<b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> Obesity is the major contributor of the metabolic syndrome (MetS), but a uniq...<b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> Obesity is the major contributor of the metabolic syndrome (MetS), but a unique phenotype of obesity known as metabolically healthy obese (MHO) shows healthier metabolic profile</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> however understanding of their biochemical correlates is poorly understood. Obesity is defined by Body mass index (BMI), but controversy exists regarding ethnic-specific BMI cut-offs. The present study used the Asian Indian BMI cut</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">offs to assess relationships of MHO phenotypes with oxidative stress (OS) and inflammation. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">In this case-control study, 299 metabolically-healthy (MH) respondents were divided into four groups as per Asian criteria for obesity: MH non-obese </span><span style="font-family:Verdana;">(MHNO), MH overweight</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(MHOW), MHO and MH severely obese (MHSO</span><span style="font-family:;" "=""><span style="font-family:Verdana;">). Their oxidative stress and pro-inflammatory markers were measured. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Levels of hydroxyl radicals (</span></span><span style="font-family:Verdana;">·</span><span style="font-family:Verdana;">OH), fluorescent oxidation products (FLOP), MDA, PCO and inflammatory markers CRP, TNF-</span><span style="font-family:Verdana;"><i></i></span><i><i><span style="font-family:Verdana;">α</span></i><i><span style="font-family:Verdana;"></span></i></i><span style="font-family:Verdana;">, IL-6</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">were highest in MHSO phenotype followed by the MHO,</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">MHOW</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">and MHNO groups (p > 0.0001), whereas antioxidant markers, CuZn-SOD, catalase, glutathione peroxidase and total antioxidant activity followed the reverse trend. The MHNO and MHOW groups showed significant difference with regard to (</span><span style="font-family:Verdana;">·</span><span style="font-family:Verdana;">OH) radicals and FLOP. Moreover, </span><span style="font-family:Verdana;">·</span><span style="font-family:;" "=""><span style="font-family:Verdana;">OH radicals, FLOP and inflammatory markers were significantly correlated to BMI in MHSO and MHO but not in MHNO and MHOW group. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The MHO and MHSO phenotype display differences in terms of OS and inflammatory markers at lower BMI cut</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">offs, indicating that they may be on the way to becoming </span><span style="font-family:Verdana;">“</span><span style="font-family:Verdana;">unhealthy</span><span style="font-family:Verdana;">”</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> ob</span><span style="font-family:Verdana;">ese. The lower BMI cut-offs proposed by Indian Consensus Group would help</span><span style="font-family:Verdana;"> in understanding of manifestation of metabolic syndrome.</span></span>展开更多
Metabolically healthy obese(MHO)individuals are reported to have a lower risk of developing cardiovascular diseases in comparison with individuals with metabolic syndrome.However,the association between MHO and type 2...Metabolically healthy obese(MHO)individuals are reported to have a lower risk of developing cardiovascular diseases in comparison with individuals with metabolic syndrome.However,the association between MHO and type 2 diabetes(T2DM)is still controversial.Some studies indicated that MHO is a favorable phenotype for T2DM,but more studies showed that MHO individuals have an increased risk of developing T2DM compared with metabolically healthy normalweight individuals,especially among those who would acquire metabolically unhealthy obesity.This has been supported by finding insulin resistance and lowgrade inflammatory responses in MHO individuals with a tendency for impaired beta-cell dysfunction.Studies also showed that liver fat accumulation increased the risk of incidence of T2DM in MHO.Here,we reviewed current literature on the relationship between MHO and T2DM,discussed the determinants for the development of diabetes in MHO,and summarized the measures for the prevention of T2DM in MHO.展开更多
Objective:To investigate the prevalence of metabolically healthy obesity(MHO)and its relationship with incidence of metabolic syndrome(MetS),type 2diabetes mellitus(T2DM)and hypertension in individuals in the city of ...Objective:To investigate the prevalence of metabolically healthy obesity(MHO)and its relationship with incidence of metabolic syndrome(MetS),type 2diabetes mellitus(T2DM)and hypertension in individuals in the city of Yulin.Methods:We studied 1,666 participants,aged over18years at baseline,with free of components of the MetS except waist criteria.Participants were divided into three groups based on body mass index(Ibm):lean/normal weight(Ibm<23kg/m2),overweight(Ibm,23-24.9kg/m2),obesity(Ibm≥25 kg/m2).The cumulative incidence of MetS,T2DM and hypertension over 5.21years among groups was assessed.Results:The prevalence of MHO was 19.5%in the baseline population.During an average 5.21year follow-up,the cumulative incidence of MetS,T2DM and hypertension in1,666participants were 16.4%,19.1%and 3.9%,respectively.The obesity group had a significantly higher cumulative incidence of MetS(16.4%vs.3.2%,P<0.001),hypertension(19.1%vs.3.7%,P<0.001),and T2DM(3.9%vs.1.6%,P<0.001)compared to the lean/normal weight group.Each kg/m2 of Ibm carried increased risk for T2DM(19%),hypertension(11%)and MetS(13%).Conclusion:Metabolically healthy obesity individuals confer increased risk for hypertension,T2DM and the MetS than their non-obese counterparts.展开更多
In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesit...In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.Chronic exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in T1DM.As our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of diabetes.Stereotypes regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes care.In this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.展开更多
Objective:To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.Methods:Seventy-one sub...Objective:To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.Methods:Seventy-one subjects were enrolled in the study.We assessed blood glucose,blood lipids,body mass index(BMI),and phlegm-dampness pattern,which was confirmed by a traditional Chinese medicine clinician.Of the participants,we included healthy participants with normal weight(NW,n=23),overweight/obese participants with normal metabolism(ONM,n=19),overweight/obese participants with pre-diabetes(OPD,n=12),and overweight/obese participants with marginally-elevated blood lipids(OML,n=17).Among them,the ONM,OPD,and OML groups were diagnosed with phlegmdampness pattern.The data-independent acquisition(DIA)method was first used to analyze the plasma protein expression of each group,and the relevant differential proteins of each group were screened.The co-expressed proteins were evaluated by Venn analysis.The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis(IPA)software.Parallel reaction monitoring(PRM)was used to verify the differential and common proteins in each group.Results:After comparing ONM,OPD,and OML groups with NW group,we identified the differentially expressed proteins(DEPs).Next,we determined the DEPs among OPD,OML,and ONM groups.Using Venn analysis of the DEPs in each group,24 co-expressed proteins were screened.Two co-expressed proteins were verified by PRM.IPA analysis showed that pathways including LXR/RXR activation,acute phase response signaling,and FXR/RXR activation were common to all three groups of phlegmdamp overweight/obesity participants.However,the activation or inhibition of these pathways was different among the three groups.Conclusion:Participants with overweight/obesity have similar proteomic characteristics,though each type shows specific proteomic characteristics.Two co-expressed proteins,VTN and ORM1,are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegmdampness retention.展开更多
<em>Objective</em>: Currently Mexico is one of the 1st places in overweight and obesity in teenagers;the health and nutrition national survey in 2018, expresses a 41.1% of women in teenager’s population a...<em>Objective</em>: Currently Mexico is one of the 1st places in overweight and obesity in teenagers;the health and nutrition national survey in 2018, expresses a 41.1% of women in teenager’s population and a 35.8% in men. To analyze teenagers’ lifestyles with healthy weight against overweight and obesity. <em>Method</em>: Descriptive, transverse, analytic and comparative, a non-probabilistic sampling distributed up to convenience in 2 groups of cases and controls, with 50 teenagers diagnosed with overweight and obesity and 50 teenagers with healthy weight, in a 12 to 15 years old age range;for previous informed consent, the survey Health-Promoting Lifestyle Profile II was applied to measure the lifestyles in 6 dimensions. The analysis got a standard deviation and the association of variables U of Mann-Whitney for independent samples. <em>Results</em>: In both teenagers’ groups male gender prevailed with a 76%, the result in teenagers’ group was identified, an average lifestyle with the dimensions of: interpersonal relationships, feeding, physical activity, stress management and spiritual growth and a low level in the dimension of health responsibility. There is a meaningful difference in the variables association in the spiritual growth lifestyle. <em>Conclusions</em>: The evaluation of both groups is similar to an average score;this shows that there is a risk to unleash overweight, obesity and complications in the adult age of the teenager.展开更多
Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World H...Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World Health Organization (WHO) has estimated that, at the end of 2022, 1 out of every 8 individuals were obese, and that the global adult obesity rates have over doubled since 1990, even as the adolescent obesity rates have quadrupled. Thus, as of 2022, nearly 2.5 billion adults, aged 18 years and above, were overweight, with 890 million being obese. Obesity and overweight incidence rate has been gradually increasing over the years, presenting significant challenges to the healthcare systems throughout the globe. In this regard, the objective of this systematic review was to evaluate the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. Methodology: To attain the above stated study objective, a systematic evaluation of previous studies was carried out, particularly studies that assessed the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. The authors have used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the selection of eligible studies for inclusion in the study. Results: The findings indicate that lifestyle interventions resulted in 5% - 10% weight reduction and significant improvements in metabolic indicators, while pharmacotherapy (GLP-1 receptor agonists) achieved up to 15% weight reduction and considerable metabolic health benefits. Further, comparative studies show lifestyle modifications provide overall health benefits, while medication is necessary for non-responders. Conclusion: Individualized treatment strategies are crucial, and further research is needed on long-term consequences and combination therapies.展开更多
The growing obesity epidemic is becoming a major public health concern,and the associated costs represent a considerable burden on societies.Among the most common complications of severe obesity are the development of...The growing obesity epidemic is becoming a major public health concern,and the associated costs represent a considerable burden on societies.Among the most common complications of severe obesity are the development of hypertension,dyslipidemia,type 2 diabetes,cardiovascular disease,and various types of cancer.Interestingly,some obese individuals have a favorable metabolic profile and appear to be somehow protected from the detrimental effects of excessive adipose tissue accumulation.These individuals remain normoglycemic,insulin sensitive,and hypotensive with proper blood lipid levels,despite their high body mass index and/or waist circumference.Multiple independent observations have led to the concept of the metabolically healthy obese(MHO) phenotype,yet no consensus has been reached to date regarding a universal definition or the main mechanism behind this phenomenon.Recent technological advances and the use of high-throughput analysis techniques have revolutionized different areas of biomedical research.A multi-omics approach,which is used to investigate changes at different molecular levels in an organism or tissue,may provide valuable insights into the interplay between the molecules or pathways and the roles of different factors involved in the mechanisms underlying metabolic health deterioration.The aim of this review is to present the current status regarding the use of omics technologies to investigate the MHO phenotype,as well as the results of targeted analyses conducted in MHO individuals.展开更多
Metabolically healthy obesity refers to obese individuals who do not develop metabolic disorders.These people store fat in subcutaneous adipose tissue(SAT)rather than in visceral adipose tissue(VAT).However,the molecu...Metabolically healthy obesity refers to obese individuals who do not develop metabolic disorders.These people store fat in subcutaneous adipose tissue(SAT)rather than in visceral adipose tissue(VAT).However,the molecules participating in this specific scenario remain elusive.Rab18,a lipid droplet(LD)-associated protein,mediates the contact between the endoplasmic reticulum(ER)and LDs to facilitate LD growth and maturation.In the present study,we show that the protein level of Rab18 is specifically upregulated in the SAT of obese people and mice.Rab18 adipocyte-specific knockout(Rab18 AKO)mice had a decreased volume ratio of SAT to VAT compared with wildtype mice.When subjected to high-fat diet(HFD),Rab18 AKO mice had increased ER stress and inflammation,reduced adiponectin,and decreased triacylglycerol(TAG)accumulation in SAT.In contrast,TAG accumulation in VAT,brown adipose tissue(BAT)or liver of Rab18AKO mice had a moderate increase without ER stress stimulation.Rab18 AKO mice developed insulin resistance and systematic inflammation.Rab18 AKO mice maintained body temperature in response to acute and chronic cold induction with a thermogenic SAT,similar to the counterpart mice.Furthermore,Rab18-deficient 3T3-L1 adipocytes were more prone to palmitate-induced ER stress,indicating the involvement of Rab18 in alleviating lipid toxicity.Rab18 AKO mice provide a good animal model to investigate metabolic disorders such as impaired SAT.In conclusion,our studies reveal that Rab18 is a key and specific regulator that maintains the proper functions of SAT by alleviating lipid-induced ER stress.展开更多
Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid...Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy(‘‘sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described:(1) normal weight obese(NWO);(2) metabolically obese normal weight;(3) metabolically healthy obese; and(4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.展开更多
Objective To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence. Method...Objective To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence. Methods A total of 2020 adolescents (1007 boys and 1013 girls) aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index (BMI) categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics (NCHS). Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity (especially for girls since the mid- adolescence), the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity (90.1% for boys and 89.2% for girls) and a relative high specificity (96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively) was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.展开更多
The study aimed to determine the relationships between the basal metabolic rate(BMR) and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus(DM). This cross-sectional clinical stu...The study aimed to determine the relationships between the basal metabolic rate(BMR) and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus(DM). This cross-sectional clinical study enrolled 193 Chinese adults with type 2 DM who were overweight(24 kg/m2≤BMI〈28 kg/m2, n=99), or obese(BMI ≥28 kg/m2, n=94). Ninety-seven adults with normal BMIs, including 50 DM patients and 47 healthy adults, were recruited as a control group. BMR was measured by indirect calorimetry; predicted BMR was calculated according to the Schofield equation; and the relationships between BMR, body composition, and biochemical results were determined by the Pearson correlation. The results showed that obese DM patients had significantly higher BMRs than both overweight patients(P〈0.05) and patients with normal BMI did(P〈0.05). The measured BMR was significantly lower than the predicted BMR(P〈0.05) in all groups. Obese and overweight DM patients had significantly greater weight, waist circumference, hip circumference, BMI, body surface area, body fat percentage, fat mass, and fat-free mass than patients with normal BMI. Except for waist circumference, these body composition measurements were significantly increased in obese DM patients when compared with those in overweight DM patients(P〈0.05). Fat-free mass was closely correlated with BMR in both DM patients(r=0.874, P〈0.01) and in healthy controls(r=0.902, P〈0.01). It was concluded that overweight and obese Chinese adults with type 2 DM had increased BMRs compared with normal-weight controls, which may result from the difference in fat-free mass.展开更多
目的:探讨不同体重指数(body mass index,BMI)青年男性静息能量消耗(resting energy expenditure,REE)的特点,比较常见静息代谢率(resting metabolic rate,RMR)预测方程与间接测热法的差异。方法:以2017年12月至2021年6月于北京大学第...目的:探讨不同体重指数(body mass index,BMI)青年男性静息能量消耗(resting energy expenditure,REE)的特点,比较常见静息代谢率(resting metabolic rate,RMR)预测方程与间接测热法的差异。方法:以2017年12月至2021年6月于北京大学第三医院运动医学科进行静息代谢测试的30名青年男性为研究对象,采用间接测热法测定RMR,采用生物电阻抗法测定体成分。分析研究对象REE的特点,并与11个常见预测方程的推算值进行比较,通过配对t检验和组内相关系数(intra-class correlation coefficient,ICC)评估两者差异。结果:30名青年男性的平均年龄为(26.93±4.16)岁,整体RMR为(1960.17±463.11)kcal/d(1 kcal=4.1868 kJ),其中BMI正常者的RMR为(1744.33±249.62)kcal/d,显著低于超重或肥胖者[(2104.06±520.32)kcal/d](P<0.01),但体质量校正后,BMI正常者的RMR显著高于超重或肥胖者[(24.02±2.61)kcal/(kg·d)vs.(19.98±4.38)kcal/(kg·d),P<0.01];不同BMI受试者的RMR与体质量、脂肪量、去脂体重、体表面积、细胞外液呈显著正相关(P均<0.05)。11个预测方程的预测值与实测值的一致性均不佳(ICC均<0.75),其中,超重或肥胖青年男性采用世界卫生组织(World Health Organization,WHO)推荐使用的RMR预测方程的预测值与实测值的一致性相对较高(ICC=0.547,P<0.01)。结论:不同BMI青年男性的RMR存在显著差异,超重或肥胖者要考虑体质量矫正后的RMR情况。不同预测方程的预测值与RMR的实测值一致性较差,建议通过间接测热法准确测定RMR。对于超重和肥胖的青年男性可以考虑采用WHO推荐使用的预测方程计算RMR,但有必要建立适用于不同BMI人群的RMR预测方程。展开更多
文摘<b><span style="font-family:Verdana;">Aims:</span></b><span style="font-family:Verdana;"> Obesity is the major contributor of the metabolic syndrome (MetS), but a unique phenotype of obesity known as metabolically healthy obese (MHO) shows healthier metabolic profile</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> however understanding of their biochemical correlates is poorly understood. Obesity is defined by Body mass index (BMI), but controversy exists regarding ethnic-specific BMI cut-offs. The present study used the Asian Indian BMI cut</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">offs to assess relationships of MHO phenotypes with oxidative stress (OS) and inflammation. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">In this case-control study, 299 metabolically-healthy (MH) respondents were divided into four groups as per Asian criteria for obesity: MH non-obese </span><span style="font-family:Verdana;">(MHNO), MH overweight</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">(MHOW), MHO and MH severely obese (MHSO</span><span style="font-family:;" "=""><span style="font-family:Verdana;">). Their oxidative stress and pro-inflammatory markers were measured. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Levels of hydroxyl radicals (</span></span><span style="font-family:Verdana;">·</span><span style="font-family:Verdana;">OH), fluorescent oxidation products (FLOP), MDA, PCO and inflammatory markers CRP, TNF-</span><span style="font-family:Verdana;"><i></i></span><i><i><span style="font-family:Verdana;">α</span></i><i><span style="font-family:Verdana;"></span></i></i><span style="font-family:Verdana;">, IL-6</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">were highest in MHSO phenotype followed by the MHO,</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">MHOW</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">and MHNO groups (p > 0.0001), whereas antioxidant markers, CuZn-SOD, catalase, glutathione peroxidase and total antioxidant activity followed the reverse trend. The MHNO and MHOW groups showed significant difference with regard to (</span><span style="font-family:Verdana;">·</span><span style="font-family:Verdana;">OH) radicals and FLOP. Moreover, </span><span style="font-family:Verdana;">·</span><span style="font-family:;" "=""><span style="font-family:Verdana;">OH radicals, FLOP and inflammatory markers were significantly correlated to BMI in MHSO and MHO but not in MHNO and MHOW group. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The MHO and MHSO phenotype display differences in terms of OS and inflammatory markers at lower BMI cut</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">offs, indicating that they may be on the way to becoming </span><span style="font-family:Verdana;">“</span><span style="font-family:Verdana;">unhealthy</span><span style="font-family:Verdana;">”</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> ob</span><span style="font-family:Verdana;">ese. The lower BMI cut-offs proposed by Indian Consensus Group would help</span><span style="font-family:Verdana;"> in understanding of manifestation of metabolic syndrome.</span></span>
文摘Metabolically healthy obese(MHO)individuals are reported to have a lower risk of developing cardiovascular diseases in comparison with individuals with metabolic syndrome.However,the association between MHO and type 2 diabetes(T2DM)is still controversial.Some studies indicated that MHO is a favorable phenotype for T2DM,but more studies showed that MHO individuals have an increased risk of developing T2DM compared with metabolically healthy normalweight individuals,especially among those who would acquire metabolically unhealthy obesity.This has been supported by finding insulin resistance and lowgrade inflammatory responses in MHO individuals with a tendency for impaired beta-cell dysfunction.Studies also showed that liver fat accumulation increased the risk of incidence of T2DM in MHO.Here,we reviewed current literature on the relationship between MHO and T2DM,discussed the determinants for the development of diabetes in MHO,and summarized the measures for the prevention of T2DM in MHO.
基金supported by the National Natural Science Foundation of China(No.30660203)the National Science and Technology Major Project(No.2013ZX10002009)the Key laboratory of High-Incidence Tumor Prevention (Guangxi Medical University),Ministry of Education(No.GK2015-ZZ06)
文摘Objective:To investigate the prevalence of metabolically healthy obesity(MHO)and its relationship with incidence of metabolic syndrome(MetS),type 2diabetes mellitus(T2DM)and hypertension in individuals in the city of Yulin.Methods:We studied 1,666 participants,aged over18years at baseline,with free of components of the MetS except waist criteria.Participants were divided into three groups based on body mass index(Ibm):lean/normal weight(Ibm<23kg/m2),overweight(Ibm,23-24.9kg/m2),obesity(Ibm≥25 kg/m2).The cumulative incidence of MetS,T2DM and hypertension over 5.21years among groups was assessed.Results:The prevalence of MHO was 19.5%in the baseline population.During an average 5.21year follow-up,the cumulative incidence of MetS,T2DM and hypertension in1,666participants were 16.4%,19.1%and 3.9%,respectively.The obesity group had a significantly higher cumulative incidence of MetS(16.4%vs.3.2%,P<0.001),hypertension(19.1%vs.3.7%,P<0.001),and T2DM(3.9%vs.1.6%,P<0.001)compared to the lean/normal weight group.Each kg/m2 of Ibm carried increased risk for T2DM(19%),hypertension(11%)and MetS(13%).Conclusion:Metabolically healthy obesity individuals confer increased risk for hypertension,T2DM and the MetS than their non-obese counterparts.
文摘In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.Chronic exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in T1DM.As our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of diabetes.Stereotypes regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes care.In this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.
基金supported by the General Program of National Natural Science Foundation of China(81673836)。
文摘Objective:To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.Methods:Seventy-one subjects were enrolled in the study.We assessed blood glucose,blood lipids,body mass index(BMI),and phlegm-dampness pattern,which was confirmed by a traditional Chinese medicine clinician.Of the participants,we included healthy participants with normal weight(NW,n=23),overweight/obese participants with normal metabolism(ONM,n=19),overweight/obese participants with pre-diabetes(OPD,n=12),and overweight/obese participants with marginally-elevated blood lipids(OML,n=17).Among them,the ONM,OPD,and OML groups were diagnosed with phlegmdampness pattern.The data-independent acquisition(DIA)method was first used to analyze the plasma protein expression of each group,and the relevant differential proteins of each group were screened.The co-expressed proteins were evaluated by Venn analysis.The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis(IPA)software.Parallel reaction monitoring(PRM)was used to verify the differential and common proteins in each group.Results:After comparing ONM,OPD,and OML groups with NW group,we identified the differentially expressed proteins(DEPs).Next,we determined the DEPs among OPD,OML,and ONM groups.Using Venn analysis of the DEPs in each group,24 co-expressed proteins were screened.Two co-expressed proteins were verified by PRM.IPA analysis showed that pathways including LXR/RXR activation,acute phase response signaling,and FXR/RXR activation were common to all three groups of phlegmdamp overweight/obesity participants.However,the activation or inhibition of these pathways was different among the three groups.Conclusion:Participants with overweight/obesity have similar proteomic characteristics,though each type shows specific proteomic characteristics.Two co-expressed proteins,VTN and ORM1,are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegmdampness retention.
文摘<em>Objective</em>: Currently Mexico is one of the 1st places in overweight and obesity in teenagers;the health and nutrition national survey in 2018, expresses a 41.1% of women in teenager’s population and a 35.8% in men. To analyze teenagers’ lifestyles with healthy weight against overweight and obesity. <em>Method</em>: Descriptive, transverse, analytic and comparative, a non-probabilistic sampling distributed up to convenience in 2 groups of cases and controls, with 50 teenagers diagnosed with overweight and obesity and 50 teenagers with healthy weight, in a 12 to 15 years old age range;for previous informed consent, the survey Health-Promoting Lifestyle Profile II was applied to measure the lifestyles in 6 dimensions. The analysis got a standard deviation and the association of variables U of Mann-Whitney for independent samples. <em>Results</em>: In both teenagers’ groups male gender prevailed with a 76%, the result in teenagers’ group was identified, an average lifestyle with the dimensions of: interpersonal relationships, feeding, physical activity, stress management and spiritual growth and a low level in the dimension of health responsibility. There is a meaningful difference in the variables association in the spiritual growth lifestyle. <em>Conclusions</em>: The evaluation of both groups is similar to an average score;this shows that there is a risk to unleash overweight, obesity and complications in the adult age of the teenager.
文摘Background: Obesity has become a serious global public health challenge, given that it leads to various adverse health outcomes that include cardiovascular illnesses, diabetes, and certain types of cancer. The World Health Organization (WHO) has estimated that, at the end of 2022, 1 out of every 8 individuals were obese, and that the global adult obesity rates have over doubled since 1990, even as the adolescent obesity rates have quadrupled. Thus, as of 2022, nearly 2.5 billion adults, aged 18 years and above, were overweight, with 890 million being obese. Obesity and overweight incidence rate has been gradually increasing over the years, presenting significant challenges to the healthcare systems throughout the globe. In this regard, the objective of this systematic review was to evaluate the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. Methodology: To attain the above stated study objective, a systematic evaluation of previous studies was carried out, particularly studies that assessed the effectiveness and safety of lifestyle modifications (diet and physical activity) and pharmacotherapy in promoting weight loss and improving metabolic health in overweight adults. The authors have used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the selection of eligible studies for inclusion in the study. Results: The findings indicate that lifestyle interventions resulted in 5% - 10% weight reduction and significant improvements in metabolic indicators, while pharmacotherapy (GLP-1 receptor agonists) achieved up to 15% weight reduction and considerable metabolic health benefits. Further, comparative studies show lifestyle modifications provide overall health benefits, while medication is necessary for non-responders. Conclusion: Individualized treatment strategies are crucial, and further research is needed on long-term consequences and combination therapies.
文摘The growing obesity epidemic is becoming a major public health concern,and the associated costs represent a considerable burden on societies.Among the most common complications of severe obesity are the development of hypertension,dyslipidemia,type 2 diabetes,cardiovascular disease,and various types of cancer.Interestingly,some obese individuals have a favorable metabolic profile and appear to be somehow protected from the detrimental effects of excessive adipose tissue accumulation.These individuals remain normoglycemic,insulin sensitive,and hypotensive with proper blood lipid levels,despite their high body mass index and/or waist circumference.Multiple independent observations have led to the concept of the metabolically healthy obese(MHO) phenotype,yet no consensus has been reached to date regarding a universal definition or the main mechanism behind this phenomenon.Recent technological advances and the use of high-throughput analysis techniques have revolutionized different areas of biomedical research.A multi-omics approach,which is used to investigate changes at different molecular levels in an organism or tissue,may provide valuable insights into the interplay between the molecules or pathways and the roles of different factors involved in the mechanisms underlying metabolic health deterioration.The aim of this review is to present the current status regarding the use of omics technologies to investigate the MHO phenotype,as well as the results of targeted analyses conducted in MHO individuals.
基金supported by the National Key Research and Development Program of China(2018YFA0506901,2019YFA0801701,2022YFA0806502)the National Natural Science Foundation of China(92254308,92157107)the Lingang Laboratory(LG-QS-202204-06)。
文摘Metabolically healthy obesity refers to obese individuals who do not develop metabolic disorders.These people store fat in subcutaneous adipose tissue(SAT)rather than in visceral adipose tissue(VAT).However,the molecules participating in this specific scenario remain elusive.Rab18,a lipid droplet(LD)-associated protein,mediates the contact between the endoplasmic reticulum(ER)and LDs to facilitate LD growth and maturation.In the present study,we show that the protein level of Rab18 is specifically upregulated in the SAT of obese people and mice.Rab18 adipocyte-specific knockout(Rab18 AKO)mice had a decreased volume ratio of SAT to VAT compared with wildtype mice.When subjected to high-fat diet(HFD),Rab18 AKO mice had increased ER stress and inflammation,reduced adiponectin,and decreased triacylglycerol(TAG)accumulation in SAT.In contrast,TAG accumulation in VAT,brown adipose tissue(BAT)or liver of Rab18AKO mice had a moderate increase without ER stress stimulation.Rab18 AKO mice developed insulin resistance and systematic inflammation.Rab18 AKO mice maintained body temperature in response to acute and chronic cold induction with a thermogenic SAT,similar to the counterpart mice.Furthermore,Rab18-deficient 3T3-L1 adipocytes were more prone to palmitate-induced ER stress,indicating the involvement of Rab18 in alleviating lipid toxicity.Rab18 AKO mice provide a good animal model to investigate metabolic disorders such as impaired SAT.In conclusion,our studies reveal that Rab18 is a key and specific regulator that maintains the proper functions of SAT by alleviating lipid-induced ER stress.
文摘Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy(‘‘sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described:(1) normal weight obese(NWO);(2) metabolically obese normal weight;(3) metabolically healthy obese; and(4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.
基金International Life Sciences Institute, Focal Point in China
文摘Objective To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence. Methods A total of 2020 adolescents (1007 boys and 1013 girls) aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index (BMI) categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics (NCHS). Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity (especially for girls since the mid- adolescence), the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity (90.1% for boys and 89.2% for girls) and a relative high specificity (96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively) was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.
基金supported by the National Natural Science Foundation of China(No.81370942)
文摘The study aimed to determine the relationships between the basal metabolic rate(BMR) and body composition of overweight and obese Chinese adults with type 2 diabetes mellitus(DM). This cross-sectional clinical study enrolled 193 Chinese adults with type 2 DM who were overweight(24 kg/m2≤BMI〈28 kg/m2, n=99), or obese(BMI ≥28 kg/m2, n=94). Ninety-seven adults with normal BMIs, including 50 DM patients and 47 healthy adults, were recruited as a control group. BMR was measured by indirect calorimetry; predicted BMR was calculated according to the Schofield equation; and the relationships between BMR, body composition, and biochemical results were determined by the Pearson correlation. The results showed that obese DM patients had significantly higher BMRs than both overweight patients(P〈0.05) and patients with normal BMI did(P〈0.05). The measured BMR was significantly lower than the predicted BMR(P〈0.05) in all groups. Obese and overweight DM patients had significantly greater weight, waist circumference, hip circumference, BMI, body surface area, body fat percentage, fat mass, and fat-free mass than patients with normal BMI. Except for waist circumference, these body composition measurements were significantly increased in obese DM patients when compared with those in overweight DM patients(P〈0.05). Fat-free mass was closely correlated with BMR in both DM patients(r=0.874, P〈0.01) and in healthy controls(r=0.902, P〈0.01). It was concluded that overweight and obese Chinese adults with type 2 DM had increased BMRs compared with normal-weight controls, which may result from the difference in fat-free mass.
文摘目的:探讨不同体重指数(body mass index,BMI)青年男性静息能量消耗(resting energy expenditure,REE)的特点,比较常见静息代谢率(resting metabolic rate,RMR)预测方程与间接测热法的差异。方法:以2017年12月至2021年6月于北京大学第三医院运动医学科进行静息代谢测试的30名青年男性为研究对象,采用间接测热法测定RMR,采用生物电阻抗法测定体成分。分析研究对象REE的特点,并与11个常见预测方程的推算值进行比较,通过配对t检验和组内相关系数(intra-class correlation coefficient,ICC)评估两者差异。结果:30名青年男性的平均年龄为(26.93±4.16)岁,整体RMR为(1960.17±463.11)kcal/d(1 kcal=4.1868 kJ),其中BMI正常者的RMR为(1744.33±249.62)kcal/d,显著低于超重或肥胖者[(2104.06±520.32)kcal/d](P<0.01),但体质量校正后,BMI正常者的RMR显著高于超重或肥胖者[(24.02±2.61)kcal/(kg·d)vs.(19.98±4.38)kcal/(kg·d),P<0.01];不同BMI受试者的RMR与体质量、脂肪量、去脂体重、体表面积、细胞外液呈显著正相关(P均<0.05)。11个预测方程的预测值与实测值的一致性均不佳(ICC均<0.75),其中,超重或肥胖青年男性采用世界卫生组织(World Health Organization,WHO)推荐使用的RMR预测方程的预测值与实测值的一致性相对较高(ICC=0.547,P<0.01)。结论:不同BMI青年男性的RMR存在显著差异,超重或肥胖者要考虑体质量矫正后的RMR情况。不同预测方程的预测值与RMR的实测值一致性较差,建议通过间接测热法准确测定RMR。对于超重和肥胖的青年男性可以考虑采用WHO推荐使用的预测方程计算RMR,但有必要建立适用于不同BMI人群的RMR预测方程。