-acting glucagon-like peptide-1 receptor agonist that is administered once weekly and approved for treating adults with type 2 diabetes mellitus. It can be used as a monotherapy or in addition to oral hypoglycemic or insulin therapy.AimThis study aims to provide information contributing to assessing the efficacy and safety of weekly 1.5 mg dulaglutide therapy in Saudi adult patients with type 2 diabetes mellitus.MethodsA retrospective single-arm cohort study using a purposive sample to recruit type 2 diabetes mellitus patients on dulaglutide from endocrine and diabetic outpatient clinics in King Saud Medical City (N = 205). Data were collected from participants’ medical profiles and through the phone using interview questionnaires.ResultsMost participants were female and married; approximately 33% had had diabetes for more than 20 years, 41.4% of the sample had third-class obesity, and more than half had used dulaglutide for the last 1–2 years. With therapy, weight, body mass index, hemoglobin A1c, and fasting blood sugar were significantly improved after 6 and 12 months from baseline. The main side effects reported were nausea (52%) and fatigue (28%).ConclusionDulaglutide is a safe and effective therapy that demonstrated favorable glycemic control and weight reduction in obese type 2 diabetes patients of Saudi origin.

The Role of Obesity in the Poor Prognosis of COVID-19 Infection: A Review of 192 Patients.

We performed a retrospective study on all patients having COVID-19 infection and admitted to our institution between March 2020 and June 2021. Inclusion criteria included any patient over the age of 18 admitted to our institution's COVID-19 unit, or intensive care unit, with a positive COVID-19 PCR or positive COVID-19 serology (IgM). 192 patients met the inclusion criteria, with an average age of 62.68 years and a slight male predominance (64.58%). 76.04% of hospitalized patients and 80% of those admitted to the ICU were either overweight or obese. No statistically significant difference was found regarding the risk of in-hospital mortality and invasive ventilation. The same applies to the length of stay, admission to intensive care, O2 needs, and for the various complications (all p values were >0.05). Patients with obesity type II and III have an increased risk of cardiac arrests and need for intubation and mechanical ventilation. Obesity tends to be a major risk factor for a pejorative evolution in the COVID-19 infection.

Fruit and vegetable consumption: Study involving Portuguese and French consumers

Abstract The regular consumption of vegetables and fruits has been indicated as part of a healthy diet. They are considered healthy foods because they are sources of vitamins, minerals, and fibre. Adequate intake of these foods can reduce the risk of certain chronic diseases, like cardiovascular disease, diabetes, obesity, and various types of cancer. The objective of the present study was to determine the consumption habits of vegetables and fruits in two different countries, Portugal and France. For this descriptive study, it was used a questionnaire survey, applied to individuals over 18 years old and carried out through the internet, being disseminated on social networks and by email. The sample was constituted by 640 participants (257 from Portugal and 383 from France). Statistical tools were used for the treatment of data, like the T-Test and chi-square test utilised to compare the results between Portuguese and French consumers. The results showed that the Portuguese eat out more often than the French. Portuguese and French like vegetables equally but the French eat more vegetables and fruit per week on average than the Portuguese. The French like soup as much as the Portuguese but the Portuguese eat soup more regularly than the French and prefer soup with cut pieces, unlike the French which prefer soup with grounded vegetables. The global consumption of vegetables and fruits is low in both countries and should be increased, most especially in Portugal, where the consumption is lower. In conclusion, despite some differences found across consumers according to country, the consumption of these foods is still below the recommendations of the World Health Organisation, and therefore, some more actions are necessary to incentivise a higher consumption of fruits and vegetables as part of a healthy lifestyle.

HYPERTENSION WITH HEALTHY OBESITY IS FAVORABLE IN CIRCADIAN RHYTHM OF BLOOD PRESSURE AND HEART RATE COMPARED WITH PATHOLOGIC OBESITY: KOREAN REGISTRY OF TARGET ORGAN DAMAGES IN HYPERTENSION (KORHR)

Objective: Metabolically healthy obesity is more advantageous in cardiovascular outcomes than pathologic obesity. This study was to evaluate blood pressure (BP) and heart rate (HR) using 24-hour ambulatory BP monitoring and to compare various types of obesity and non-obesity hypertensives. Design and method: The Korean Registry of Target Organ Damages in Hypertension (KorHR), established in March 2013 was a nationwide prospective observation study including 16 tertiary care hospitals. A total of 1654 hypertensive subjects aged more than 30 years old without a history of obvious cardiovascular disease were divided into 4 groups according to body mass index (BMI) and waist circumference (WC). (table) Office BP and 24-hour ambulatory BP with HR were measured with other laboratory data. Results: A total of 1096 subjects [mean age = 51.4±11.9 years, including 699 (63.8%) male and 524 (47.8%) naïve hypertensives] BMI and WC data were available. There were no significant differences in lipid profile, hs-CRP, and HbA1C levels among various obesity groups (group 1, 2, and 3). However, the 24-hour mean SBP was significantly lower in group 3 compared with other groups. (138.7±15.0 vs. 137.8±12.7 vs. 133.1±17.6∗ vs. 136.5±14.0, ∗p=0.016 vs. other groups) Early morning HR was significantly lower in group 3 (71.1±11.4 vs. 66.2±12.2∗ vs. 66.2±11.8∗ vs. 69.6±11.9 bpm, ∗p=0.026 vs. group 1) and dipper pattern showed a strong tendency of more prevalent in group 3 and 4 with intermediate significance. The results were consistent in both naïve population and patients with anti-hypertensive medications. Conclusions: Healthy obesity hypertensives showed more favorable circadian rhythm in BP and HR than pathologic obesity regardless of metabolic profiles and history of anti-hypertensive medication. This would be a mechanism of advantageous cardiovascular outcomes in healthy obesity hypertensives.

PREDICTING THE PROBABILITY OF DEVELOPING OBESITY DEPENDING ON LEPTIN AND LEPTIN RECEPTOR POLYMORPHISMS

Introduction. Metabolic syndrome is a heterogeneous pathological condition that combines different stages of obesity, impaired glucose tolerance, atherogenic dyslipidemia and arterial hypertension. Obesity itself is a key element of this syndrome. Hormonal disorders, the central one of which is insulin resistance, trigger a cascade of neuroendocrine changes that lead to the progression of MetS. Monogenic mutations are often detected in patients with severe obesity, as well as with early (up to 10 years) its debut. In recent years, it has been increasingly investigated for a genetically determined breakdown in the mechanism of leptin's influence on the development of obesity. The aim of this study – to evaluate the probability of obesity development in patients with LEP and LEPR polymorphisms in Ukrainian population. Research Methods. 53 obesity and 43 non-obesity patients underwent genotyping of the LEP and LEPR genes (K109R (rs1137100), Q223R (rs1137101), K656N (rs1805094), G2548A (rs7799039)) polymorphism was performed using TaqMan™ SNP Genotyping Human Assays (Thermo Fisher Scientific, USA). Results and Discussion. Comparing rs1137101 Allele A, rs1137101 Allele G statistically significant differences were revealed, while comparing rs1805094 Allele C, rs1805094 Allele G, rs7799039 Allele A, rs7799039 Allele G, rs1137100 Allele A, rs1137100 Allele G depending on group indicated no statistically significant differences. SNP (rs1137101) Allele A statistically significant differences depending on obesity degree (p &lt; 0.001). Comparing the rest of SNP`s Allele`s (rs1805094 Allele C, rs1805094 Allele G, rs7799039 Allele A, rs7799039 Allele G, rs1137101 Allele G, rs1137100 Allele A, rs1137100 Allele G, rs696217 Allele G) no statistically significant differences was noted. Prediction of the probability of developing obesity depending on the polymorphism of leptin and leptin receptors revealed the dependence of only mutations in LEPR (Q223R (rs1137101)) in the Ukrainian population. According to the results of the ROC analysis sensitivity and specificity of the method were 65.5 % and 67.8 %, respectively. Conclusions. Our analysis showed that LEPR Q223R (rs1137101) polymorphism could be a potential genetic risk factor for obesity in Ukrainian population regardless of the homozygous or heterozygous genotype (genotypes AA, AG, GG). At the same time, allele A was found in 70.83 % of cases of patients with 2nd and 3rd degree obesity. And homozygous AA and GG genotypes in 24.5 % and 28.3 %, respectively. The results obtained can be used in the practice for early diagnosis of different types of obesity and for prognosing of results of bariatric surgery.

Prevalence of Sutterella wadsworthensis in the fecal microbiota of obese children

Sutterella wadsworthensis are Gram-negative, non-spore-forming, bile-resistant, microaerophilic bacteria. IgA-specific serine endopeptidase is among one of the crucial biochemical traits of S. wadsworthensis. In scientific publications, Sutterella spp. has been linked to ulcerative colitis, autism spectrum disorder, and obesity in children. Moreover, after analyzing various clinical complications in obese patients, it was found that Sutterella spp. influences an increase in insulin resistance, which subsequently leads to the development of type 2 diabetes. Here, the fecal microbiome from 156 patients in the pediatric department was analyzed, of which 23 children comprised control group, 23 children — with obesity lacking concomitant pathology, 110 children — with obesity and concomitant pathology. The study was aimed at determining a correlation between microorganism S. wadsworthensis and types of obesity in children as well as its role in developing this pathology. As a result, a direct relationship was revealed between the isolated bacillus and obesity without concomitant pathology in girls vs boys aged 14 to 17 years, and data were also obtained that S. wadsworthensis was isolated significantly more often. In addition, it was decided to analyze microorganisms associated with S. wadsworthensis in order to identify microbiome members characteristic of obese people. Statistical processing revealed a marked significant positive correlation with the isolation of Streptococcus spp., S. anginosus, C. perfringens, S. aureus and W. confusa. In addition, the ability of S. wadsworthensis to reduce the functionality of the intestinal antibacterial immune response due to the enzyme IgA-specific serine endopeptidase can lead to developing inflammation and penetration of various pathobionts into enterocytes. Thus, our and others study results indicate the controversial importance and a need to further investigate S. wadsworthensis both in obesity and other gastrointestinal diseases.

Metabolic and Skeletal Characterization of the KK/Ay Mouse Model-A Polygenic Mutation Model of Obese Type 2 Diabetes.

Type 2 diabetes (T2D) increases fracture incidence and fracture-related mortality rates (KK.Cg-Ay/J. The Jackson Laboratory; Available from: https://www.jax.org/strain/002468 ). While numerous mouse models for T2D exist, few effectively stimulate persistent hyperglycemia in both sexes, and even fewer are suitable for bone studies. Commonly used models like db/db and ob/ob have altered leptin pathways, confounding bone-related findings since leptin regulates bone properties (Fajardo et al. in Journal of Bone and Mineral Research 29(5): 1025-1040, 2014). The Yellow Kuo Kondo (KK/Ay) mouse, a polygenic mutation model of T2D, is able to produce a consistent diabetic state in both sexes and addresses the lack of a suitable model of T2D for bone studies. The diabetic state of KK/Ay stems from a mutation in the agouti gene, responsible for coat color in mice. This mutation induces ectopic gene expression across various tissue types, resulting in diabetic mice with yellow fur coats (Moussa and Claycombe in Obesity Research 7(5): 506-514, 1999). Male and female KK/Ay mice exhibited persistent hyperglycemia, defining them as diabetic with blood glucose (BG) levels consistently exceeding 300mg/dL. Notably, male control mice in this study were also diabetic, presenting a significant limitation. Nevertheless, male and female KK/Ay mice showed significantly elevated BG levels, HbA1c, and serum insulin concentration when compared to the non-diabetic female control mice. Early stages of T2D are characterized by hyperglycemia and hyperinsulinemia resulting from cellular insulin resistance, whereas later stages may feature hypoinsulinemia due to β-cell apoptosis (Banday et al. Avicenna Journal of Medicine 10(04): 174-188, 2020 and Klein et al. Cell Metabolism 34(1): 11-20, 2022). The observed hyperglycemia, hyperinsulinemia, and the absence of differences in β-cell mass suggest that KK/Ay mice in this studyare modeling the earlier stages of T2D. While compromised bone microarchitecture was observed in this study, older KK/Ay mice, representing more advanced stages of T2D, might exhibit more pronounced skeletal manifestations. Compared to the control group, the femora of KK/Ay mice had higher cortical area and cortical thickness, and improved trabecular properties which would typically be indicative of greater bone strength. However, KK/Ay mice displayed lower cortical tissue mineral density in both sexes and increased cortical porosity in females. Fracture instability toughness of the femora was lower in KK/Ay mice overall compared to controls. These findings indicate that decreased mechanical integrity noted in the femora of KK/Ay mice was likely due to overall bone quality being compromised.

No genetic causality between obesity and benign paroxysmal vertigo: A two-sample Mendelian randomization study.

We applied Mendelian randomization to explore the causal relationship between obesity and benign paroxysmal vertigo (BPV). We chose two types of obesity diseases. Obesity due to excessive calories and other or unspecified obesity from the FinnGen database. We used genomic significance (p < 5 × 10-8) to obtain independent single nucleotide polymorphisms (SNPs) as instrumental variables. Similarly, genome-wide association study data for the disease BPV were selected from the FinnGen database. R was then used to test the data for multiplicity and heterogeneity, as well as to detect the effect of individual SNPs on the results. Random effects inverse variance weighting was used as the main statistical analysis. First, by analyzing, we found an outlier in obesity due to excessive calories (rs12956821). Outliers were then removed, and the statistical results were analyzed without heterogeneity (p > 0.05) and horizontal pleiotropy (p > 0.05), as well as individual SNPs having no effect on the results. Meanwhile, random-effects IVW results showed obesity due to excessive calories (p = 0.481; OR = 0.941), and other or unspecified obesity (p = 0.640; OR = 0.964). The present study did not find a causal relationship between the above two obesity types and BPV at the genetic level.

The agreement of low lean mass with obesity using different definitions and its correlation with hyperuricemia.

The agreement on the identification of sarcopenic obesity remains elusive, and its association with hyperuricemia remains unestablished. This study sought to evaluate the agreement of low lean mass (LLM) with obesity and its correlation with hyperuricemia. A total of 25,252 study participants, comprising 4,597 individuals with hyperuricemia, were obtained from the National Health and Nutrition Examination Survey spanning the years 1999-2006 and 2011-2018. LLM with obesity was characterized by the coexistence of LLM, determined by the ratio of appendicular lean mass to body mass index (BMI), and three categories of obesity including BMI, body fat percentage (BF%), and waist circumference (WC). We employed Cohen's kappa to evaluate the agreement among the different diagnostic criteria and implemented survey multiple logistic regression and stratified analyses to explicate the connection between LLM with obesity and the risk of hyperuricemia. When defining obesity using BF%, BMI, and WC, the prevalence of LLM with obesity varied from 6.6 to 10.1%, with moderate-to-strong agreement. In the fully adjusted model, individuals with LLM or any of the three types of obesity exhibited notably elevated odds of developing hyperuricemia. Likewise, participants with LLM and obesity had 2.70 (LLM + BMI), 2.44 (LLM + BF%), and 3.12 (LLM + WC) times the risk of hyperuricemia, respectively, compared with healthy individuals. The association between LLM with obesity and hyperuricemia remained stable and significant across different age and sex subgroups. When employing the three definitions of obesity, the incidence of LLM with obesity was not high, and the diagnostic agreement was relatively good. The participants with LLM and obesity exhibited an increased risk of hyperuricemia.

A Study to find the association between Obesity and Osteoporosis according to distinct fat depots - A survey study

Medodhara Kala is the zone of transition between Meda Dhatu (Adipose Tissue) and Asthi Dhatu (Bone Tissue). So, any pathology in Medodhara kala is responsible for deprived Asthi Dhatu (Osteoporosis). Obesity is the condition where there is abnormal built-up of Meda Dhatu (Adipose tissue) altering the osteogenic potential of Adipose tissue. Among the various types of Obesity based on the fat accumulation at different fat depots, abdominal obesity is identified as the risk factor for the lower bone mineral density and resulting fracture. The present study aims to find the prevalence of osteoporosis among various types of obesity like generalised obesity, abdominal obesity, isolated Abdominal Obesity etc. Cross sectional survey was designed in which 100 subjects fulfilling inclusion criteria, willing to participate were enrolled in the study after obtaining informed consent. Participants were divided into two groups i.e. 50 Medoroga (obesity) patients and 50 non-obese volunteers between age group of 20 and 50 irrespective of genders. The collected data comprising Waist Circumference, Waist Hip ratio, BMI classification and other anthropological measurements and T-score was analysed using GraphPad InStat Version 3.6 software. Chi-Square test showed significant association (p&lt;0.05) of osteoporosis or osteopenia in patients of generalised with abdominal obesity and isolated abdominal obesity, indicating that the prevalence of osteoporosis rises with increasing waist circumference. Significant association between visceral fat depot (Abdominal Obesity) with the bone mineral density, suggesting the osteogenic potential of Medodhara Kala which gets minimised with increase BMI (Body mass index).

Portuguese observational cross-sectional clinical imaging study protocol to investigate central dopaminergic mechanisms of successful weight loss through bariatric surgery

IntroductionBariatric surgery (BS) is the treatment of choice for refractory obesity. Although weight loss (WL) reduces the prevalence of obesity-related comorbidities, not all patients maintain it. It has been suggested...

Obésité de type complexe : à la jonction entre obésité développementale et réactionnelle

ContextWhether medical or surgical, the management of obesity faces significant resistance to weight loss. In this context, Bruch's work (1973) on the concepts of developmental and reactive obesity is foundational for clinical practice. However, in the most severe cases of obesity, these concepts can be reductionist and can limit the complexity observed when caring for these patients. These questions are particularly present in hospital services that handle third-level care, especially in Specialized Obesity Centers. ObjectivesUsing a clinical vignette, we will illustrate the utility of the concept of complex obesity and emphasize the therapeutic challenges in the management of patients requiring third-level care, as defined by the Health Authority. MethodIn the context of research on obesity and trauma, we present a clinical vignette of a patient treated in a specialized obesity service. We rely on data collected during clinical research interviews. ResultsThis singular case highlights the challenge regularly faced by clinicians in differentiating developmental and reactive types of obesity. Indeed, listening to the life stories of patients with severe obesity often reveals a construction of this chronic disease through successive layers. Thus, including patients in a single typology would overlook fundamental aspects involved in the onset of their obesity. Faced with this difficulty, we suggest introducing the notion of complex obesity, which would precisely account for situations at the intersection between developmental and reactive obesity. The relevance of developing this third typology becomes clinically meaningful, allowing questioning of the proposed accompaniments, particularly for level 3 interventions. ConclusionThe use of this third typology is now necessary to consider issues of resistance to weight loss and to highlight the complexity of the psychogenic origin of this disease in interdisciplinary exchanges. These reflections also question the relevance of treatments that prioritize urgent weight loss. Thus, we emphasize the importance of focusing on individuals’ intrapsychic functioning of and on promoting long-term historical work. Finally, we propose several perspectives to address the challenges encountered in the transformations of hospital and healthcare institutions in France, and suggest research perspectives to demonstrate the long-term effectiveness of a comprehensive approach to individuals with obesity.

Protective Effect of Pemafibrate Treatment against Diabetic Retinopathy in Spontaneously Diabetic Torii Fatty Rats.

Diabetic retinopathy (DR) can cause visual impairment and blindness, and the increasing global prevalence of diabetes underscores the need for effective therapies to prevent and treat DR. Therefore, this study aimed to evaluate the protective effect of pemafibrate treatment against DR, using a Spontaneously Diabetic Torii (SDT) fatty rat model of obese type 2 diabetes. SDT fatty rats were fed either a diet supplemented with pemafibrate (0.3 mg/kg/day) for 16 weeks, starting at 8 weeks of age (Pf SDT fatty: study group), or normal chow (SDT fatty: controls). Normal chow was provided to Sprague-Dawley (SD) rats (SD: normal controls). Electroretinography (ERG) was performed at 8 and 24 weeks of age to evaluate the retinal neural function. After sacrifice, retinal thickness, number of retinal folds, and choroidal thickness were evaluated, and immunostaining was performed for aquaporin-4 (AQP4). No significant differences were noted in food consumption, body weight, or blood glucose level after pemafibrate administration. Triglyceride levels were reduced, and high-density lipoprotein cholesterol levels were increased. Extension of oscillatory potential (OP)1 and OP3 waves on ERG was suppressed in the Pf SDT fatty group. Retinal thickness at 1,500 microns from the optic disc improved in the Pf SDT fatty group. No significant improvements were noted in choroidal thickness or number of retinal folds. Quantitative analyses showed that AQP4-positive regions in the retinas were significantly larger in the Pf SDT fatty group than in the SDT fatty group. The findings suggest that pemafibrate treatment can exert protective effects against DR.

The relation between plasma apelin 36 and insulin resistance in obese type 2 diabetic Egyptian population

ABSTRACT Background Obesity causes changes in the production of adipose tissue secreted factors, which are responsible for metabolism modulation. One of these factors is Apelin, a small peptide that interacts with a specific cell-surface receptor to modulate various cells signaling processes. Apelin is regarded as a new player because of its powerful role in energy metabolism and improvement of insulin sensitivity. Aim of the Work This study investigates the plasma apelin 36 role and to what extent it can impact the insulin resistance in obese Egyptians diagnosed with type 2 diabetes (T2DM). Subjects and Methods The study involved 90 participants, with 30 assigned to each of the three study involved categories: obese individuals with diabetes, obese individuals without diabetes, and healthy controls (n = 30 for each group). Measurements of skin fold thickness, body mass index (BMI), waist/hip ratio, and body fat % were obtained along with a comprehensive clinical examination and history. The following were investigated: plasma insulin, Hb A1c, lipid profile, plasma apelin (ELISA), plasma leptin (ELISA), and plasma adiponectin (ELISA). Results The median value of serum leptin in obese subjects (groups I and II) was higher significantly than healthy control group (group III) (p = <0.001). A significant decrease in serum adiponectin could be detected in obese subjects (groups I and II) compared to control subjects (Group III) (p = 0.004). When compared to the healthy control group (group III), the mean serum apelin level was significantly higher in the obese participants (groups I and II) and much higher among obese diabetic group (p = <0.001). A statistically significant correlation (p = 0.001) was observed between fasting serum insulin and both HOMA-IR and serum apelin among the non-diabetic obese participants involved in the study. Conclusions Obese people have raised serum apelin levels; those with T2DM have significantly greater serum apelin levels. While it showed a positive correlation with insulin level and HOMA-IR among the obese non-diabetic individuals.