Piperine regulates the circadian rhythms of hepatic clock gene expressions and gut microbiota in high-fat diet-induced obese rats

The interplay between the host circadian clock and microbiota has significant influences on host metabolism processes,and circadian desynchrony triggered by high-fat diet(HFD)is closely related to metabolic disorders.In this study,the modulatory effects of piperine(PIP)on lipid metabolism homeostasis,gut microbiota community and circadian rhythm of hepatic clock gene expressions in obese rats were investigated.The Sprague-Dawley(SD)rats were fed with normal diet(ND),HFD and HFD supplemented with PIP,respectively.After 9 weeks,rats were sacrificed with tissue and fecal samples collected for circadian analysis.Results showed that chronic PIP administration ameliorated the obesity-induced alterations in lipid metabolism and dysregulation of hepatic clock gene expressions in obese rats.The gut microbial communities studied through 16S rRNA sequencing showed that PIP ameliorated the imbalanced nicrobiota and recovered the circadian rhythm of Lactobacillaceae,Desulfovibrionaceae,Paraprevotellaceae,and Lachnospiraceae.The fecal metabolic profiles indicated that 3-dehydroshikimate,cytidine and lithocholyltaurine were altered,which were involved in the amino acid and fatty acid metabolism process.These findings could provide theoretical basis for PIP to work as functional food to alleviate the lipid metabolism disorder,circadian rhythm misalignment,and gut microbiota dysbiosis with wide applications in the food and pharmaceutic industries.

Interaction between adolescent sleep rhythms and gender in an obese population

BACKGROUND The obesity rate of adolescents is gradually increasing,which seriously affects their mental health,and sleep plays an important role in adolescent obesity.AIM To investigate the relationship between sleep rhythm and obesity among adolescents and further explores the interactive effect of sleep rhythm and gender on adolescent obesity,providing a theoretical basis for developing interventions for adolescent obesity.METHODS Research data source Tianjin Mental Health Promotion Program for Students.From April to June 2022,this study selected 14201 students from 13 middle schools in a certain district of Tianjin as the research subject using the convenient cluster sampling method.Among these students,13374 accepted and completed the survey,with an effective rate of 94.2%.The demographic data and basic information of adolescents,such as height and weight,were collected through a general situation questionnaire.The sleep rhythm of adolescents was evaluated using the reduced version of the morningness-eveningness questionnaire.RESULTS A total of 13374 participants(6629 females,accounting for 49.56%;the average age is 15.21±1.433 years)were analyzed.Among them,the survey showed that 2942 adolescent were obesity,accounting for 22%and 2104 adolescent were overweight,accounting for 15.7%.Among them,1692 male adolescents are obese,with an obesity rate of 25.1%,higher than 18.9%of female adolescents.There is a statistically significant difference between the three groups(χ2=231.522,P<0.000).The obesity group has the smallest age(14.94±1.442 years),and there is a statistical difference in age among the three groups(F=69.996,P<0.000).Obesity rates are higher among individuals who are not-only-child,have residential experience within six months,have family economic poverty,and have evening-type sleep(P<0.05).Logistic regression analysis shows a correlation between sleep rhythm and adolescent obesity.Evening-type sleep rhythm can increase the risk of obesity in male adolescents[1.250(1.067-1.468)],but the effect on female obesity is not remarkable.Further logistic regression analysis in the overall population demonstrates that the interaction between evening-type sleep rhythm and the male gender poses a risk of adolescent obesity[1.122(1.043-1.208)].CONCLUSION Among adolescents,the incidence of obesity in males is higher than in females.Evening-type sleep rhythm plays an important role in male obesity but has no significant effect on female obesity.Progressive analysis suggests an interactive effect of sleep rhythm and gender on adolescent obesity,and the combination of evening-type sleep and the male gender promotes the development of adolescent obesity.In formulating precautions against adolescent obesity,obesity in male adolescents with evening-type sleep should be a critical concern.

Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography

AIM:To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography(SS-OCT).METHODS:According to the body mass index(BMI)results,the adults enrolled in the cross-sectional study were divided into the normal group(18.50≤BMI<25.00 kg/m^(2)),the overweight group(25.00≤BMI<30.00 kg/m^(2)),and the obesity group(BMI≥30.00 kg/m^(2)).The one-way ANOVA and the Chi-square test were used for comparisons.Pearson’s correlation analysis was used to evaluate the relationships between the measured variables.RESULTS:This research covered the left eyes of 3 groups of 434 age-and sex-matched subjects each:normal,overweight,and obesity.The mean BMI was 22.20±1.67,26.82±1.38,and 32.21±2.35 kg/m^(2) in normal,overweight and obesity groups,respectively.The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group(P<0.05 for all),while the retinal thickness of the three groups did not differ significantly.Pearson’s correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness,but no significant correlation was observed between BMI and retinal thickness.CONCLUSION:Choroidal thickness is decreased in people with overweight or obesity.Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.

Effects of exercise training on glucose metabolism indicators and inflammatory markers in obese children and adolescents:A metaanalysis

BACKGROUND Obesity in children and adolescents is a serious problem,and the efficacy of exercise therapy for these patients is controversial.AIM To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers.METHODS The PubMed,Web of Science,and Embase databases were searched for randomized controlled trials related to exercise training and obese children until October 2023.The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children.RESULTS In total,1010 patients from 28 studies were included.Exercise therapy reduced the levels of fasting blood glucose(FBG)[standardized mean difference(SMD):-0.78;95%confidence interval(CI):-1.24 to-0.32,P=0.0008],fasting insulin(FINS)(SMD:-1.55;95%CI:-2.12 to-0.98,P<0.00001),homeostatic model assessment for insulin resistance(HOMA-IR)(SMD:-1.58;95%CI:-2.20 to-0.97,P<0.00001),interleukin-6(IL-6)(SMD:-1.31;95%CI:-2.07 to-0.55,P=0.0007),C-reactive protein(CRP)(SMD:-0.64;95%CI:-1.21 to-0.08,P=0.03),and leptin(SMD:-3.43;95%CI:-5.82 to-1.05,P=0.005)in overweight and obese children.Exercise training increased adiponectin levels(SMD:1.24;95%CI:0.30 to 2.18,P=0.01)but did not improve tumor necrosis factor-alpha(TNF-α)levels(SMD:-0.80;95%CI:-1.77 to 0.18,P=0.11).CONCLUSION In summary,exercise therapy improves glucose metabolism by reducing levels of FBG,FINS,HOMA-IR,as well as improves inflammatory status by reducing levels of IL-6,CRP,leptin,and increasing levels of adiponectin in overweight and obese children.There was no statistically significant effect between exercise training and levels of TNF-α.Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.

Comparative observation of the effectiveness and safety of remimazolam besylate versus dexmedetomidine in gastrointestinal surgery in obese patients

BACKGROUND Surgery for obese patients carries a higher risk of anesthesia complications compared with surgery for nonobese patients.Thus,a safe and effective anesthesia strategy is necessary to improve the medical experience of such patients and ensure their safety.AIM To compared the effectiveness and safety of remimazolam besylate versus dexmedetomidine(DEX)in gastrointestinal surgery in obese patients.METHODS The study cohort included 60 obese patients undergoing gastrointestinal surgery between July 2021 and April 2023,comprising 30 patients who received DEX intervention(control group)and 30 patients who received remimazolam besylate intervention(research group).Heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),blood oxygen saturation(SpO_(2)),safety(nausea and vomiting,bradycardia,hypotension,and apnea),anesthesia and examination indices[induction time,anesthesia recovery time,and postanesthesia care unit(PACU)discharge time],sedation effect(Ramsay Sedation Scale),and postoperative pain visual analog scale were comparatively analyzed before anesthesia(T0),during anesthesia(T1),and after anesthesia(T2).RESULTS At T1,the research group showed significantly smaller changes in HR,RR,MAP,and SpO_(2) than the control group,with a significantly lower adverse reaction rate and shorter induction,anesthesia recovery,and PACU discharge times.Additionally,the intra-and postoperative Ramsay Sedation Scale scores were statistically higher in the research group than in the control group.CONCLUSION Remimazolam besylate was significantly more effective than DEX in gastrointestinal surgery in obese patients and had a higher safety profile and value in clinical promotion.

Epidemiological, Clinical and Paraclinical Profile of Osteoarthritis of the Lower Limbs in Obese Patients at the Cocody University Teaching Hospital

Objective: To describe the epidemiological, clinical and paraclinical characteristics of osteoarthritis of the lower limbs in obese patients at the Cocody University Teaching Hospital. Methodology: This was an analytical cross-sectional study carried out in the rheumatology department of the Cocody UTH in Abidjan (Ivory Coast) from March 1 to April 30 2023. Patients who came for rheumatology consultation presenting with mechanical arthralgia of the lower limbs, who were obese, had radiographic images were included. All patients without radiographic images were excluded. Obesity was defined as a body mass index (BMI) greater than or equal to 30 kg/m. The Chi2 test was used to compare proportions and determine the existence of associations between osteoarthristis and obesity, obesity severity and radiographic stage of osteoarthritis as well as the functional impact. A p-value below a predefined threshold (p = 0,05) indicates a significant relationship between the variables. Result: Out of 185 patients received for osteoarthritis of the lower limbs during the study period, 136 were obese (74%). There were 115 women (84.6%) with an average age of 56.03 with a standard deviation of 12.72 years (extremes: 22 and 84 years). The main socio-professional category was the informal sector (30%). The majority of patients had a low socio-economic level (80.2%) and lived in urban areas (92.6%). The most common past medical history was hypertension (33.08%) followed by peptic ulcer disease (16.91%). Patients had a body mass index class 1 (81.6%), class 2 (15.40%) and class 3 (2.90%). The average duration of symptom progression until diagnosis was 11 months. Genu varum was the main static disorder (56.10%) and the knee joint was the dominant topography (90.4%) with a bilateral localization (80%). The average Lequesne index was greater than 8 (59.5%). The Kellgren and Lawrence radiographic stages were stage 1 (9.20%), stage 2 (46.90%), stage 3 (29.20%) and stage 4 (6.90%). The Obesity severity was significantly associated with osteoarthritis of the knee (p = 0.042). There was no statistically significant association between obesity severity and radiographic stage of osteoarthritis (p = 0.163) or functional impact (p = 0.180). Conclusion: Osteoarthritis of the lower limbs affected obese women and was dominated by stage 2 osteoarthritis of the knee (Kellgren and Lawrence). There is an association between the severity of obesity and osteoarthritis of the knee.

Laryngeal mask airway bougie ultrasonography guided intubation in a morbidly obese patient with diffi cult airway

Airway management of morbidly obese patients is challenging due to inherent anatomical and physiological variations.[1]The frequent association of compromised hemodynamics,hypoxemia,or acidosis in an emergency department(ED)setting adds to the difficulty of the procedure.Rapid airway management position(RAMP),awake fiber-optic guided intubation,use of intubating laryngeal mask airway(ILMA),and video-laryngoscope are a few techniques that have been described to tackle difficult airways in these patients.[2]Studies have shown that the availability of fi ber-optic scopes(3%–60%),videolaryngoscopes(39%–88%),and laryngeal mask airways(LMA)(65%–83%)varies in different ED settings.[3,4]Furthermore,a lack of adequate training and the need for time-bound resuscitation make implementation of the above techniques challenging.

Edible mushrooms as a potent therapeutics of subclinical thyroid dysfunction among adults,especially in obese individuals:a prospective cohort study

Background:Mushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases.We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction(SCTD).Therefore,we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults.Methods:This prospective cohort study investigated 6631 participants(mean age:(45.0±10.2)years;55.1%men).Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire.SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine.Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD.Results:During follow-up period,a total of 262 new cases of SCTD were identified,the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years.After adjusting potential confounding factors,the multivariable hazard ratios(95%confidence intervals)for subclinical hypothyroidism were 1.00(reference)for almost never,0.53(0.29,0.97)for 1-3 times/week and 0.30(0.10,0.87)for≥4 times/week(P for trend=0.02).It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals,the final hazard ratios(95%confidence intervals)were 0.14(0.03,0.73)(P for trend<0.01).Conclusions:This population-based prospective cohort study has firstly demonstrated that higher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population,especially in obese individuals.

Effects of glucagon-like peptide-1 receptor agonists on glucose excursion and inflammation in overweight or obese type 2 diabetic patients

BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.

Gunsight suture with subcutaneous vacuum drainage during enterostomy decreased the surgical site infection rate in obese rectal cancer patients:A retrospective study

Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed;however,the best technique is still under debate.The purpose of this study was to explore the effectiveness of subcutaneous vacuum drains(SVDs)after two surgical suture techniques following stoma reversal in obese patients. Methods:Data from 190 obese patients with rectal cancer who underwent stoma reversal for enterostomy between February 2012 and April 2023 at Jinxiang Hospital Affiliated to Jining Medical University were retrospectively analyzed.These patients were divided into two groups:gunsight suture(GS)with SVD and primary linear suture(PLS)with SVD.The GS group and PLS group included 90 and 100 patients,respectively.The clinical characteristics and short-term outcomes were compared between the two groups.Postoperative pain scores were analyzed using a generalized estimation equation. Results:Surgery was successfully performed in both groups.The rate of SSI in the GS group was significantly lower than that in the PLS group(2.2%vs 9.0%,P=0.046).Patients in the GS group had a significantly shorter wound healing time than did patients in the PLS group,as well as a significantly shorter postoperative fasting time(P<0.05).No significant differences were found between the groups in terms of the postoperative hospital stay,operative time,and estimated blood loss(P>0.05).The results of the generalized estimation equation analysis showed that the GS group had significantly lower pain scores at 12,24,48,and 72 h after surgery than the PLS group(P<0.05).Moreover,the GS group showed significantly better alleviation of wound pain between 12 and 72 h after surgery(P<0.05). Conclusions:The GS technique with SVD may be recommended for wound closure of a nonfunctioning stoma in obese patients.

Chronotropic incompetence is more frequent in obese adolescents and relates to systemic inflammation and exercise intolerance

Background:Adults with obesity may display disturbed cardiac chronotropic responses during cardiopulmonary exercise testing,which relates to poor cardiometabolic health and an increased risk for adverse cardiovascular events.It is unknown whether cardiac chronotropic incompetence(CI)during maximal exercise is already present in obese adolescents and,if so,how that relates to cardiometabolic health.Methods:Sixty-nine obese adolescents(body mass index standard deviation score=2.23±0.32,age=14.1±1.2 years;mean±SD)and 29lean adolescents(body mass index standard deviation score=-0.16±0.84,age=14.0±1.5 years)performed a maximal cardiopulmonary exercise testing from which indicators for peak performance were determined.The resting heart rate and peak heart rate were used to calculate the maximal chronotropic response index.Biochemistry(lipid profile,glycemic control,inflammation,and leptin)was studied in fasted blood samples and during an oral glucose tolerance test within obese adolescents.Regression analyses were applied to examine associations between the presence of CI and blood or exercise capacity parameters,respectively,within obese adolescents.Results:CI was prevalent in 32 out of 69 obese adolescents(46%)and 3 out of 29 lean adolescents(10%).C-reactive protein was significantly higher in obese adolescents with CI compared to obese adolescents without CI(p=0.012).Furthermore,peak oxygen uptake and peak cycling power output were significantly reduced(p<0.05)in obese adolescents with CI vs.obese adolescents without CI.The chronotropic index was independently related to blood total cholesterol(standardized coefficientβ=-0.332;p=0.012)and C-reactive protein concentration(standardized coefficientβ=-0.269;p=0.039).Conclusion:CI is more common in the current cohort of obese adolescents,and is related to systemic inflammation and exercise intolerance.

Importance of proper ventilator support and pulmonary rehabilitation in obese patients with heart failure:Two case reports

BACKGROUND The optimal treatment for heart failure(HF)is a combination of appropriate medications.Controlling the disease using only medical therapy is difficult in patients with HF,severe hypercapnia,and desaturation.These patients should first receive ventilator support followed by pulmonary rehabilitation(PR).CASE SUMMARY We report two cases in which arterial blood gas(ABG)improved and PR was possible with appropriate ventilator support.Two patients with extreme obesity complaining of worsening dyspnea–a 47-year-old woman and a 36-year-old man both diagnosed with HF–were hospitalized because of severe hypercapnia and hypoxia.Despite proper medical treatment,hypercapnia and desaturation resolved in neither case,and both patients were transferred to the rehabilitation department for PR.At the time of the first consultation,the patients were bedridden because of dyspnea.Oxygen demand was successfully reduced once noninvasive ventilation was initiated.As the patients’dyspnea gradually improved to the point where they could be weaned off the ventilator during the daytime,they started engaging in functional training and aerobic exercise.After 4 mo of followup,both patients were able to perform activities of daily living and maintain their lower body weight and normalized ABG levels.CONCLUSION Symptoms of patients with obesity and HF may improve once ABG levels are normalized through ventilator support and implementation of PR.

Retinal microvascular and microstructural alterations in the diagnosis of meibomian gland dysfunction in severely obese population:a new approach

AIM:To study retinal microvascular and microstructural alterations in meibomian gland dysfunction(MGD)in severely obese population using optical coherence tomography angiography(OCTA).METHODS:Twelve MGD patients with severely obese population(PAT group;24 eyes)and 12 healthy controls(HC group;24 eyes)were recruited.OCTA images were segmented into five[superior(S),nasal(N),inferior(I),temporal(T),and central foveal(C)]or nine[inner superior(IS),outer superior(OS),inner nasal(IN),outer nasal(ON),inner inferior(II),outer inferior(OI),inner temporal(IT),outer temporal(OT),and C]subregions.The superficial vessel density(SVD),retinal thickness(RT),foveal avascular zone(FAZ)parameters,and retinal volume were measured.RESULTS:Visual acuity was significantly different between two groups(0.8±0.17 in PAT group vs 0.2±0.06 in HC group).SVD was significantly lower in PATs in N,T,OS,IN,OT,and ON.The area under the receiver operating characteristic curve(AUC)for T was 0.961[95% confidence interval(CI):0.908 to 1.000],for OS was 0.962(95%CI:0.915 to 1.000).RT was significantly lower in PATs in IS,OS,OI,OT,ON,IT,IN,and II.AUC for OT was 0.935(95%CI:0.870 to 0.999),for IS was 0.915(95%CI:0.838 to 0.992).Angiography results showed significantly lower area and perimeter of FAZ,SVD of the inner retina and both retinal volume and the average volume thickness in the PAT group.CONCLUSION:Vision may be affected in patients with MGD due to changes in retinal microvessels and microstructures.These changes detected by OCTA may be a potential marker for diagnosing MGD in severe obesity.

Impact of bariatric surgery on glucose and lipid metabolism and liver and kidney function in food-induced obese diabetic rats

BACKGROUND Obesity usually causes diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesityinduced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.AIM To investigate the effect of bariatric surgery on glucose and lipid metabolism and liver and kidney function in rats.METHODS Male Sprague-Dawley rats aged 6-8 wk underwent Roux-en-Y gastric bypass surgery(RYGB),sleeve gastrectomy(SG),or gastric banding(GB).Glucose and insulin tolerance tests,analyses of biochemical parameters,histological examination,western blot,and quantitative real-time polymerase chain reaction were conducted.RESULTS In comparison to the sham operation group,the RYGB,SG,and GB groups had decreased body weight and food intake,reduced glucose intolerance and insulin insensitivity,downregulated biochemical parameters,alleviated morphological changes in the liver and kidneys,and decreased levels of protein kinase Cβ/P66shc.The effect in the RYGB group was better than that in the SG and GB groups.CONCLUSION These results suggest that RYGB,SG and GB may be helpful for the treatment of foodborne obesity-induced DM.

Differences in metabolic improvement after metabolic surgery are linked to the gut microbiota in non-obese diabetic rats

BACKGROUND Different metabolic/bariatric surgery approaches vary in their effect on weight loss and glucose levels,although the underlying mechanism is unclear.Studies have demonstrated that the gut microbiota might be an important mechanism of improved metabolism after metabolic/bariatric surgery.AIM To investigate the relationship between the improvement in metabolic disturbances and the changes in gut microbiota after gastric or intestinal bypass.METHODS We performed sleeve gastrectomy(SG),distal small intestine bypass(DSIB)or sham surgery in nonobese rats with diabetes induced by 60 mg/kg streptozotocin(STZ-DM).RESULTS The group comparisons revealed that both SG and DSIB induced a reduction in body weight and significant improvements in glucose and lipid metabolism in the STZ-DM rats.Furthermore,DSIB exhibited a stronger glucose-lowering and lipidreducing effect on STZ-DM rats than SG.16S ribosomal RNA gene sequencing revealed the gut abundance of some Lactobacillus spp.increased in both the SG and DSIB groups after surgery.However,the DSIB group exhibited a more pronounced increase in the gut abundance of Lactobacillus spp.compared to the SG group,with more Lactobacillus spp.types increased in the gut.CONCLUSION The gut abundance of Lactobacillus was significantly correlated with the improvement in glycolipid metabolism and the change in serum fibroblast growth factor 21 levels.

Bariatric surgery reduces colorectal cancer incidence in obese individuals:Systematic review and meta-analysis

BACKGROUND Colorectal cancer ranks third in global cancer prevalence and stands as the second leading cause of cancer-related mortalities.With obesity recognized as a pivotal risk factor for colorectal cancer,the potential protective role of bariatric surgery,especially laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy,has garnered attention.AIM To investigate the Roux-en-Y gastric bypass(RYGB)vs sleeve gastrectomy(SG)effect on colorectal cancer incidence in obese individuals.METHODS A systematic review and meta-analysis of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Seventeen studies with a total of 12497322 patients were included.The primary outcome was the relative risk(RR)of developing colorectal cancer in obese patients who underwent weight loss surgery compared to those who did not.Secondary outcomes included determining the RR for colon and rectal cancer separately and subgroup analyses by gender and type of weight loss surgery.RESULTS The meta-analysis revealed a 54%reduction in colorectal cancer risk in morbidly obese patients who underwent bariatric surgery compared to those who did not.A significant 46%reduction in colorectal cancer risk was observed among female patients.However,no significant differences were found in the meta-analysis for various types of bariatric surgery,such as SG and RYGB.CONCLUSION This meta-analysis reveals weight loss surgery,regardless of type,reduces colorectal cancer risk,especially in women,as indicated by RR and hazard ratio assessments.Further validation is essential.

Effects and mechanisms of nutritional interventions on extradigestive complications in obese patients

BACKGROUND Obesity is associated with an increased risk of multiple extradigestive complic-ations.Thus,understanding the global epidemiology of obesity and its relation-ship with extradigestive complications,such as cardiovascular disease,type 2 diabetes mellitus,and non-alcoholic fatty liver disease is important.However,nutritional intervention can positively manage issues associated with obesity.Hence,the identification of the current high prevalence of extradigestive complica-tions among patients with obesity and the potential role of nutritional inter-ventions is also essential.AIM To determine the relationship between obesity and extradigestive complications and emphasize the importance of nutritional interventions in the management of patients with obesity.METHODS Overall,110 patients with obesity admitted to our hospital from February 2020 to November 2022 and 100 healthy individuals were included in the present study.Information of the study population,including demographic characteristics,such as age,sex,body mass index,indicators of extradigestive complications,dietary intake,and biomarkers was collected.The study design,participant selection,interventions,and development of the nutritional intervention program were described.The collected data were analyzed to assess the effect of nutritional inter-ventions on extradigestive complications.RESULTS As a part of nutritional intervention,the dietary structure was modified to decrease the saturated fatty acid and cholesterol intake and increase the dietary fiber and polyunsaturated fatty acid intake to improve the blood lipid levels and cardiovascular health.Mechanistic studies showed that these nutritional inter-ventions positively affected mechanisms that regulate lipid metabolism,improved inflammatory markers in the blood,and improved vascular functions.CONCLUSION The study discusses the consistency of the present results with previous findings to assess the clinical significance of the present findings.The study provides direction for future research on improving nutritional intervention strategies.

Evaluation of the Key Mechanism Justifying the High Sensitivity of Obese Rodents to Treptozotocin (STZ)

Diabetes mellitus (DM) is a metabolic disease caused by the absence or dysfunction of insulin;a hormone secreted by the pancreatic beta cell (β-cell) whenever blood glucose exceeds the normal physiological value. The long-term effects of the disease on the body’s organs are one of the leading causes of death in the world. To alleviate this global burden of DM, a number of studies have been conducted to lower blood glucose levels in patients. For genetic and ethical reasons, humans are far from being appropriate subjects in such investigations and the use of animal models has therefore been the way forward. Streptozotocin (STZ) is a glucosamine-nitrosourea compound that selectively destroys β-cells and has been widely used to induce Type I diabetes in several animal species. Recent literature has shown that a non-diabetic dose of STZ, combined with a high-fat diet (HFD), can mimic Type II diabetes. Yet, researchers seldom provide data to corroborate the high sensitivity of STZ on these animal models. In addition, there are few reports of potentially fatal effects of the use of STZ as a supplement in obese HFD animals when attempting to induce Type II diabetes. The present review article highlights the parameters that could be at the origin of the extreme sensitivity and vulnerability of obese animals to STZ.

Relationship between Serum Leptin and Adiponectin Levels in Obese Nigerians with Type 2 Diabetes Subjects

Background: Obesity is rising globally, independent of ethnicity, race and age, and is associated with increased risk of cardiovascular mortality and morbidity especially in persons living with diabetes. The effect of adipokines such as leptin, resistin and adiponectin which are secreted by adipose tissue factors has been linked to the increased risk of the cardiovascular mortality and morbidity. Aim: This study aims to assess the levels of serum leptin and serum adiponectin in obese type 2 diabetes subjects, and their relationship with cardio-metabolic component (using lipid profile). Method: This is a cross-sectional comparative hospital-based study in which one hundred and fifty participants grouped into 60 obese, 60 non-obese none diabetic and 30 non-obese non-diabetic adults with similar age from the Endocrinology outpatient’s clinic, General outpatient department (GOPD) and staff clinic of Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC). Anthropometric parameters and other relevant clinical details of all subjects were obtained. Fasting venous blood samples were taken from all subjects for the determination of fasting plasma glucose (FPG), fasting lipid profile, glycosylated haemoglobin levels (HbA1C), fasting serum insulin, leptin, and adiponectin. Data was analysed using the Statistical Package of Social Sciences (SPSS) version 23.0. Results: Twenty-eight (46.7%)) subjects were males while 32 subjects (53.3%) were females (in obese groups). There was no statistical difference between these two groups for both sexes (p = 1.000). The age range for all subjects was 34 to 64 years with their mean age being 52 ± 7.3 years, and for type 2 subjects and the obese non-diabetic 50.7 ± 7.3 years respectively. The mean body mass index of the non-obese and non-diabetic was 23.7 ± 4 Kg/m2 while the anthropometric measurements of the obese two groups were similar. The lipid profile, serum leptin and adiponectin in both the obese groups showed no difference. The relationship between components of obesity and serum leptin level in all subjects showed that serum leptin levels had significant positive correlation with BMI, WC, and serum insulin level. The correlation between adiponectin and lipid profile showed a positive correlation between serum adiponectin values and High-density lipoprotein (HDL) in obese diabetic (p = 0.02) but not in the non-diabetic group. Conclusion: In this study, there was no correlation in the serum leptin levels with the anthropometric parameters of obesity studied. For the components of the lipid profile, Triglycerides and low-density lipoprotein cholesterol (LDL) correlated with serum adiponectin and HDL showed a positive correlation with adiponectin. It is concluded that the effects of both serum adiponectin and serum leptin are driven by obesity rather than the glycaemic status of the obese subjects.

Analysis of Changes in BDNF Levels Before and After Bariatric Surgery in Obese Patients

Objectives:The rate of obesity has been increasing globally,so is the number of obese patients undergoing bariatric surgery.The relationship between brain-derived neurotrophic factor(BDNF)and body weight has been highlighted in recent years,but there are few related studies in China.The purpose of this study was to investigate the changes of BDNF in obese patients before and after bariatric surgery and to provide evidence for obesity-related mechanisms.Methods:The BDNF levels in 44 obese patients who underwent bariatric surgery were measured by enzyme-linked immunosorbent assay(ELISA)before and 4.5 months after surgery.SPSS 27.0 was used for statistical analysis.Results:Among the 44 patients,30 were female and 14 were male.The body mass index(BMI)decreased significantly after bariatric surgery(P<0.001);the serum BDNF of the patients significantly increased(P<0.001)after surgery.There was no significant difference in BDNF among patients with different degrees of obesity before and after surgery(P>0.05).There were no significant differences in BMI and BDNF levels between different sexes before and after surgery(P>0.05).Conclusion:The BDNF levels of obese patients increased significantly after bariatric surgery,which proved that bariatric surgery has an effect on BDNF levels.