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.

Global research trends and hotspots in overweight/obese comorbid with depression among children and adolescents: A bibliometric analysis

BACKGROUND Overweight/obesity combined with depression among children and adolescents(ODCA)is a global concern.The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity.Childhood and adolescence represent critical periods for physical and psychological development,during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes.AIM To evaluate the relationship between ODCA,we conduct a bibliometric analysis to aid in formulating prevention and treatment strategies.METHODS From 2004 to 2023,articles related to ODCA were selected using the Science Citation Index Expanded from the Web of Science Core Collection.Bibliometric analysis of relevant publications,including countries/regions,institutions,authors,journals,references,and keywords,was conducted using the online bibliometric analysis platforms,CiteSpace,VOSviewer,and bibliometrix.RESULTS Between 2004 and 2023,a total of 1573 articles were published on ODCA.The United States has made leading contributions in this field,with Harvard University emerging as the leading contributor in terms of research output,and Tanofsky being the most prolific author.The J Adolescent Health has shown significant activity in this domain.Based on the results of the keyword and reference analyses,inequality,adverse childhood experiences,and comorbidities have become hot topics in ODCA.Moreover,the impact of balancedrelated behavior and exploration of the biological mechanisms,including the potential role of key adipocytokines and lipokines,as well as inflammation in ODCA,have emerged as frontier topics.CONCLUSION The trend of a significant increase in ODCA publications is expected to continue.The research findings will contribute to elucidating the pathogenic mechanisms of ODCA and its prevention and treatment.

Epidemiological Aspects of Obesity, Overweight and Cardiovascular Risk Factors at Associes in Semi-Urban Areas (Case of Sébikotane)

Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

The Prevalence of Overweight/Obesity and Related Comorbidities among HIV-Positive and HIV-Negative Patients Attending the Same Clinics in Gaborone, Botswana

Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countries like Botswana where ±84% of PLHIV is on ART, the paucity of data comparing overweight/obesity between HIV-positive on ART and HIV-negative patients may impede clinical and policy decision-making. This study sought to estimate and compare: i) the prevalence of overweight/obesity between HIV-positive on ART and HIV-negative patients;ii) the prevalence of hypertension (HTN), diabetes mellitus (DM)/coronary heart disease (CHD) between HIV-positive patients on ART and HIV-negative patients attending same outpatient departments of general clinics in Gaborone, Botswana. Patients and Methods: Five hundred eighty-one (581) outpatients were recruited in four major clinics of Gaborone, Botswana, between June and July 2019;294 or 51% of them were HIV-negative and 287 or 49% were HIV-positive on ART. The prevalence of overweight/obesity and of HTN and DM/CHD were calculated and examined using stratified analysis. Subgroups were compared using Chi-square analysis with Yates correction or Fisher exact test and t-student test for continuous data. Results: Major findings after stratification of the study population by HIV status were: i) the prevalence of all categories of (BMI), including overweight/obesity, were comparable between HIV-negative-patients and HIV-positive. In fact, there were 24 (8.0%) cases of underweight among HIV-negative-Patients and 15(5%) cases among HIV-positive patients, p = 0.2;145 (49%) HIV-negative-patients and 128 (45%) HIV-positive, p = 0.07 cases of normal weight;72 (25%) HIV-negative-patients and 87 (30%) HIV-positive, p = 0.08, were overweight;53 (18%) HIV-negative-patients and 57 (20%) HIV-positive, p = 0.12, were obese;125 (43%) HIV-negative patients and 144 (50%) HIV-positive, p=0.06 were overweight/obese;ii) the prevalence of HTN and DM/CHD among HIV-positive-patients were significantly lower (p < 0.05) compared to HIV-negative patients: There were 32 (10.9%) cases of HTN among HIV-negative patients compared to 18 (6.3%) cases of HTN among HIV-positive patients, p = 0.001;32 (11%) cases of DM/CHD HIV-negative patients compared to 4 (1.4%) cases of DM/CHD among HIV-positive patients, p = 0.001. Conclusion: the prevalence of overweight/obesity observed between HIV-negative and HIV-positive patients may suggest that the two groups shared the same exposure factors. That HTN and DM/CHD prevalence was lower among HIV-positive compared to HIV-negative patients, is possibly due to interplay factors of ART, HIV or the host population. Further studies are, however, recommended for clarifications.

Overweight/Obesity in University Students from Mexico: Comparison Using Different Indices

The goal was to compare body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), and relative fat mas (RFM), to identify the best predictor of overweight and obesity in university students from Mexico. This is a cross-sectional survey with 697 university students from northern and central Mexico (448 women, and 249 men aged 18 - 19 years). Data was collected during 2018. Overweight and obesity were calculated from those indices and for both, female and male students, the order of correlation between a pair of indices were WHtR vs. RFM > WHtR vs. WC > RFM vs. WC > WHtR vs. BMI > BMI vs. WC > RFM vs. BMI. It is concluded to use the WHtR and the RFM to better predict overweight and obesity in young Mexican university students.

Factors Associated with Overweight among Workers of the Ministry of Labor and Public Service in Benin in 2023

Introduction: The problem of excess weight is pandemic and affects the majority of nations, regardless of their level of development. However, the prevalence of overweight among workers in Benin is very poorly documented. To fill this gap, the present study aimed to determine the prevalence and factors associated with overweight among workers of the Ministry of Labor and Public Service (MTFP) in 2023 in Benin. Materials and Methods: This is a descriptive cross-sectional study with analytical purposes carried out from August 16 to December 17, 2023, among MINISTRY OF LABOR AND PUBLIC SERVICE staff. The variables studied were overweight, sociodemographic, occupational and dietary characteristics, lifestyle, anthropometric factors and family history of obesity. An exhaustive recruitment of workers meeting our inclusion criteria and a questionnaire survey was carried out. Data were analyzed using R 4.0.4 software. A bivariate analysis followed by a multivariable analysis made it possible to identify the factors associated with overweight at the p Results: In total, 379 workers were included in our study. The average age of the surveyed workers was 44.86 years ± 7.67 years, with 202 (53.30%) workers at least 45 years old. Men predominated with a number of 228 (60.16%). The prevalence of overweight was 63.32% (95% CI: [58.23 - 68.15]) and the associated factors after multivariate analysis were: female sex (ORa = 4.00;95% CI [2.11 - 7.76];p Conclusion: The prevalence of overweight is high among ministry of labor and public service workers. Education and awareness in the professional environment on the prevention and management of risk factors are essential for a long-term impact on a notable regression of this public health phenomenon.

2型糖尿病合并肥胖患者血清肌联素水平与胰岛素抵抗的相关性

目的 观察2型糖尿病(T2DM)合并肥胖患者血清肌联素(myonectin)水平的变化,探讨血清myonectin水平的影响因素及其与胰岛素抵抗的相关性。方法 选择2020年11月至2022年6月在河北北方学院附属第一医院内分泌科住院的186例T2DM患者,根据体重指数(BMI)分为糖尿病正常体重组(60例)、糖尿病超重组(65例)和糖尿病肥胖组(61例)。另选取同期于医院体检且BMI正常的健康者作为正常对照组(60例)。测定各组血清myonectin、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,计算BMI及稳态胰岛素抵抗指数(HOMA-IR)。比较各组血清myonectin水平,并分析血清myonectin水平与胰岛素抵抗的相关性。结果 与正常对照组比较,糖尿病正常体重组、糖尿病超重组和糖尿病肥胖组的血清myonectin水平降低,差异有统计学意义(P<0.05)。与糖尿病正常体重组比较,糖尿病超重组和糖尿病肥胖组的myonectin水平降低,差异有统计学意义(P<0.05)。与糖尿病超重组比较,糖尿病肥胖组的myonectin水平降低,差异有统计学意义(P<0.05)。多元逐步回归分析表明,影响T2DM患者BMI的主要因素为myonectin、HOMA-IR、LDL-C、HDL-C、HbA1c。影响HOMA-IR的主要因素为myonectin、BMI、HbA1c、HDL-C。结论 血清myonectin水平在T2DM合并肥胖患者中显著降低,myonectin与胰岛素抵抗密切相关,与糖脂代谢共同参与了肥胖及糖尿病的发生、发展。

Food insecurity increases the risk of overweight and chronic diseases in adolescents: a systematic review and meta-analysis

To investigate the relationship between food insecurity(FI)and overweight/obesity(OW/OB)or corresponding chronic diseases in adolescents,33 studies with 181135 individuals were included in this meta-analysis.Six studies and 10 studies,reported a higher risk of overweight and obesity in adolescents experiencing FI,respectively(OR 1.38,95%CI 1.20‒1.58,P<0.0001;OR 1.11,95%CI 1.01‒1.22,P=0.035,respectively).Based on the pooled results,adolescents with severe FI had the highest risk of OW/OB(OR 1.45,95%CI 1.20‒1.75,P<0.0001).The pooled OR indicated no signifi cant association between FI and OW/OB,when the adolescents were stratifi ed into those under 6 years old and those between 6 and 18 years old.Eleven studies assessed the relationship between FI and the risk of chronic diseases.The anemia subgroup was significantly associated with FI(OR 1.67,95%CI 1.30‒2.13,P<0.0001).Severe FI was reported to increase the risk of hypertension(OR 1.59,95%CI 1.28‒1.98,P<0.0001).Furthermore,a pooled analysis revealed a signifi cant association between FI and the risk of chronic diseases in both 6 and 6-18-year-old subgroups.

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.

2011-2021年北京市门头沟区中小学生超重肥胖流行趋势分析

目的 了解北京市门头沟区2011-2021学年度中小学生超重肥胖流行状况及变化趋势,为有针对性地制定儿童青少年超重肥胖防控策略与健康教育规划提供科学依据。方法 利用2011-2021学年度门头沟区所有在册中小学生健康体检数据,对其中超重、肥胖相关数据进行整理分析。结果 中小学生超重和肥胖总检出率从27.18%增加至41.82%,10个学年度间年平均增长3.80%。中小学生超重检出率在10个学年度间总体变化不明显,而肥胖的检出率年平均增长5.99%。女生的超重检出率年平均增长1.46%,初中学段学生年平均增长2.55%;男生的肥胖检出率年平均增长5.65%,女生年平均增长6.66%,所有学段均随时间推移有不同程度的上升。男生超重、肥胖的检出率均高于女生。2020-2021学年为肥胖检出增长最迅速的时期。结论 门头沟区中小学生超重、肥胖防控形势依然严峻。有针对性地加强防控薄弱环节管理刻不容缓。

体重指数对不同严重程度卒中患者短期预后的影响

目的探讨BMI对不同严重程度卒中患者3个月临床结局的影响。方法本研究是前瞻性多中心队列研究,观察发病7 d内首次卒中住院患者的BMI与3个月卒中结局的关系。根据入院时NIHSS评分,将患者分为轻度卒中(NIHSS评分<11分)组和中重度卒中(NIHSS评分≥11分)组。收集患者入院时的一般资料以及高血压、糖尿病等血管危险因素情况。记录入院时BMI、是否存在吞咽障碍及在院期间肺炎等资料,其中BMI按照四分位数分为4层。发病后3个月对患者进行随访,采集mRS评分,以mRS评分0~2分为预后良好,3~6分为预后不良。比较轻度卒中组和中重度卒中组BMI及其他基线指标的差异并探索不同水平BMI对不同严重程度卒中患者预后的影响。结果共纳入733例患者,其中男性474例(64.7%),女性259例(35.3%)。缺血性卒中552例(75.3%),出血性卒中181例(24.7%)。轻度卒中组526例,中重度卒中组207例。在校正混杂因素后,不同水平BMI对整体患者及轻度卒中患者3个月结局均无显著影响;在中重度卒中患者中,与BMI最低四分位水平患者相比,最高四分位水平患者3个月预后良好的比例降低(OR 0.376,95%CI 0.142~0.992,P=0.048)。结论不同BMI水平对不同严重程度卒中患者短期预后的影响不同,其中,在中重度卒中患者人群中,高BMI水平可能导致预后不良。

福州地区汉族人群Mfn2基因多态性与超重/肥胖易感性的关系

目的 探讨福州地区汉族人群线粒体融合蛋白2(Mfn2)基因多态性与超重/肥胖易感性的关系。方法 选择福州地区汉族健康体检者198例,其中体质量正常104例,超重/肥胖94例。采集受试者空腹静脉血,Sanger测序法检测Mfn2基因rs2295281位点的基因型。统计基因位点和基因型频率,采用非条件Logistic回归模型校正混杂因素后,分析不同基因型与超重/肥胖易感性的关系;进一步根据性别进行分层,分析男性、女性人群中不同基因型与超重/肥胖易感性的关系。结果 Mfn2基因rs2295281位点存在CT、TT、CC三种基因型,其中CC基因型携带者78例,CT基因型携带者88例,TT基因型携带者32例;C等位基因频率为61.62%,T等位基因频率为38.38%。Logistic回归分析结果显示,Mfn2基因rs2295281位点的T等位基因较C等位基因超重/肥胖的发病风险增加(P=0.019,OR=1.688,95%CI为1.088~2.618),TT基因型较CC基因型发病风险增加(P=0.018,OR=3.099,95%CI为1.214~7.909),TT基因型较CC+CT发病风险增加(P=0.032,OR=2.572,95%CI为1.086~6.089)。根据性别进行分层统计,男性人群中,T等位基因较C等位基因超重/肥胖的发病风险增加(P=0.043,OR=1.900,95%CI为1.022~3.533),CT基因型较CC基因型发病风险增加(P=0.027,OR=2.803,95%CI为1.123~6.993),CT+TT基因型较CC基因型发病风险增加(P=0.02,OR=2.784,95%CI为1.178~6.584);女性人群中,TT基因型较CC+CT基因型超重/肥胖的发病风险增加(P=0.014,OR=4.683,95%CI为1.366~16.047)。结论 Mfn2基因rs2295281位点的基因分布频率与超重/肥胖易感性存在明显相关性,T等位基因可能增加发病风险,含CT基因的男性人群及含TT基因的女性人群可尽早进行饮食结构调整、运动干预。

超重和肥胖与哮喘患儿肺功能的相关性研究

目的 研究超重和肥胖与哮喘患儿肺功能的相关性。方法 选取2022年7月—2022年9月在呼吸科门诊就诊的368例哮喘患儿,根据体重指数(BMI)分为非超重肥胖组235例(63.8%)、超重组57例(15.5%)、肥胖组76例(20.7%),检测3组患儿肺功能的指标。包括用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、1秒率(FEV_(1)/FVC),用力呼出25%肺活量时的瞬间流量(FEF_(25))、用力呼出50%肺活量时的瞬间流量(FEF_(50))、用力呼出75%肺活量时的瞬间流量(FEF_(75)),用力呼气中期流量(FEF_(25~75)),呼气峰值流量(PEF)。结果 在超重和肥胖患儿中,哮喘控制不良的比例更高,与非超重肥胖组比较,差异有统计学意义(P<0.05)。在368例哮喘患儿中,BMI数值和FEV_(1)/FVC呈负相关(r=-0.22,P<0.05),与FVC、FEV_(1)、FEF_(25)、FEF_(50)、FEF_(75)、FEF_(25~75)各指标呈正相关(P<0.05)。在急性发作期及缓解期患儿中,BMI数值和肺功能各指标的相关性表现结果同前。结论 超重和肥胖患儿中,哮喘控制不良的比例更高。随着BMI数值的升高,哮喘患儿的FEV_(1)/FVC呈下降趋势,超重和肥胖对哮喘患儿的负面影响主要表现在中央气道。

TyG指数、血压、血糖相关指标与单纯性超重/肥胖患者早期肾功能损伤的关系

目的:探讨TyG指数、血压、血糖相关指标与单纯性超重/肥胖患者早期肾功能损伤(ERFI)的关系及交互作用。方法:选取2017年1月至2021年12月于郑州大学第一附属医院体检的BMI≥24 kg/m 2者3956例为研究对象,按尿白蛋白与肌酐比值(UACR)分组,<3 mg/mmol为对照组(n=3844),3~≤30 mg/mmol为ERFI组(n=112)。采用Logistic回归分析甘油三酯葡萄糖(TyG)指数、血压和糖化血红蛋白(HbA1c)与ERFI的关联,并进一步分析各因素的交互作用。结果:ERFI组的BMI、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、HbA1c、总胆固醇(TG)、TyG指数高于对照组,HDL-C低于对照组(P<0.05)。TyG指数>8.77(OR=2.138,95%CI:1.411~3.240)、正常血压高值(OR=2.450,95%CI:1.652~3.635)和HbA1c 5.61%~<7.00%(OR=1.510,95%CI:1.024~2.226)是单纯性超重/肥胖患者ERFI的危险因素。TyG指数与血压有交互作用(RERI=1.754,95%CI:-0.126~3.636;APAB=0.405,95%CI:0.068~0.741)。结论:TyG指数≥8.77、正常血压高值和HbA1c 5.61%~<7.00%可增加单纯性超重/肥胖患者ERFI的患病风险,且血压与TyG指数存在交互作用。

北京市海淀区中小学生营养状况和饮食运动行为分析

目的了解北京市海淀区中小学生营养状况和饮食运动行为情况及不同营养状况学生饮食运动行为的差异,为制定干预措施提供科学依据。方法2021年9—11月,采用分层整群随机抽样的方法抽取海淀区1906名中小学学生进行饮食运动行为电子问卷调查和身高体重等体格检查。结果2021年海淀区中小学生肥胖、超重和消瘦检出率分别为15.48%、17.45%和6.28%。肥胖检出率男生(20.00%)高于女生(10.50%),超重检出率男生(21.12%)高于女生(13.41%),男女生的营养状况比较,差异具有统计学意义(χ^(2)=66.658,P<0.001)。肥胖检出率由高到低依次为职高(22.85%)、小学(17.18%)、初中(15.66%)、高中(9.67%),不同学段学生营养状况比较,差异具有统计学意义(χ^(2)=51.989,P<0.001)。含糖饮料达到每天1次及以上男生发生率为11.02%,女生为5.51%;新鲜水果少于每天1次男生发生率为22.04%,女生为17.07%;蔬菜摄入少于每天1次男生发生率为10.62%,女生为6.83%;中高强度运动少于每周3 d(包含3 d)男生发生率为51.50%,女生为65.53%;以上指标男女生比较,差异均具有统计学意义(χ^(2)_(含糖饮料)=18.808,χ^(2)_(水果)=7.442,χ^(2)_(蔬菜)=8.511,χ^(2)_(中高强度运动)=38.441,P均<0.01)。职高、高中、初中及小学学段糖饮料达到每天1次以上发生率分别为19.27%、6.55%、7.73%和5.40%;新鲜水果少于每天1次发生率分别为42.91%、22.54%、13.85%和11.33%;蔬菜摄入少于每天1次发生率分别为23.27%、10.02%、4.32%和5.04%;不是每天吃早餐(不吃或有时吃)发生率分别为28.73%、15.03%、14.75%和8.81%;中高强度运动少于每周3天发生率分别为76.73%、71.68%、42.27%和52.34%;以上指标不同学段比较,差异均具有统计学意义(χ^(2)_(含糖饮料)=51.430,χ^(2)_(水果)=133.072,χ^(2)_(蔬菜)=96.333,χ^(2)_(早餐)=57.002,χ^(2)_(中高强度运动)=143.140,P均<0.001)。不同营养状况学生的新鲜水果摄入少于每天1次发生率分别为消瘦(28.81%)、超重(22.87%)、肥胖(19.24%)和正常(17.94%),差异具有统计学意义(χ^(2)=10.569,P=0.014)。不同营养状况学生的含糖饮料、油炸食品、蔬菜摄入频率、早餐摄入情况和中高强度运动频率分布比较,差异均无统计学意义。结论海淀区中小学超重肥胖情况不容乐观,应引起学校和教育部门的重视,针对营养不良重点人群开展有针对性的预防和干预措施。

超重/肥胖合并2型糖尿病患者血清ANGPTL4、HSP70、IL-34水平与胰岛素抵抗的相关性

目的 探讨超重/肥胖合并2型糖尿病(T2DM)患者血清血管生成素样蛋白4(ANGPTL4)、热休克蛋白(HSP)70、白细胞介素-34(IL-34)水平与胰岛素抵抗的相关性。方法 选取2020年5月—2022年5月保定市第一中心医院T2DM患者182例(T2DM组)。参考相关诊断标准,将T2DM患者分为超重/肥胖T2DM组(90例)和体重正常T2DM组(92例)。另选取同期健康体检者90名作为正常对照组,其中超重/肥胖者40名(超重/肥胖对照组)、体重正常者50名(体重正常对照组)。检测所有研究对象血清ANGPTL4、HSP70、IL-34、胰岛素和血糖水平,计算稳态模型胰岛素抵抗指数(HOMA-IR)。T2DM患者治疗3个月后,再次检测其血清ANGPTL4、HSP70、IL-34水平和HOMA-IR。采用Pearson相关分析评估血清ANGPTL4、HSP70、IL-34与HOMA-IR的相关性。结果 与正常对照组和体重正常T2DM组比较,超重/肥胖T2DM组血清ANGPTL4和HSP70显著降低(P<0.05),血清IL-34和HOMA-IR显著升高(P<0.05)。与正常对照组比较,体重正常T2DM组血清ANGPTL4和HSP70显著降低(P<0.05),血清IL-34和HOMA-IR显著升高(P<0.05)。Pearson相关分析结果显示,血清ANGPTL4、HSP70与HOMA-IR呈负相关(r值分别为-0.733、-0.758,P<0.001),IL-34和HOMA-IR呈正相关(r=0.705,P<0.001)。治疗后,超重/肥胖T2DM组和体重正常T2DM组血清ANGPTL4和HSP70均明显升高,血清IL-34和HOMA-IR明显降低;且相对于超重/肥胖T2DM组,体重正常T2DM组血清ANGPTL4和HSP70升高更显著(P<0.05),血清IL-34和HOMA-IR降低更显著(P<0.05)。结论 超重/肥胖合并T2DM患者ANGPTL4、HSP70和IL-34与胰岛素抵抗显著相关,或可作为超重/肥胖合并T2DM的疗效监测指标。

基于“痰瘀同治”理论治疗超重/肥胖糖耐量异常

目的基于“痰瘀同治”理论,运用痰瘀同调方治疗超重/肥胖糖耐量异常人群,评价痰瘀同调方治疗超重/肥胖糖耐量异常人群的临床有效性及安全性。方法选择超重/肥胖糖耐量异常痰湿瘀滞证患者72例,随机分为对照组与治疗组,各36例,对照组予基础治疗,治疗组在对照组基础上联合痰瘀同调方治疗。治疗3个月后观察2组体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、空腹血清胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、血脂以及中医痰湿瘀滞症状积分等指标变化,客观评价痰瘀同调方的临床疗效。结果治疗组治疗后BMI、WC、WHR、FPG、2 h PG、HbAlc、FINS、HOMA-IR、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),均较治疗前有明显改善,且改善程度均优于对照组(P<0.05);治疗组治疗后改善患者形体肥胖、腹部增大、脘腹胀满、倦怠乏力、胸闷、便溏、口淡无味或黏腻等中医症状方面均优于对照组(P<0.05);治疗组中医证候综合疗效总有效率明显高于对照组(P<0.05)。2组研究过程中均未出现不良事件。结论痰瘀同调方干预治疗超重/肥胖糖耐量异常效果明显,安全性良好。

老年超重或肥胖男性体检人群正常血尿酸水平对腰椎骨密度的影响

目的探讨60岁以上男性超重或肥胖体检人群正常血清尿酸水平(serum uric acid,SUA)与腰椎骨密度(bone mineral density,BMD)的关系。方法选取470名于2022年1~12月在宁夏回族自治区人民医院体检的60岁及以上男性,利用双能X线骨密度仪对腰椎L1~4的BMD进行检测,依据T值将所有患者分为3组:骨量正常G1组、骨量减少G2组和骨质疏松G3组,所有纳入患者的SUA水平均在正常水平(180~428μmol/L)。先将各组进行指标差异对比,再依据体质量指数(body mass index,BMI)把所有研究对象分为超重组、肥胖组,观察BMI的变化对BMD值、T值、骨质疏松症患病率高低的影响;把BMD、T值分别与其他指标如SUA、BMI等进行Pearson相关性分析;把数据进行赋值定义,再分别做单因素Logistic回归分析、有序多分类Logistic回归分析。结果(1)G3组SUA水平均高于G1组和G2组,G3组年龄、BMI、糖尿病的患病率均高于G1组和G2组,而eGFR、BMD、T值则低于G1组和G2组,差异具有统计学意义(P<0.05)。(2)将血尿酸按三分位法分为低1/3组(S1组)、中1/3组(S2)、高1/3组(S3)组共3组,其中组间比较发现S3组的BMD值、T值、骨质疏松症患病率均高于S1、S2组,S2组骨质疏松症患病率高于S1组,差异均有统计学意义(P<0.05)。(3)相较于肥胖组,超重组的BMD值、T值更低,且骨质疏松症患病率更高。(4)Pearson相关分析显示,eGFR的变化与BMD、T值的变化趋势较为一致,相反,BMI、SUA、年龄的数值升高,伴随BMD及T值的降低(P<0.05)。(5)单因素Logistic回归分析结果提示,年龄增加、BMI增高、SUA升高、eGFR降低以及糖尿病病史会增加骨量异常的罹患风险(P<0.05);经有序多分类Logistic回归分析显示,年龄、BMI、SUA、患有糖尿病与骨量异常的风险呈正相关性(P<0.05)。结论在60岁以上的男性超重或肥胖体检人群中,SUA、BMI、糖尿病促进老年男性发生骨量异常。

体检人群中超重和肥胖对基底动脉、颈内动脉和椎动脉功能的影响

目的探讨健康体检人群中,体质量指数(BMI)与颅内动脉(基底动脉、颈内动脉和椎动脉)功能的相关性。方法回顾性选取2023年6至8月健康体检者共1169例。收集一般资料、实验室指标以及经颅多普勒数据。依据BMI分为3组:正常组(<24 kg/m^(2))546例、超重组(24~<28 kg/m^(2))484例和肥胖组(≥28 kg/m^(2))139例。比较3组临床特征、实验室指标、颅内动脉血流速度情况。分析BMI与颅内动脉血流速度的相关性,利用多元线性回归及限制性立方条分析BMI与颅内动脉血流速度的关系,并确定颅内动脉血流速度减慢风险增加的临界值。结果与正常组相比,肥胖组和超重组颅内动脉收缩期血流速度、舒张期血流速度和平均血流速度均较低(P<0.05)。多元线性回归分析显示,BMI与颅内动脉收缩期血流速度、舒张期血流速度及平均血流速度呈负相关(P<0.01),与血管搏动指数、阻力指数无相关性(P>0.05)。限制性立方条结果显示,基底动脉和双侧椎动脉血流速度与BMI之间呈线性相关(P>0.05),双侧颈内动脉血流速度与BMI之间呈非线性相关(P<0.05)。结论健康体检人群中BMI与颅内动脉血流速度呈负相关,当BMI超过特定值(24.18~24.26 kg/m^(2))时,颅内动脉血流速度减慢的风险增加。

司美格鲁肽对2型糖尿病合并超重及肥胖患者的胰腺和肝脏脂肪含量以及胰岛β细胞功能的影响

目的探讨司美格鲁肽对2型糖尿病(T2DM)合并超重及肥胖患者的血糖控制、胰腺和肝脏脂肪含量以及胰岛β细胞功能的影响。方法采用单中心、前瞻性、临床病例对照试验的方法,选取2021年10月至2022年10月在金华市中心医院诊断为T2DM合并超重(BMI 25~<28 kg/m^(2))及肥胖(BMI≥28 kg/m^(2))的86例患者为研究对象,均接受稳定剂量的二甲双胍单药或联合口服用药至少3个月,糖化血红蛋白(HbA1C)为6.5%~8.0%。采用随机数字表法将患者分为对照组和观察组,各43例。对照组继续原方案口服降糖,观察组在原方案的基础上联合司美格鲁肽(起始剂量0.25 mg,4周后增加至0.5 mg并稳定,1次/周,皮下注射)。两组均干预24周。比较两组患者血糖(FPG、餐后2 h血糖和HbA1C)、血脂(TC、TG、LDL-C、HDL-C)、BMI、腰围、胰岛细胞功能[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)]。通过非对称回波的最小二乘估算法迭代水脂分离序列测量胰头、胰体和胰尾的胰腺脂肪分数(PFF),计算平均PFF并进行组间比较;测量肝脏右上、右下和左叶的肝脏脂肪分数(HFF),计算平均HFF并进行组间比较。结果对照组39例和观察组40例随访至研究结束。治疗后观察组患者FPG、餐后2 h血糖、HbA1C、BMI、FINS、HOMA-IR、平均PFF和平均HFF均低于对照组,而HOMA-β高于对照组,差异均有统计学意义(均P<0.01)。结论司美格鲁肽应用方便,对T2DM合并超重及肥胖患者能够在常规降糖药的基础上进一步改善胰岛素和胰岛β细胞功能,降低血糖水平、胰腺和肝脏脂肪含量,同时可产生额外的减重获益。