Weight Reduction Research Articles

Effect of Replacing Sucrose in Beverages with Nonnutritive Sweetener Sucralose on Cardiometabolic Risk Factors Among Asian Indian Adults with Type2 Diabetes: A 12-Week Randomized Controlled Trial.

Country-specific evidence-based research is crucial for understanding the role of nonnutritive sweeteners (NNS) in managing type2 diabetes (T2D). The main aim of this study was to explore the effect of replacing sucrose with sucralose in coffee/tea in Asian Indians with type2 diabetes (T2D). This 12-week, parallel-arm randomized controlled trial included 210 participants with T2D, assigned to the intervention group, where sugar/sucrose in coffee or tea was substituted with sucralose, or the control group, where sugar/sucrose was continued. Lifestyle factors remained unchanged. The primary outcome was change in HbA1c. Secondary outcomes were changes in body weight (BW), body mass index (BMI), waist circumference (WC), lipid profiles, and inflammatory markers. At the end of 12weeks, no change was observed in HbA1c, fasting plasma glucose, lipid profile, and inflammatory markers between or within groups. There was a small but significant reduction in BW (- 0.5kg [95%CI - 1.0, - 0.1]; p = 0.02), BMI (- 0.2kg/m2 [- 0.4, 0.0]; p = 0.03), and WC (- 0.8cm [- 1.4, - 0.3]; p = 0.002) in the intervention group. Improvements were also observed in lipid accumulation product (p = 0.01), visceral adiposity index (p = 0.04), triglyceride/glucose index (p = 0.04), total energy intake (p = 0.04), and carbohydrate intake (p < 0.0001). In Asian Indians with T2D, replacing about 60kcal of added sucrose with sucralose in coffee/ tea had no benefit on glycemia but resulted in a small reduction in body weight, body mass index, and waist circumference. Clinical Trials Registry of India (CTRI/2021/04/032686).

Rational use of short-term anorectic drugs for one-year effective treatment of obesity: An analysis of four studies.

Obesity is a complex disease for which pharmacotherapy is often used. Anti-obesity drugs (AODs) are characterized by inducing a variable inter-subject body weight reduction (BWR), the attainment of a plateau after their maximal effect is achieved, and weight regain after drug discontinuation, which complicate individualized treatment of obesity. This exploratory analysis aimed to compare the first-month body weight reduction in kg (1mo-BWRkg) and tolerance development (moT) of four known interventions with low (placebo), intermediate (phentermine or mazindol monotherapy), and high (5 active ingredients fixed-dose combination) efficacy, as predictors of their 6-month body weight reduction efficacy in percent (6mo-BWR%). In addition, a detailed analysis of the 6-to-12-month BWR follow-up in subjects under orlistat or diet and exercise regimens was performed. The analysis included 662 adult subjects with obesity. After the construction of average efficacy and weight rebound curves, subjects were grouped into various 1mo-BWRkg, moT, and 6mo-BWR% intervals, or 6-month body weight rebound parameters for further evaluation. The 6mo-BWR% efficacy level of interventions was confirmed, although a general high intersubject variation was observed. 1mo-BWRkg + moT was found as an acceptable predictor of 6mo-BWR%. Between 50 and 80% of the 6-to-12-month follow-up completers maintained at least 5% BWR%. Short-term AODs are useful adjuvants for the 1-year rational treatment of obesity. 1mo-BWRkg + moT is an acceptable parameter to predict the 6mo-BWR% efficacy of these interventions.

Assessment of maternal phthalate exposure in urine across three trimesters and at delivery (umbilical cord blood and placenta) and its influence on birth anthropometric measures

Phthalates, commonly used in plastic manufacturing, have been linked to adverse reproductive effects. Our research from the Saudi Early Autism and Environment Study (2019–2022), involving 671 participants, focused on the impacts of maternal phthalate exposure on birth anthropometric measures. We measured urinary phthalate metabolites in 390 maternal samples collected during each of the three trimesters of pregnancy and in cord serum and placental samples obtained at delivery. We employed various statistical methods to analyze our data. Intraclass correlation coefficients were used to assess the consistency of phthalate measurements, generalized estimating equations were used to explore temporal variations across the trimesters, and linear regression models, adjusted for significant confounders and Bonferroni correction, were used for each birth outcome. Exposure to six phthalates was consistently high across trimesters, with 82 %–100 % of samples containing significant levels of all metabolites, except for mono-benzyl phthalate. We found a 3.15 %–3.73 % reduction in birth weight (BWT), 1.39 %–1.69 % reduction in head circumference (HC), and 3.63 %–5.45 % reduction in placental weight (PWT) associated with a one-unit increase in certain urinary di(2-ethylhexyl) phthalate (DEHP) metabolites during the first trimester. In the second trimester, exposure to MEP, ∑7PAE, and ∑LMW correlated with a 3.15 %–4.5 % increase in the APGAR 5-min score and increases in PWT by 8.98 % for ∑7PAE and 9.09 % for ∑LMW. Our study also highlighted the maternal-to-fetal transfer of DEHP metabolites, indicating diverse impacts on birth outcomes and potential effects on developmental processes. Our study further confirmed the transfer of DEHP metabolites from mothers to fetuses, evidenced by variable rates in the placenta and cord serum, with an inverse relationship suggesting a passive transfer mechanism. Additionally, we observed distinct phthalate profiles across these matrices, adversely impacting birth outcomes. In serum, we noticed increases associated with DEHP metabolites, with birth gestational age rising by 1.01 % to 1.11 %, HC by 2.84 % to 3.67 %, and APGAR 5-min scores by 3.77 % to 3.87 %. Conversely, placental analysis revealed a different impact: BWT decreased by 3.54 % to 4.69 %, HC reductions ranged from 2.57 % to 4.69 %, and chest circumference decreased by 7.13 %. However, the cephalization index increased by 3.67 %–5.87 %. These results highlight the complex effects of phthalates on fetal development, indicating their potential influence on crucial developmental processes like sexual maturation and brain development.

Glucagon-like peptide-1 receptor agonists in adolescents with overweight or obesity with or without type 2 diabetes multimorbidity-a systematic review and network meta-analysis.

To synthesize the evidence on the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in adolescents with overweight or obesity. For this systematic review and network meta-analysis, we searched five databases and registries until 2 March 2024 for eligible randomized controlled trials (RCTs). The primary outcome was weight change. We did a pairwise meta-analysis to compare GLP-1RAs and placebo, followed by a drug-wise network meta-analysis (NMA) to compare GLP-1RAs against each other. We screened 770 records to include 12 RCTs with 883 participants. The evidence suggests that GLP-1RAs reduced weight (mean difference -4.21 kg, 95% confidence interval [CI] -7.08 to -1.35) and body mass index (BMI; mean difference -2.11 kg/m2, 95% CI -3.60 to -0.62). The evidence on waist circumference, body fat percentage and adverse events (AEs) was very uncertain. The results remained consistent with subgroup analyses for coexisting type 2 diabetes. Longer therapy duration led to a greater reduction in weight and BMI. In the NMA, semaglutide led to the greatest weight reduction, followed by exenatide, liraglutide and lixisenatide. The evidence suggests that GLP-1RAs reduce most weight-related outcomes in adolescents, with semaglutide being the most efficacious. There is uncertain evidence on body fat and serious AEs, probably due to fewer studies and low incidence, respectively. Larger RCTs with head-to-head comparisons, pragmatic design, adiposity-related outcomes, and economic evaluation can further guide the use and choice of GLP-1RAs.

Duodeno-ileal diversion with self-forming magnets in a sutureless neodymium anastomosis procedure (SNAP) for weight recidivism after sleeve gastrectomy: feasibility and 9-month results.

The sleeve gastrectomy (SG) has become the most common bariatric procedure worldwide. However, insufficient weight loss or weight recidivism is frequent, which may require effective and safe revisional procedures. To determine the technical feasibility and safety of a minimally invasive, duodeno-ileal side-to-side anastomosis using a Sutureless Neodymium Anastomosis Procedure (SNAP) for patients with weight recidivism or inadequate weight loss following SG. This is a prospective, single-arm, open-label pilot study that enrolled patients with obesity to assist in weight reduction following an SG performed > 12months prior. For the SNAP, self-assembling magnets were deployed into the ileum (laparoscopically) and duodenum (per-oral endoscopy). Magnets were coupled under laparoscopic and fluoroscopic guidance to create a compression anastomosis. The primary endpoints were technical feasibility, weight loss, and rate of serious adverse events (SAEs). Successful duodeno-ileal diversions were created with SNAP in 27 participants (mean age: 50.6 ± 9.1, mean BMI: 38.1 ± 4.6kg/m2) with no device-related serious adverse events. Upper endoscopy at 3months confirmed patent, healthy anastomoses in all patients. At 9months, patients (n = 24) experienced 11.9 ± 6.2%, 14.5 ± 10.8%, and 17.0 ± 13.9% TBWL at 3, 6, and 9months, respectively. There were no device-related SAEs. The SNAP is technically feasible and relatively safe, with all patients presenting widely patent anastomosis at 3months. Patients experienced a progressive, clinically meaningful weight loss. Further studies are needed to confirm our findings.

Long-term cost-effectiveness analysis of rugby fans in training–New Zealand: a body weight reduction programme for males

ObjectivesWe sought to extrapolate the long-term costs and clinical impacts attributed to the rugby fans in training–New Zealand (RUFIT-NZ) trial in Aotearoa, New Zealand.DesignA modelled cost-effectiveness analysis using efficacy data...

Clinical Efficacy and Safety of Anti-Obesity Medications Among Adult East Asian People with Obesity: A Systematic Literature Review and Indirect Treatment Comparison.

The prevalence of obesity has increased worldwide over the past decades. Regional variations exist in the relationship between body mass index (BMI), body fat, and health risks: Asians typically have a lower BMI than people of European descent, but a higher risk of obesity-related comorbidities. However, there is a paucity of evidence for anti-obesity medications (AOMs) in East Asian populations. In this study, we aimed to systematically review evidence regarding the safety and efficacy of AOMs among adults with obesity disease in East Asia, and to assess the feasibility of conducting an indirect treatment comparison (ITC) between the semaglutide and mazindol trials. The Embase, MEDLINE, and ICHUSHI databases were searched via the Ovid SP platform for randomized controlled trials, in English or Japanese, reporting data on semaglutide or mazindol therapy with placebo or diet and exercise as comparators. The potential risks of bias in conducting a population-adjusted ITC were determined based on the heterogeneity of potential effect modifiers and variations in study design. Of 21 publications, 2 were included in this study based on the eligibility criteria. The STEP 6 study established the clinical efficacy of subcutaneous semaglutide compared with placebo in the reduction of body weight and cardiometabolic risk factors [glycated hemoglobin (HbA1c), total cholesterol, and systolic blood pressure] among Japanese and South Korean people with obesity disease. Mazindol also proved beneficial in reducing body weight and total cholesterol compared with placebo in Japan. Both semaglutide and mazindol were associated with higher rates of adverse events and treatment discontinuation than placebo. An ITC between the two studies was not deemed feasible based on the potential risks of bias. Semaglutide and mazindol are associated with significant body weight reduction among people with obesity in East Asia. Further research based on label indications and up-to-date real-world data among East Asian people with obesity would help determine additional clinical benefits.

Design of Inner Ribs with Unequal Stiffness for Deep-Sea Highly Pressure-Resistant Cylindrical Shells and Utilizing NSGA-2 for Lightweight Optimization

For conducting scientific research at depths in the ocean, deep-sea probes are essential pieces of equipment. The cylindrical shell is the most sensible and rational packaging structure for these detectors. New technical challenges for enhancing the pressure resistance and lightweight design of the pressure-resistant cylindrical shell arise from the need to ensure that the detector packaging structure can withstand the immense water pressure at tens of thousands of meters in the underwater environment, while simultaneously reducing the detector packaging structure’s self-weight. This article examines the detection system’s deep-sea pressure-resistant cylindrical shell. To address the issue of the pressure-resistant shell’s insufficient ability to counteract the overall instability caused by the inability to form unstable half-waves in the radial direction when the ring rib pressure-resistant shell experiences it, a design method for the ribs inside the unequal-stiffness pressure-resistant cylindrical shell is suggested. The shell’s instability pressure increases by 9.65 MPa following the stiffness adjustment. Simultaneously, in order to attain even more lightweight optimization, the optimal inner rib section was obtained by applying the orthogonal topology optimization method, which also reduced the weight by 106.8 g and effectively improved the compression stability of the high-pressure cylindrical shell structure. Based on this, key optimization variables were found by performing sensitivity analysis on the cylindrical shell structure’s parameters. Then, with lightweighting as the primary objective, the high-pressure-resistant cylindrical shell’s optimal structural parameters were found using a multi-objective optimization process using the second-generation fast non-dominated genetic algorithm (NSGA-2). This resulted in a weight reduction of 1.2492 kg, or 17.26% of the original pressure-resistant shell. This has led to the development of a lightweight, highly pressure-resistant method for packaging marine exploration equipment structures.

Mechanical performance simulation and optimal design of carbon fiber composite B-pillar

This study primarily concentrates on the layer optimization and structural refinement of carbon fiber composite B-pillars. In the initial phase, an initial layer configuration for the carbon fiber composite material B-pillar was devised, followed by comprehensive finite element numerical simulations. The weight of the B-pillar was effectively diminished by 44.9% compared to its metal counterpart, while maintaining consistent performance across diverse operational conditions. Subsequently, an advanced layer thickness optimization model was formulated, incorporating the innovative ‘super layer’ concept. Integration of simulation software, such as ISIGHT and ABAQUS, facilitated the determination of optimal layer thickness and ratio for the composite material. The layer order was systematically optimized through the application of a discrete particle swarm optimization algorithm based on exchange order, adeptly addressing issues related to discontinuous design variables and potential combinations. The incorporation of a ply drop-off structure laying scheme was derived, resulting in an impressive weight reduction of 57.5%. In the final phase, adherence to NCAP side collision testing standards enabled a comprehensive evaluation, where in various indicators including deformation mode, intrusion amount, and intrusion speed were employed. The results substantiate that the composite B-pillar exhibits equivalent side impact resistance to the original metal B-pillar, ensuring robust passenger protection.

Maternal AMPK pathway activation with uterine artery blood flow and fetal growth maintenance during hypoxia.

High altitude (HA) hypoxia lowers uterine artery (UtA) blood flow during pregnancy and birth weight. Adenosine monophosphate kinase (AMPK) activation has selective, uteroplacental vasodilator effects which lessen hypoxia-associated birth weight reductions. In this study, we determined the relationship between AMPK-pathway gene expression and metabolites in the maternal circulation during HA pregnancy as well as with the maintenance of UtA blood flow and birth weight at HA. HA (2793 m) vs low altitude (LA; 1640 m) residents had smaller UtA diameters at weeks 20 and 34, lower UtA blood flow at week 20, and lower birth weight babies. At week 34, HA vs LA women had decreased expression of up- and down-stream AMPK-pathway genes. Expression of the a-1 AMPK catalytic subunit, PRKAA1, correlated positively with UtA diameter and blood flow at week 20 (HA) and 34 (LA). Downstream AMPK-pathway gene expression positively correlated with week 20 fetal biometry at both altitudes and with UtA diameter and birth weight at LA. Reduced gene expression of AMPK activators and downstream targets in HA versus LA women, together with positive correlations between PRKAA1 gene expression, UtA diameter, and blood flow suggest that greater sensitivity to AMPK activation at mid-gestation at HA may help offset later depressant effects of hypoxia on fetal growth.

Recognition of overweight and obesity by patients and medical practitioners and their practices related to weight reduction; a cross-sectional study

Introduction: Accurate perception of weight by overweight/obese patients and the acknowledgment of their excess weight by medical practitioners are pivotal in managing obesity. This study aims to assess knowledge, perception and practices related to weight reduction among overweight/obese patients and the recognition of their overweight status and interventions by medical practitioners.Methods: This descriptive cross-sectional study interviewed 317 overweight/ obese patients during their first visits to general medical clinics at the University Hospital of Kotelawala Defence University. A structured questionnaire assessed their demographic characteristics, comorbidity, knowledge, perception and practices related to weight reduction. Recognition and management of overweight/ obesity by medical practitioners were evaluated through recall of previous six-month consultations and review of medical records.Results: Among the study participants, 163 (51.4%) were obese and 154 (48.6%) were overweight. Only 63 (19.9%) patients knew the meaning of BMI, and 306 (96.5%) could not define the ideal BMI for a Sri Lankan adult. Less than half (45.4%) considered overweight/obesity a medical problem. Body weight misperception observed among 92 (59.7%) overweight and 150 (92.0%) obese participants. Of the 267 participants who reported being evaluated by another medical practitioner in the previous six months, 102 (38.2%) were told the diagnosis of overweight/obesity. However, weight status was documented only in seven (2.6%) patient records. Nonetheless, 110 (41.2%) patients had received weight reduction advice during previous consultations, and 68 (61.8%) had attempted to lose weight.Conclusions: Low comprehension of the term BMI and misperception of body weight among the studied population is concerning. Patients who received weight reduction advice from medical practitioners were more inclined to lose weight. However, acknowledgment and intervention of the excess weight status of overweight /obese patients by medical practitioners were largely inadequate.

Potassium silica nanostructure improved growth and nutrient uptake of sorghum plants subjected to drought stress

IntroductionRecent advancements in nanotechnology present promising opportunities for enhancing crop resilience in adverse environmental conditions.MethodsIn this study, we conducted a factorial experiment to investigate the influence of potassium nanosilicate (PNS) on sorghum plants exposed to varying degrees of drought stress A randomized complete block design with three replications was employed to subject the sorghum plants to different drought conditions. The three levels of stress were designated as non-stress (NS at -0.03 MPa), moderate stress (MD at -0.6 MPa), and severe stress (SD at -1.2 MPa). The plants were administered PNS at concentrations of 0 mM (control), 3.6 mM Si, and 7.2 mM Si.Results and discussionAs drought stress intensified, we observed significant reductions in multiple plant parameters, including height, fresh weight, dry weight, leaf number, stem diameter, cluster length, seed weight, and nutrient uptake, with the most pronounced effects observed under SD conditions. Interestingly, nitrogen (N) and potassium (K) levels exhibited an increase under drought stress and PNS application, peaking at MD, alongside Si concentrations. Notably, PNS application facilitated enhanced nutrient uptake, particularly evident in the significant increase in nitrogen concentration observed at 3.6 mM PNS. Furthermore, the application of PNS significantly enhanced the fresh weight and nutrient concentrations (notably K and Si) in sorghum seeds under drought stress, despite varying statistical significance for other nutrients. These findings shed light on the mechanisms through which PNS exerts beneficial effects on plant performance under drought stress. By elucidating the complex interactions between PNS application, drought stress, and plant physiology, this study contributes significantly to the development of sustainable agricultural practices aimed at bolstering crop resilience and productivity in water-limited environments.

Comprehensive analysis on investigating water-saving potentials of irrigated cotton in semi-arid area in China

Deficit irrigation is a common strategy to reduce water use and improve the sustainability of cotton production. However, the effects of water deficits on crop productivity and quality are subject to genotype by management by environmental interactions. This study investigated effects of water deficits and frequency of irrigation on cotton performance grown in semi-arid region, Xinjiang, the main cotton-growing area in China. Two field trials (2020 and 2021) with split experimental design, including main factors of three irrigation levels (moderate-deficit, mild-deficit and full-irrigation) and split factors of three irrigation frequencies (4, 8 and 12 days) were conducted. Results from two trials both showed little negative influence of irrigation levels on yield, and higher irrigation frequency improved yield under same irrigation level. Significant effects of irrigation levels on yield components were found in 2021, with a 22 % increase in boll number and an 18 % reduction in boll weight under moderate-deficit irrigation compared with those under full-irrigation. Interactions between irrigation levels and frequencies significantly affected harvest index (HI), showing that reduced irrigation might be beneficial for improving HI. However, decreased fibre length while increased fibre micronaire were found under deficit irrigation. A strong association between radiation use efficiency (RUE) and boll growth rate was observed, suggesting that RUE might be the driving force of yield formation. A tight correlation between both biomass and transpiration efficiency versus delta temperature between air and canopy (ΔTair-canopy) was observed, suggesting ΔTair-canopy could be used as an efficient tool to assess plant production under deficit irrigation. This study provided an improved understanding of the physiological basis of cotton yield formation and further identified a high-throughput and instantaneous method to monitor effects of deficit irrigation on crop productivity.

Weighing in on the role of brown adipose tissue for treatment of obesity

Brown adipose tissue (BAT) activation is an emerging target for obesity treatments due to its thermogenic properties stemming from its ability to shuttle energy through uncoupling protein 1 (Ucp1). Recent rodent studies show how BAT and white adipose tissue (WAT) activity can be modulated to increase the expression of thermogenic proteins. Consequently, these alterations enable organisms to endure cold-temperatures and elevate energy expenditure, thereby promoting weight loss. In humans, BAT is less abundant in obese subjects and impacts of thermogenesis are less pronounced, bringing into question whether energy expending properties of BAT seen in rodents can be translated to human models. Our review will discuss pharmacological, hormonal, bioactive, sex-specific and environmental activators and inhibitors of BAT to determine the potential for BAT to act as a therapeutic strategy. We aim to address the feasibility of utilizing BAT modulators for weight reduction in obese individuals, as recent studies suggest that BAT’s contributions to energy expenditure along with Ucp1-dependent and -independent pathways may or may not rectify energy imbalance characteristic of obesity.

Unlocking the Potential: PEGylation and Molecular Weight Reduction of Ionenes for Enhanced Antifungal Activity and Biocompatibility.

Numerous synthetic polymers, imitating natural antimicrobial peptides, have demonstrated potent antimicrobial activity, positioning them as potential candidates for new antimicrobial drugs. However, the high activity of these molecules often comes at the cost of elevated toxicity against eukaryotic organisms. In this study, a series of cationic ionenes with varying molecular weights to assess the influence of polymer chain length on ionene activity is investigated. To enhance polymer antimicrobial activity and limit toxicity a PEG side chain is introduced into the repeating unit. The resulting molecules consistently exhibited high activity against three model organisms: E. coli, S. aureus and C. albicans. The incorporation of side PEG chain improves antifungal properties and biocompatibility, regardless of molecular weight. The most important finding of this work is that the reduction of polymer molecular mass led to increased antifungal activity and reduced cytotoxicity against HMF and MRC-5 cell lines simultaneously. As a result, the best-performing molecules reported herein displayed minimal inhibitory concentrations (MIC) as low as 2 and 0.0625µgmL1 for C. albicans and C. tropicalis respectively, demonstrating exceptional selectivity. It is plausible that some of described herein molecules can serve as potential lead candidates for new antifungal drugs.

Lipoprotein lipase as a target for obesity/diabetes related cardiovascular disease

Worldwide, the prevalence of obesity and diabetes have increased, with heart disease being their leading cause of death. Traditionally, the management of obesity and diabetes has focused mainly on weight reduction and controlling high blood glucose. Unfortunately, despite these efforts, poor medication management predisposes these patients to heart failure. One instigator for the development of heart failure is how cardiac tissue utilizes different sources of fuel for energy. In this regard, the heart switches from using various substrates, to predominantly using fatty acids (FA). This transformation to using FA as an exclusive source of energy is helpful in the initial stages of the disease. However, over the progression of diabetes this has grave end results. This is because toxic by-products are produced by overuse of FA, which weaken heart function (heart disease). Lipoprotein lipase (LPL) is responsible for regulating FA delivery to the heart, and its function during diabetes has not been completely revealed. In this review, the mechanisms by which LPL regulates fuel utilization by the heart in control conditions and following diabetes will be discussed in an attempt to identify new targets for therapeutic intervention. Currently, as treatment options to directly target diabetic heart disease are scarce, research on LPL may assist in drug development that exclusively targets fuel utilization by the heart and lipid accumulation in macrophages to help delay, prevent, or treat cardiac failure, and provide long-term management of this condition during diabetes.

Treatment Outcomes of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Co-Transporter-2 Inhibitors in Diabetes Mellitus with Poor Glycemic Control

Background: Diabetes, a progressive disease necessitating multifaceted pharmacological interventions for glycemic control, commonly employs Dipeptidyl Peptidase-4 inhibitors (DPP-4i) and Sodium-Glucose Co-Transporter-2 inhibitors (SGLT-2i). The ongoing challenge lies in determining the superior option for safety and efficacy. Objective: This study aims to describe the treatment outcomes of DPP-4 inhibitors (DPP-4i) and Sodium- Glucose Co-Transporter-2 inhibitors (SGLT-2i) in individuals with diabetes mellitus (DM) receiving metformin with poor glycemic control. Methods: This prospective study was conducted at the Endocrinology Outpatient Department of Dhaka Medical College Hospital, Dhaka, and included 90 individuals with diabetes mellitus who met the selection criteria. Divided into two groups, Group I (n=45) received DPP-4 inhibitors plus metformin, and Group II (n=45) received SGLT2 inhibitors plus metformin. Baseline data, including HbA1c, fasting blood glucose (FBG), blood glucose 2 hours after breakfast, weight, lipid profile, and serum creatinine, were recorded at the first visit and 12 weeks. Safety was assessed based on adverse drug effects. Results: After 12 weeks, both groups exhibited significant reductions in HbA1c, FBG, and postprandial blood glucose levels. However, the SGLT-2i group demonstrated significant improvements in HbA1c (P&lt;0.012), fasting plasma glucose (P&lt;0.003), and postprandial glucose levels (P&lt;0.001), along with a reduction in body weight (P&lt;0.042). Hypoglycemia rates were low and balanced between groups. Notably, SGLT-2i usage correlated with an increased incidence of urinary tract infections (13.33% vs. 6.66% in DPP-4i) and exclusive genital infections (11.11%, P&lt;0.022). Conclusion: Diabetic patients receiving SGLT-2 inhibitors had better glycemic control and body weight improvements in comparison to DPP-4 inhibitors. However, SGLT-2 inhibitors encountered more genital infections than DPP-4 inhibitors. J MEDICINE 2024; 25: 107-114

Role of Brown Adipose Tissue in Metabolic Health and Efficacy of Drug Treatment for Obesity

(1) Background: Brown adipose tissue (BAT) is responsible for non-shivering thermogenesis, and its activation has become a new object as both a determinant of metabolic health and a target for therapy. This study aimed to identify the relationships between the presence of BAT, parameters that characterize metabolic health (glucose, lipids, blood pressure (BP)), and the dynamics of body mass index (BMI) during weight-reducing therapy. (2) Methods: The study included 72 patients with obesity. We investigated metabolic parameters, anthropometric parameters, and BP. Dual-energy X-ray absorptiometry (DXA) and positron emission tomography and computed tomography (PET/CT) imaging with 18F-fluorodeoxyglucose (18F-FDG) were performed. (3) Results: Before weight-reducing therapy, BAT was revealed only in 19% patients with obesity. The presence of BAT was associated with a lower risk of metabolic deviations that characterize metabolic syndrome: shorter waist circumference (WC) (p = 0.02) and lower levels of glucose (p = 0.03) and triglycerides (p = 0.03). Thereafter, patients were divided into four groups according to the type of therapy (only lifestyle modification or with Liraglutide or Reduxin or Reduxin Forte). We did not find a relationship between the presence of BAT and response to therapy: percent weight reduction was 10.4% in patients with BAT and 8.5% in patients without BAT (p = 0.78) during six months of therapy. But we noted a significant positive correlation between the volume of BAT and the effectiveness of weight loss at 3 months (r = 0.52, p = 0.016). The dynamic analysis of BAT after 6 months of therapy showed a significant increase in the volume of cold-induced metabolically active BAT, as determined by PET/CT with 18F-FDG in the Liraglutide group (p = 0.04) and an increase in the activity of BAT standardized uptake value (SUV mean and SUV max) in the Reduxin (p = 0.02; p = 0.01, respectively) and Liraglutide groups (p = 0.02 in both settings). (4) Conclusions: The presence of brown adipose tissue is associated with a lower risk of metabolic abnormalities. In general, our study demonstrated that well-established drugs in the treatment of obesity (Liraglutide and Reduxin) have one more mechanism for implementing their effects. These drugs have the ability to increase the activity of BAT. A significant positive relationship between the total volume of BAT and the percentage of weight loss may further determine the priority mechanism of the weight-reducing effect of these medicaments.

Safety and efficacy of very low calorie diet (VLCD) in patients receiving haemodialysis therapy

Abstract Background Very low calorie diets (VLCDs) are an obesity treatment option in the general population, but their efficacy and safety in patients on haemodialysis (HD) is unknown. Methods Prospective single arm study of VLCD in haemodialysis patients. All participants received 2.5–3.3 MJ/day for 12 weeks. Weekly assessment of VLCD, pre and post dialysis weight, interdialytic weight gain, and blood electrolytes occurred for the first 4 weeks, then fortnightly for another 8 weeks. Linear mixed models compared the change in weight over time as well as biochemical outcomes including potassium. Results 22 participants (9 home HD (HHD) and 13 satellite HD (SHD)) enrolled with 19 completing the 12 week intervention. Mean post-dialysis weight declined from 121.1 kg at baseline to 109.9 at week 12 resulting in average decline of 0.88 kg per week (95% C.I. 0.71, 1.05, p &amp;lt; 0.001) with 12 week mean percentage weight loss9.3% (SD 3.5). Mean post-dialysis BMI declined from 40.9 kg/m2 at baseline to 37.1 kg/m2 at week 12 (95% C.I. 0.25, 0.35, p &amp;lt; 0.001). Serum potassium rose from week 1 to 3, stabilised week 4 to 6 and fell from week 8, returning near baseline by week 12. Six of the nine (66.6%) HHD participants and seven of the thirteen (70%) SHD participants had at least one episode of hyperkalaemia (K &amp;gt; 6 mmol/L). There were no clinical changes in serum sodium, corrected calcium, phosphate levels during the study. Conclusion VLCD with dietitian supervision was effective in producing significant weight reduction, with an acceptable safety profile in patients treated with haemodialysis.

Microbiome variations induced by delta9-tetrahydrocannabinol predict weight reduction in obese mice

IntroductionObesity and high-fat diets induce consistent alterations in gut microbiota composition. Observations from epidemiological reviews and experiments also illustrate weight regulation effects of delta9-tetrahydrocannabinol (THC) with microbiome shifts. Therefore, we investigated the weight-loss potential of THC in obese mice models and to elucidate the contribution of specific gut microbiome changes in THC-induced weight loss.MethodsHigh-fat diet induced obese mice were treated with oral THC supplementation for two weeks and compared with controls. In addition to measuring weight, fecal samples were obtained at various timepoints, sequenced for bacterial 16s rRNA content and analyzed using QIIME2. Alpha and beta diversity were computed followed by linear mixed effects (LME) modeling of bacterial relative abundance relationship to THC treatment and weight change.ResultsIn both male and female mice, the THC group had significantly greater average weight loss than controls (−17.8% vs. −0.22%, p&amp;lt;0.001 and −13.8% vs. +2.9%, p&amp;lt;0.001 respectively). Male mice had 8 bacterial taxonomic features that were both significantly different in relative abundance change over time with THC and correlated with weight change. An LME model using three bacterial features explained 76% of the variance in weight change with 24% of variation explained by fixed effects of feature relative abundance alone. The model also accurately predicted weight change in a second male mouse cohort (R=0.64, R2=0.41, p=&amp;lt;0.001). Female mice had fewer significant predictive features and were difficult to model, but the male-produced 3-feature model still accurately predicted weight change in the females (R=0.66, R2=0.44, p&amp;lt;0.001).ConclusionUsing a stepwise feature selection approach, our results indicate that sex-specific gut microbiome composition changes play some role in THC-induced weight loss. Additionally, we illustrated the concept of microbiome feature-based modeling to predict weight changes.