Idiopathic intracranial hypertension (IIH) is characterized by raised intracranial pressure (ICP). It predominantly affects women with obesity and can cause disabling headaches and permanent visual loss. IIH is misdiagnosed in up to 40% of cases. Diagnosis and monitoring often rely on frequent invasive lumbar puncture. This pilot study aimed to identify serum microRNA (miRNA) markers associated with a diagnosis of IIH and disease activity and to assess their relevance in the CNS through identification in CSF. Serum and CSF samples from participants in the IIH-Weight Trial (a randomized controlled trial comparing the effectiveness of bariatric surgery with that of a community weight management intervention in lowering ICP, recruited 2014-2017) were analyzed at baseline (active disease) and 12 months (participants in remission with no papilledema). Eligible participants were adult women with active IIH (those without papilledema were excluded). Disease activity was assessed by quantifying the degree of papilledema using Spectralis spectral-domain optical coherence tomography. A panel of 40 candidate miRNAs was assessed. Comparator groups included participants with obesity or migraine. Analyses used Student t tests and one-way ANOVA followed by Tukey multiple comparisons test. Differentially expressed miRNAs were evaluated in relation to clinical disease activity and metabolic profiles, using linear regression analysis. Five of 40 serum miRNAs showed significantly lower expression in active IIH (n = 9; 100% female, mean 30.25 ± 4.75 years) compared with IIH in remission. Serum hsa-miR-16-5p had the highest diagnostic performance for active IIH (area under the curve 0.951). Serum hsa-miR-16-5p (p < 0.0001; CI -7.286 to -2.503) and hsa-miR-7-5p (p = 0.0032; CI -7.240 to -1.372) were significantly lower in active IIH compared with obesity controls (n = 9; 100% female, mean 38.22 ± 7.99 years). Serum hsa-miR-7a-5p were significantly higher in active IIH compared with migraine (n = 12; 100% female, mean 44.67 ± 8.88 years). Only hsa-miR-16-5p differentiated active IIH from both participants with migraine and obesity. hsa-miR-16-5p also differentiated active IIH from IIH remission in CSF (p = 0.0354; CI -3.062 to -0.1282). Serum and CSF hsa-miR-16-5p correlated significantly with ICP (serum p < 0.0001; CI -0.1660 to -0.0732; CSF p = 0.046; CI 0.0018-0.1841), papilledema (serum p = 0.0236; CI -0.01548 to -0.0001; CSF p = 0.0241; CI 0.002-0.033). hsa-miR-16-5p was associated with metabolites involved in fatty acid metabolism and lipid biosynthesis. Serum hsa-miR-16-5p emerged as a candidate biomarker associated with active IIH. It differentiated active disease from remission, migraine, and obesity. It correlated with clinical and metabolic markers of disease activity. These findings warrant validation in larger studies to assess its potential as a minimally invasive biomarker for IIH diagnosis and monitoring. This study provides Class III evidence that serum microRNA markers may potentially distinguish active idiopathic intracranial hypertension from remission and controls in adult women.

Epicurean eating pleasure may not help weight management: A cross-sectional survey on Japanese-speaking adults.

Obesity and overweight are major contributing factors for type2 diabetes (T2D). Here, we explored the perspectives of people with T2D on the value and expected impacts of reaching a lower weight. Adult residents of Canada with T2D completed a cross-sectional survey informed by qualitative interviews. Survey questions explored weight management experiences, T2D and weight impacts on quality of life, and the value of losing 5%, 10%, or 20% body weight. Results were summarized descriptively. Of 358 participants, 56% were male and 81% were white, with a mean age of 59years (SD 13) and a mean self-reported body mass index of 32.9kg/m2 (SD 7.9); 44% of participants had a current hemoglobin A1C < 7%. T2D negatively affected quality of life, particularly impacting emotional well-being (50%), other illnesses (48%), and sleep (49%). Most participants believed their weight affected their T2D (85%), felt they needed to lose weight (89%), struggled to lose weight (79%), and deemed weight management to be crucial for T2D management (94%). Participants' average "dream" weight loss was a 19% reduction. Most participants anticipated losing 5%, 10%, or 20% body weight would significantly improve their future with T2D (64%, 75%, or 71%) and overall health (79%, 85%, and 90%), and would have a positive impact (70%, 78%, or 71%), particularly on appearance, comorbidities, and emotional well-being. Participants with T2D valued weight loss and anticipated improvements to their health and quality of life with greater perceived value and impacts associated with increased weight reductions.

Osteoarthritis is the most common degenerative joint disease worldwide and one of the leading causes of morbidity and reduced quality of life in older adults. In Germany, approximately 17.9% of adults are affected, including 21.8% of women and 13.9% of men. In individuals over 65years of age, up to 48% of women and 31% of men are affected, with direct annual costs exceeding 12billion euros in 2020. The pathophysiology is multifactorial and is driven by the interplay of cellular senescence, inflammatory cascade reactions, biomechanical factors, and metabolic dysregulation. Modifiable risk factors such as overweight, previous joint injuries, and physical inactivity account for roughly half of all incident cases of knee osteoarthritis. Evidence-based management prioritizes intensive (active) exercise therapy, weight management, and targeted analgesic strategies, with topical NSAIDs as the first-line option. Emerging biological approaches, including mesenchymal stem cell therapy, platelet-rich plasma (PRP), and disease-modifying osteoarthritis drugs (DMOADs), show promising potential but still require further clinical validation.

Weight management remains a significant challenge for patients with class II-III obesity, even after metabolic bariatric surgery (MBS). This study aimed to investigate the association between early, short-term adjunctive semaglutide therapy and postoperative weight-loss outcomes after laparoscopic sleeve gastrectomy (LSG) in patients with class II-III obesity. In this prospective, non-randomized controlled clinical study, patients with class II-III obesity, defined as a body mass index (BMI) ≥ 35kg/m² scheduled for LSG were enrolled. Semaglutide was administered as adjunctive therapy in the treatment group from 1 to 6 months postoperatively, while the control group received LSG alone. The primary outcome was the percentage of total weight loss (%TWL) at 12 months after surgery. The main secondary outcomes included the percentage of excess weight loss (%EWL) at 12 months, the %TWL and %EWL at 6 months, the distributions of %TWL and %EWL, and metabolic parameters. Exploratory analyses were also performed for body composition parameters. A total of 103 participants were included in the study, including 48 in the treatment group and 55 in the control group. At 12 months postoperatively, patients in the treatment group showed significantly greater weight loss than the control group, as reflected by a larger %TWL (-35.14 ± 6.88% vs. -30.73 ± 6.91%, P = 0.002) and a higher %EWL (86.42 ± 19.94% vs. 76.87 ± 22.95%, P = 0.026). Similarly, at 6 months postoperatively, %TWL was significantly greater in the treatment group (-29.74 ± 5.38% vs. -26.32 ± 4.10%, P < 0.001), whereas no significant between-group difference in %EWL was observed at 6 months. In addition, the distributions of %TWL and %EWL were more favorable in the treatment group. These results were generally consistent after propensity score adjustment for baseline confounders, although the between-group difference in %EWL distribution was not significant. Both groups showed comparable improvements in metabolic indicators from baseline. Exploratory analyses further showed a greater increase in lean body mass percentage and a greater reduction in visceral fat area in the treatment group, although these body composition findings should be interpreted cautiously. This non-randomized, single-center study indicates that, among patients with a BMI ≥ 35kg/m2, early adjunctive semaglutide therapy initiated at one month and continued until six months after LSG was associated with greater weight loss at one year postoperatively. These findings provide hypothesis-generating evidence for the potential role of early short-term adjunctive semaglutide therapy after MBS in this population.

BACKGROUND Tirzepatide is a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved for type 2 diabetes and chronic weight management in adults meeting clinical criteria. Appetite suppression and gastrointestinal intolerance can markedly reduce intake. This report describes a 30-year-old woman with tirzepatide-associated euglycemic ketoacidosis after unsupervised use of tirzepatide obtained without a prescription for weight loss, despite having no history of obesity or diabetes. CASE REPORT A 30-year-old woman with a body mass index of 24.8 kg/m² and no known diabetes presented with 4 days of severe nausea, approximately 10 vomiting episodes daily, poor intake, and periumbilical abdominal pain. She had self-administered tirzepatide 2.5 mg once weekly and increased the dose to 5 mg 1 week before presentation. Initial testing showed high anion gap metabolic acidosis with a pH of 7.15, bicarbonate level of 10.5 mEq/L, and an anion gap of 24. Lactate was in the normal range. Urine ketones were positive, serum ketones measured 4.5 mmol/L, and glucose level was 4.2 mmol/L. Acidosis persisted after administration of 1.5 L crystalloid, prompting intensive care unit admission. Tirzepatide was stopped. She received 10% dextrose, lactated Ringer's solution, thiamine, antiemetics, electrolyte monitoring and replacement, and gradual refeeding. The anion gap closed and ketones normalized within 36 hours, without bicarbonate therapy or insulin infusion. CONCLUSIONS Tirzepatide-related nausea, vomiting, and caloric deprivation can be associated with significant euglycemic ketoacidosis even without diabetes or obesity. Clinicians should consider starvation ketoacidosis in tirzepatide users with vomiting, poor intake, abdominal pain, and high anion gap metabolic acidosis.

Semaglutide has previously been approved for weight management and cardiovascular disease as a subcutaneous formulation, and more recently also as an oral formulation. However, there is limited information across oral dose levels, and there are no studies for the 25 mg dose in people with obesity and type 2 diabetes (T2D). To fulfil health authority approval requirements, population pharmacokinetic and exposure-response analyses were used to extrapolate efficacy and safety data from subcutaneous to oral semaglutide. Once-daily oral semaglutide 25 mg was approved for obesity treatment based on historical semaglutide data and the OASIS programme. Two studies were simulated: a modelled/virtual Phase 2 trial to establish efficacy across different oral semaglutide dose levels, and a modelled/virtual Phase 3 trial to assess efficacy in a population with overweight/obesity and T2D. Most participants (82.2%) treated with oral semaglutide 25 mg in OASIS 4 achieved exposure levels within the same range as participants treated with once-weekly subcutaneous semaglutide 2.4 mg in STEP 1. In the simulated studies, oral semaglutide 25 mg provided significantly greater weight reduction compared with placebo, for the trial product estimand and treatment policy estimand, respectively, in those with overweight/obesity and T2D (9.4% and 7.8%), and in those with overweight/obesity without T2D (16.3% and 14.7%). Estimated exposure levels and efficacy observed with oral semaglutide 25 mg were similar to those obtained with subcutaneous semaglutide 2.4 mg, supporting application of oral semaglutide 25 mg to treat individuals with overweight/obesity, with/without T2D.

Tirzepatide, an injectable glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist (RA), is approved for weight management in several regions. Oral GLP-1 RAs, such as semaglutide, are under investigation to improve convenience, acceptance and adherence versus injectable formulations. Currently, no studies have compared the efficacy and safety of tirzepatide with oral semaglutide for weight management. This study aimed to indirectly compare the efficacy and safety of weekly injectable tirzepatide 5, 10 and 15 mg for weight management in obesity and overweight versus daily oral semaglutide 50 mg. Pivotal trials SURMOUNT-1 (tirzepatide, Week 72) and OASIS 1 (oral semaglutide, Week 68) were compared using multilevel network meta-regression (ML-NMR) to adjust for differences in sex, ethnicity and outcome baselines between trial populations. Participants were adults without type 2 diabetes and with obesity (BMI ≥ 30 kg/m2), or overweight (BMI ≥ 27 kg/m2) with ≥ 1 obesity-related complication. Tirzepatide 10 and 15 mg were associated with statistically significantly greater reductions in weight (mean difference: -4.48% [-6.35, -2.61] and -5.59% [-7.52, -3.77]) and waist circumference (-3.60 cm [-5.59, -1.72] and -4.32 cm [-6.30, -2.40]), and higher odds of achieving ≥ 5%/10%/15%/20% weight reduction compared with oral semaglutide. Cardiometabolic benefits and safety profiles were improved or generally comparable for tirzepatide versus oral semaglutide. This ML-NMR provides an indirect comparison of injectable tirzepatide with oral semaglutide for weight management. Tirzepatide was associated with statistically significantly greater weight and waist circumference reduction versus oral semaglutide and improved or similar cardiometabolic benefits and safety.

The rapid expansion of glucagon-like peptide-1 receptor agonist (GLP-1 RA) use for weight management and diabetes has raised perioperative questions, particularly regarding delayed gastric emptying and infection risk. Emerging real-world data suggest a more nuanced perioperative profile. This scoping review synthesizes evidence on preoperative GLP-1 RA exposure and postoperative outcomes across orthopaedic procedures, with emphasis on soft-tissue sports medicine, and is intended to map associative perioperative outcomes rather than establish causality. Following Arksey-O'Malley and Joanna Briggs Institute methodology and PRISMA-ScR reporting, we searched PubMed, Scopus, Web of Science, CINAHL Ultimate, Academic Search Premier, and Ovid Emcare (2015 to 2025). Eligible studies evaluated adult orthopaedic patients with documented GLP-1 RA use and postoperative outcomes. Three reviewers independently screened and extracted study characteristics, exposure timing, perioperative management, and outcomes. Of 117 records screened, 35 studies met inclusion. Most were large retrospective cohorts spanning arthroplasty, spine fusion, trauma fixation, foot/ankle fusion, shoulder arthroplasty, and rotator cuff repair. Across hip, knee, and shoulder arthroplasty, GLP-1 RA use was generally associated with similar or lower 90-day complications, reduced periprosthetic joint infection, shorter length of stay, and fewer readmissions or revisions. Spine findings were mixed: Several cohorts showed lower infection and readmission, while others noted increased pneumonia, acute kidney injury, or pseudarthrosis in long-term semaglutide users. Trauma and ankle fracture cohorts showed no increase in short-term complications and in some cases lower mortality, with isolated signals for increased late fall-related injuries. Soft-tissue cohorts (rotator cuff repair and distal radius fixation) demonstrated fewer adverse events without increased aspiration or revision surgery risk. Functional outcomes (PROMIS) were rarely reported. Preoperative GLP-1 RA exposure is not broadly associated with increased postoperative risk and often correlates with lower infection, readmission, and mortality rates-particularly in arthroplasty, spine, and ankle fracture fixation cohorts. Findings in spine surgery are more mixed and warrant cautious interpretation, especially with prolonged semaglutide exposure. Outcomes in sports-medicine procedures seem reassuring, although prospective multicenter studies with standardized perioperative protocols and PROMIS-based outcomes are needed.

Unsaturated fatty acids mediate the bidirectional link between psoriasis and depression: Evidence from observational and mendelian randomization studies.

Postpartum urinary incontinence is an important but underreported maternal health issue, with limited available evidence from Ethiopia, particularly in Northwest Ethiopia. This study aimed to determine the magnitude and its associated factors among women attending the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. An institution‑based cross‑sectional study was conducted among 423 postpartum women selected via systematic random sampling from January 1 to April 30, 2025. Data were collected by interviewer‑administered questionnaires and analyzed using STATA 17. Variables with p ≤ 0.25 in bivariable analysis were entered into multivariable logistic regression. Statistical significance was declared at p < 0.05, and adjusted odds ratios with 95% confidence intervals were reported. A total of 421 women participated (99.50% response rate). The magnitude of postpartum urinary incontinence was 28.00% (95% CI: 24.15%, 32.77%). Thus, parity two or more (AOR = 11.23; 95% CI: 7.32, 15.23), body mass index ≥ 25kg/m² (AOR = 2.87; 95% CI: 1.06, 7.44), history of abortion (AOR = 7.61; 95% CI: = 4.43, 12.21), episiotomy (AOR = 4.27; 95% CI: 1.15, 10.85), and constipation (AOR = 2.09; 95% CI: 1.14, 9.45) were significantly associated with urinary incontinence. Urinary incontinence was common among postpartum women in the study area. Findings may contribute to the need for weight management counseling, prevention and management of constipation, and focused counseling for women with identified obstetric risk factors such as multiparty, episiotomy, and history of abortion for women with obstetric risk factors such as multiparty, episiotomy, and prior abortion during postpartum care. Not applicable.

Weight loss and cardiovascular outcomes with incretin-based therapies after metabolic and bariatric surgery: a nationwide US cohort study.

Rapid weight loss (RWL) is widely practiced in combat sports, yet comparative data across sports and sexes are limited. This study aimed to compare RWL patterns, methods, and associated physical and psychological difficulties by sport and sex among elite Korean combat sports athletes. A cross-sectional analysis was conducted in 414 elite athletes from taekwondo, judo, wrestling, and boxing. Body mass was recorded before RWL, at the official weigh-in, and prior to competition. RWL practices, sources of information, and physical and psychological difficulties were assessed using validated questionnaires. One-way analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) were performed separately for male and female athletes. Athletes engaged in RWL for an average of 6.53 days, losing 5.49% of body mass and regaining approximately 95% before competition. RWL duration did not differ by sport or sex. However, significant sport-specific differences were observed in absolute and relative weight loss and weight regain, with judo and wrestling athletes showing greater weight loss and wrestlers exhibiting the highest regain. No significant differences were found among sports in RWL methods, sources of information, or reported physical and psychological difficulties. Athletes predominantly relied on coaches and peers and commonly reported fatigue, dizziness, irritability, and impaired concentration. While RWL duration is similar across sports and sexes, the magnitude of weight loss and regain varies according to sport-specific regulations. Despite these differences, RWL methods and associated difficulties are consistent, emphasizing the need for evidence-based weight management and greater involvement of health professionals.

Post-cessation Weight Regain After Weight Management Medications: A Systematic Review and Meta-Analysis

Changes in Body Composition and Metabolic Parameters after a Combined Korean Medicine Weight Management Program Including Soeumin Prescriptions: A Multicenter Retrospective Observational Study

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder among women of reproductive age with significant metabolic impairments. Time-restricted eating (TRE) has emerged as a promising dietary strategy for improving metabolic health. Although both early time-restricted eating (eTRE) and mid-day time-restricted eating (mTRE) have shown beneficial metabolic effects, their comparative efficacy in women with PCOS remains unclear. This study aimed to directly compare the effects of eTRE and mTRE on glycemic control, lipid profiles, and anthropometric outcomes in women with PCOS. In this 6-week randomized controlled trial, 75 women with PCOS were allocated to one of three groups: eTRE (8:00 AM-6:00 PM), mTRE (11:00 AM-9:00 PM), or a control group with ad libitum eating. The primary outcome was fasting insulin level. Secondary outcomes included FBS, insulin resistance indices, lipid profile (total cholesterol (TC), LDL-C, HDL-C, and TG), body weight, BMI, waist circumference (WC), and dietary intake. Metabolic and anthropometric variables were assessed at baseline and post-intervention, while dietary intake was evaluated at baseline, mid-intervention, and study completion. Both eTRE and mTRE significantly reduced FBS, fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), body weight, and WC compared with the control group (P < 0.05). Additionally, eTRE significantly improved TC (P < 0.001) and LDL-C levels (P = 0.01), whereas similar changes were not observed in the mTRE group. TRE, particularly eTRE, appears to be an effective dietary intervention for women with PCOS, offering significant benefits for glycemic control, metabolic health, and weight management. IRCT20221122056575N1.

To investigate knee biomechanical characteristics and kinesiophobia levels across different body mass index (BMI) categories in patients following tibial plateau fracture surgery, and to examine the mediating role of kinesiophobia in the relationship between BMI and knee biomechanical outcomes. A cross-sectional controlled study was conducted. Sixty postoperative tibial plateau fracture patients were stratified into Group A (obese, BMI ≥ 28kg/m2), Group B (overweight, BMI 24.0-27.9kg/m2), and Group C (normal weight, BMI 18.5-23.9kg/m2), with 20 patients per group, alongside 20 healthy controls (Group D). Kinesiophobia and knee function were assessed using the Tampa Scale for Kinesiophobia-17 (TSK-17) and the Lysholm Knee Scoring Scale, respectively. A three-dimensional motion capture system synchronized with a force platform was used to collect spatiotemporal gait parameters and knee kinematic and kinetic data. Between- and within-group bilateral limb differences were analyzed, and correlation analysis, multiple linear regression, and bootstrap mediation analysis were performed to examine the mediating effect of kinesiophobia. Between-group comparisons revealed that Lysholm scores progressively decreased (Group A: 73.80 ± 4.74; Group B: 77.95 ± 2.86; Group C: 81.65 ± 3.63), whereas TSK-17 scores progressively increased (Group A: 57.00 ± 3.88; Group B: 51.40 ± 3.44; Group C: 46.70 ± 4.66) with increasing BMI (P < 0.01). On the affected side, cadence (Group A: 60.90 ± 12.56; Group D: 105.90 ± 4.61 steps/min), gait velocity (Group A: 0.58 ± 0.19; Group D: 1.08 ± 0.06m/s), and sagittal plane range of motion (Group A: 47.46° ± 9.46°; Group D: 67.23° ± 2.82°) progressively decreased, whereas sagittal plane moments progressively increased (Group A: 680.35 ± 130.98; Group D: 225.13 ± 85.78 N·m) across BMI groups (P < 0.01). Within-group comparisons demonstrated that sagittal plane range of motion on the affected side was significantly smaller than that on the unaffected side, and that joint moments were significantly greater on the affected side across all three patient groups (P < 0.05); however, no significant bilateral differences were observed in the control group. Mediation analysis indicated that kinesiophobia partially mediated the relationship between BMI and gait velocity on the unaffected side (indirect effect = - 0.01; 95% CI [- 0.03, - 0.00]) as well as between BMI and sagittal plane moments on the affected side (indirect effect = 7.45; 95% CI [0.43, 18.56]), with mediation proportions of 48.4% and 27.5%, respectively. Patients with postoperative tibial plateau fractures and higher BMI exhibited significantly worse knee function, greater kinesiophobia, and compromised biomechanical characteristics, including slower gait, reduced sagittal plane range of motion, and elevated knee joint moments. Kinesiophobia partially mediated the adverse effects of elevated BMI on gait velocity and sagittal plane moments. Clinical rehabilitation programs should incorporate BMI-stratified individualized interventions integrating weight management with targeted psychological support to reduce kinesiophobia. Chinese Clinical Trial Registry ChiCTR2500101020. Registered on 18/04/2025.

Obesity is a significant public health issue that has been increasingly linked to various musculoskeletal disorders, including intervertebral disk degeneration (IVDD). The interplay between metabolic dysfunction, chronic inflammation, and biomechanical stress suggests a multifactorial link between obesity and IVDD, warranting further investigation. This review aims to explore the pathophysiological mechanisms through which obesity contributes to IVDD and discuss this relationship's clinical implications. Obesity induces an occurrence of minor chronic inflammation and metabolic abnormalities, which can exacerbate degenerative changes in the intervertebral disks. Pro-inflammatory cytokines (TNF-α and IL-6) secreted by visceral adipose tissue can promote disk degeneration by enhancing catabolic processes and inhibiting anabolic repair mechanisms within the disk matrix. Additionally, mechanical loading due to excess body weight increases stress on the spinal structures, accelerating wear and tear of the intervertebral disks. This review summarizes current research findings on the biochemical and biomechanical pathways linking obesity to IVDD. We examine evidence from epidemiological studies, clinical trials, and animal models that highlight the multifaceted impact of obesity on spinal health. Furthermore, we discuss the implications of these findings for clinical practice, emphasizing the importance of weight management in preventing and treating IVDD. Interventions such as lifestyle modifications, dietary changes, and bariatric surgery are evaluated for their effectiveness in mitigating the adverse effects of obesity on the spine. The review also addresses the potential for targeted pharmacological therapies that modulate inflammatory pathways and mechanical stress responses. Understanding the association between obesity and IVDD is crucial when establishing all-encompassing management approaches for those who are impacted by the growing global prevalence of obesity. By elucidating the pathophysiological underpinnings and clinical consequences of obesity-induced IVDD, this review aims to inform future research directions and clinical guidelines, ultimately improving patient outcomes in this growing population.

Obesity plays a central role in the pathomechanism of obstructive sleep apnea and is strongly associated with the severity of sleep-disordered breathing. Weight reduction in obese patients has been shown to decrease the apnea-hypopnea index (AHI), improve sleep architecture, and reduce cardiometabolic risk. However, traditional, specialty-specific models of care do not address sleep and metabolic disorders in an integrated manner, and weight management often receives less emphasis in obstructive sleep apnea care compared with positive airway pressure (PAP) therapy. Incretin-based therapies - particularly glucagon-like peptide-1 (GLP1) receptor agonists and dual GLP1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists - have demonstrated promising results in the treatment of obesity, thereby generating growing interest in their potential role in obstructive sleep apnea management. Based on an analysis of randomized clinical trials, our review indicates that GLP1/GIP receptor agonist therapy not only promotes weight loss but also alleviates sleep-disordered breathing in obstructive sleep apnea, as reflected by reductions in AHI. An additional benefit of weight loss is the concurrent reduction in cardiometabolic risk among obese patients, alongside the improvement in obstructive sleep apnea severity. Collectively, the combined application of GLP1/GIP receptor agonist pharmacotherapy and PAP therapy may represent a novel, comprehensive, and effective therapeutic approach for the management of obstructive sleep apnea. As the management of obesity requires consideration of multiple somatic, psychological, and lifestyle-related factors, the success of a multidisciplinary sleep-metabolic program depends on the coordinated involvement of relevant specialists (pulmonologists, internists, dietitians, psychologists, and physiotherapists) with clearly defined roles and responsibilities. Further studies are needed to evaluate the effectiveness of integrated sleep-metabolic programs and to determine their potential clinical benefits. Orv Hetill. 2026; 167(26): 1011-1017.

Hypertension is a frequent comorbidity among people living with HIV (PLHIV) in sub-Saharan Africa, but analytical data from routine HIV clinics in Cameroon remain limited. This study assessed factors associated with prevalent hypertension among adults receiving antiretroviral therapy (ART) at an urban HIV clinic in Yaounde, Cameroon. We conducted a cross-sectional study at the Day Hospital of Yaounde Central Hospital between January and March 2024. The analytical dataset included 460 adults living with HIV receiving ART. Prevalent hypertension was coded as a binary outcome. Robust Poisson regression was used to estimate prevalence ratios (PRs) and adjusted prevalence ratios (aPRs) because hypertension was common. Sensitivity models were fitted to clarify the interpretation of cumulative ART duration in relation to current age. Among 460 participants, 199 (43.3%) had prevalent hypertension. The mean age was 50.5 ± 10.9 years, and 338 (73.5%) participants were women. In bivariable analysis, older age (PR per 1-year increase 1.02, 95% CI 1.01-1.03; p < 0.001), longer ART duration (PR per 1-year increase 1.03, 95% CI 1.01-1.05; p < 0.001), family history of hypertension (PR 2.98, 95% CI 2.40-3.71; p < 0.001), HIV stage II at ART initiation (PR 1.29, 95% CI 1.03-1.60; p = 0.024), and obesity (PR 1.43, 95% CI 1.10-1.87; p = 0.007) were associated with hypertension. In the final multivariable model, older age (aPR 1.02, 95% CI 1.01-1.03; p = 0.002), family history of hypertension (aPR 2.83, 95% CI 2.25-3.57; p < 0.001), and obesity (aPR 1.29, 95% CI 1.01-1.65; p = 0.045) remained independently associated with prevalent hypertension, whereas cumulative ART duration was not independently associated after adjustment (aPR 1.00, 95% CI 0.99-1.02; p = 0.619). Restricted cubic spline analysis did not show evidence of an overall association or non-linearity for ART duration. In this urban HIV clinic, hypertension was frequent and was associated mainly with age, family history of hypertension, and obesity in the adjusted model. Cumulative ART duration was associated with hypertension in crude or minimally adjusted models but not after adjustment for age and cardiometabolic factors. These findings support integrating routine blood-pressure screening, weight management, lifestyle counselling, and standardized hypertension care into HIV services.