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.

Effects of excessive body fat on colostrum lipid patterns: overweight/obese vs. normal weight mothers

Prenatal overweight/obesity(OW/OB)can alter colostrum lipid patterns,thereby affecting the lipid metabolism and even the cognitive and healthy development of infants.However,studies on changes in colostrum lipids in the context of OW/OB are limited,particularly for glycerides and polar lipids.Therefore,this study investigated the infl uence of maternal prenatal weight on colostrum in lipid subclasses and molecular species.The concentration of triacylglycerols(TAGs)in the colostrum of the OW/OB group(35894.43 mg/L)was higher than that of the normal weight(NW)group(26639.20 mg/L),suggesting that colostrum from OW/OB mothers could provide more energy to their infants.Further analysis of the fatty acid composition of TAGs revealed that elevated maternal body weight enhanced the concentration of TAGs containing saturated or n-6 fatty acids and shortened the carbon number of TAGs.Docosahexaenoic acid(DHA)/arachidonic acid(AA)/choline-containing lipids,such as DHA-containing TAGs,AA/DHA-containing phosphatidylethanolamine,and choline-containing phospholipids,were present in higher levels in the colostrum of OW/OB mothers than NW mothers.However,the concentrations of palmitic acid-containing TAGs,linoleic acid-containing TAGs,dihomo-γ-linolenic acid-containing TAGs,and polar lipids and the ratio of TAGs containing n-6 fatty acid/n-3 fatty acid were signifi cantly higher in the colostrum of OW/OB mothers than in that of NW mothers.The fatty acid composition and sphingoid bases of sphingolipids were also altered due to elevated body weight.In conclusion,OW/OB affects colostrum lipids with respect to composition,concentration,and percentage.Although the colostrum of healthy OW/OB mothers can provide suffi cient DHA/AA/choline-containing lipids to their infants,normalization of body weight and fat reserves should be considered as a strategy for highquality human milk lipids.

Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring

BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in adulthood.It is very important to identify relevant risk factors and intervene as early as possible.At present,the relationship between maternal and offspring metabolic factors is conflicting.AIM To estimate the association of maternal obesity and gestational diabetes mellitus(GDM)with overweight/obesity and fatty liver risk in offspring at 8 years of age.METHODS The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age.Offspring birth weight,sex,height,weight,and body mass index(BMI)were measured and calculated.FibroScan-502 examination with an M probe(Echosens,Paris,France)was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.RESULTS A total of 430 mother-child pairs were included in the analysis.A total of 62(14.2%)mothers were classified as obese,and 48(11.1%)were classified as having GDM.The mean age of the offspring at follow-up was 8 years old.Thirty-seven(8.6%)offspring were overweight,14(3.3%)had obesity,and 60(14.0%)had fatty liver.The prevalence of overweight,obesity and fatty liver in offspring increased significantly across maternal BMI quartiles(all P<0.05).Among offspring of mothers with GDM,12(25.0%)were overweight,4(8.3%)were obese,and 12(25.0%)had fatty liver vs.25(6.5%),10(2.6%)and 48(12.6%),respectively,for offspring of mothers without GDM(all P<0.05).In multiple logistic regression,after adjustment for variables,the OR for fatty liver in offspring was 8.26(95%CI:2.38-28.75)for maternal obesity and GDM.CONCLUSION This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring,and GDM status also increases the odds of overweight/obesity in offspring.Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.

Gender Differences in the Prevalence of Overweight and Obesity,Associated Behaviors,and Weight-related Perceptions in a National Survey of Primary School Children in China

Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio （OR） 2.30, 95% CI 2.00 to 2.65] and rural areas （OR = 1.85, 95% CI 1.55 to 2.20）. Girls reported healthier diets （e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85） whereas boys consumed fried food （OR = 1.21, 95% CI 1.06 to 1.38） and sugar-sweetened drinks more often （OR = 1.49, 95% CI 1.34 to 1.65）. Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers （OR = 1.35, 95% CI 1.09 to 1.68）, less educated fathers （OR = 0.79, 95% CI 0.63 to 0.99）, and if they frequently consumed carbonated drinks （OR = 1.48, 95% CI 1.07 to 2.05）. Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.

Relationship between circulating irisin levels and overweight/obesity: A meta-analysis

BACKGROUND Currently, the findings about irisin as a novel myokine related to obesity are inconsistent in overweight/obese people. To our knowledge, no systematic analysis has been conducted to evaluate the relationship between irisin levels and overweight/obesity. AIM To evaluate the association between circulating irisin levels and overweight/obesity. METHODS The Cochrane Library, MEDLINE, SCOPUS, and the ISI Web of Science were searched to retrieve all of the studies associated with circulating irisin levels and overweight/obesity. Standard mean difference values and 95% confidence intervals (CI) were estimated and pooled using meta-analysis methodology. RESULTS A total of 18 studies were included in our meta-analysis containing 1005 cases and 1242 controls. Our analysis showed that the circulating irisin level in overweight/obese people was higher than that in overall healthy controls (random effects MD = 0.63;95%CI: 0.22-1.05;P = 0.003). In the subgroup analysis by ethnicity, the irisin level was higher in overweight/obesity people than that in controls in Africa (random effects MD = 3.41;95%CI: 1.23-5.59;P < 0.05) but not in European, Asian, or American populations. In addition, in a subgroup analysis by age, the results showed that obese children exhibited a higher irisin level than controls (random effects MD = 0.86;95%CI: 0.28-1.43;P < 0.05). CONCLUSION This meta-analysis provides evidence that circulating irisin is higher in obese individuals compared to healthy controls and it is important to identify the relationship between circulating irisin levels and overweight/obesity in predicting overweight/obesity.

The prevalence of hypertension overweight/obesity and its relation with cardiovascular disease among middle-aged Chinese population

Objective To investigate the prevalence of hypertension overweight/obesity and the combined effect on the incidence of cardiovascular disease(CVD).Methods The study population(aged from 35 to 64)were selected from 9 regions of China by cluster sampling method.The baseline was conducted in 2010,and the follow-up survey was done in 2017.Participants with 24≤BMI28 kg/m^2 was defined as overweight,BMI≥28 kg/m^2 was defined as obesity.

Serum resistin and adiponectin concentrations in patients with overweight and obesity

Objective:To explore the serum levels of resistin and adiponectin in patients with overweight and obesity.Methods:Fifty-eight cases with normal weight and 24 patients with overweight and obesity have taken fasting blood samples for measurements of plasma glucose,plasma lipids,insulin,C-peptide, thyroid hormones,C-response protein,interleukin-6,TNF-α,leptin,adiponectin and resistin.Results: The concentrations of resistin in cases with overweight and obesity were significant higher than those in the normal weight cases (16.01±8.60 vs 11.63±9.05ng/ml,P=0.047).Pearson relation analysis showed that serum resistin concentrations were positively correlated with age (r=0.476,P=0.019),but negatively correlated with C-peptide (r=-0.45,P=0.024),and adiponectin concentrations were posi- tively correlated with HDL-c (r=0.463,P=0.023) and systolic blood pressure (r=0.409,P=0.047)in overweight and obesity cases.Conclusion:The concentrations of resistin in cases with over-weight and obesity are higher,and there is no correlation between resistin and blood glucose,blood lipids and insulin, while the serum adiponectin concentrations positively correlated with HDL-c and systolic blood pressure.

Lifestyle Characterization in Mexican Teenagers: Healthy Weight against Overweight and Obesity

Objective: 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. Method: 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. Results: 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. Conclusions: 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.

Prevalence and Determinants of Overweight and Obesity among the Catholic University of Eastern Africa Staff, Langata Campus, Nairobi, Kenya

Background: Overweight and obesity are escalating global problem, causing multiple life threatening non-communicable diseases including cardiovascular disease, dyslipidemia, hypertension, type 2 diabetes, osteoarthritis and some forms of cancer [1] [2]. Although the burden is particularly heavy in developing countries including Kenya, yet extensive data is still lacking in these countries. Therefore, the aim of this study was to determine the prevalence and risk factors for obesity and overweight among the Catholic University of Eastern Africa (CUEA) staff, Langata Campus, Nairobi, Kenya. Methods and Materials: A cross sectional, descriptive study was carried out among 301 CUEA staff. WHO stepwise-structured questionnaire was used to collect the data regarding respondents’ socio-demographic, lifestyle characteristics and anthropometric. Data were analyzed using SPSS software version 22.0. Descriptive Data were descriptively analyzed into proportions and frequency tables, while to determine relationships between various variables;One-Way ANOVA was employed. The ethical approval to conduct the study was obtained from KNH-University of Nairobi Ethical Review Committee. The institutional permission was granted by the administration of CUEA. The consent was obtained from the respondents before data collection was commenced. Results: The prevalence of overweight and obesity among the respondents was 47.5% and 36.3% respectively. Based on waist circumference (WC), the prevalence of overweight and obesity among men was 42.6% and 37.2% respectively. While among the women the prevalence of overweight and obesity was 56.8% and 19.5% respectively. The mean BMI (p = 0.006) and the mean WC (p = 0.004) were significantly higher among respondents aged ≤40 years old. Additionally, the mean WC was significantly higher among male respondents compared to the female counterparts (p = 0.003). Daily consumption of vegetables (p = 0.022) and fruits (p = 0.017) was significantly associated with lower WC. While, higher WC (p = 0.015) and BMI (p = 0.003) were significantly associated with daily consumption of fast foods. Respondents who had involved in vigorous intensity physical activity for ≥20 minutes for ≥3 days in a week had significantly lower mean BMI (p = 0.025) and mean WC (p = 0.002) compared to respondents who did not involve in any vigorous intensity physical activity for ≥20 minutes for ≥3 days in a week respectively. Additionally, respondents who had involved in moderate intensity physical activity for ≥30 minutes for ≥5 days in a week had significantly lower mean BMI (p = 0.011) and mean WC (p = 0.023) than respondents who did not involve in moderate intensity physical activity for ≥30 minutes for ≥5 days in a week respectively. Moreover, both mean BMI (p = 0.002) and WC (p = 0.005) were significantly higher among respondents who drink alcohol ≥ 3 standard drinks per drinking occasion compared to those who drink less than 3 standard drinks per drinking occasion. Conclusion and recommendation: There is a high prevalence of overweight and obesity among the respondents. Consumption of fast foods and excessive alcohol is a predictor for obesity. While high consumption of fruits and vegetable and engaging in physical activities are protective against obesity. Institution like the Catholic University of Eastern Africa should be involved in lifestyle modification programs that lead to improve nutrition, physical activity and behavioral change.

Epidemiologic surve of Overweight and obesity among residents aged≥60 years in ronggui community

Objectives To investigate prevalence of overweight and obesity among residents aged 3≥60 years in ronggui community.Methods 1372 ones(570 males,802 females,68.03±6.62 years) Of total 1503 residents aged≥60 years in the 2 villages which were randomly exampled in rong-gui community were investigated.857 ones aged among 60-69 years(62.5%),416 ones aged among 70-79 years (30.3%),99 ones aged≥60 years(7.2%).Investigative items included age,sex,body height,body weight,waist circumference(WC),hip circumference(HC)、fasting plasma glucose(FG),total cholesterol(TC),triglyceride(TG),blood pressure,history of past illness,body mass index(BMI),waist hip ratio(WHR) and waist height ratio(WHtR).Results (1)Of total 1372 residents,the combined prevalence of overweight and obesity was 39.4%.Prevalence of overweight, obesity were 29.4%,10.0%respectively.Prevalence of overweight, obesity of male were 30.8%,6.0%,and female, 28.5%,12.8%respectively.Prevalence of overweight,obesity of residents aged 60-69 years were 31.2%,11.3%,70-79 years were 27.0%,9.1%and≥80 years were 25.2%,2.0% respectively.The difference between male and female、among three age groups were not significant.(2)Of total 1372 residents, prevalence of central adiposity were 34.6%,male was 15.9%and female was 52.4%,female signifleanfly higher than male(P【0.01).(3)The FG^TG.SBP^DBP of residents with overweight、obesity or central adiposity were higher than residents with normal weight or WC(P【0.01).(4)By Pearson correlation analysis,we found that overweight、obesity and central adiposity were obviously correlated with FG、TG、SBP、DBP(P【0.01),were not correlated with TC(P】0.05). Conclusions(1)Of total 1372 residents,the combined preva- lence of overweight and obesity was 39.4%,prevalence of overweight,obesity were 29.4%,10.0%respectively,prevalence of central adiposity were 34.6%,female was 52.4%, female signifleanfly higher than male.(2)overweight.obesity and central adiposity were obviously correlated with FG,TG, SBP,DBP.

Association between sleep duration and overweight/obesity among Chinese children and adolescents:a longitudinal study

Background:To determine the associations between sleep duration and overweight/obesity in Chinese children and adolescents.Methods:This longitudinal study analyzed 3,126 children and adolescents aged 7 to 18 years who had participated in the China Health and Nutrition Survey during 2004-2011.Sleep duration was classified into<9 h,9-10 h,and>10 h for children aged 7-12 years,and<8 h,8-9 h,and>9 h for adolescents aged 13-18 years.Results:After adjusting for confounder,short sleep duration was associated with overweight/obesity for girls aged 7-12 years(β=4.32,95%confidence interval=1.27 to 7.37,P=0.006)and boys aged 13-18 years(β=3.38,95%confidence interval=2.01 to 4.74,P<0.001).No statistically significant association was found among the other 2 groups.Meanwhile,long sleep duration was not statistically significant at any age.Conclusion:The association between short sleep duration and overweight/obesity to be dependent on both age and gender.

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.

An association between overweight and obesity and dietary sugar intake among adults in China

Objective:The aim of this study was to explore the relationship between total dietary sugar and overweight and obesity in North China.Methods:A total of 1,074 permanent residents of Baoding,China aged 18-65 were selected by cluster random sampling method.Relevant information was collected by questionnaires.A multiple logistics regression model was used to analyze the relationship between total dietary sugar intake and obesity-related indicators.Results:The average dietary sugar intake of residents aged between 18 and 65 in Baoding was 34.6 g per day.The average dietary total sugar intake of men was lower than that of women(28.5 g vs.37.4 g).The combined detection rate of overweight and obesity was 68.1%.After adjusting variables such as age,gender,education level,smoking,and energy intake,it was found that excessive dietary sugar intake may be a risk factor for overweight[OR(95%CI)=1.382(1.014,1.889)]and obesity[OR(95%CI):1.490(1.112,2.002)]in men.In women,only dietary sugar intake was found to be a risk factor for overweight[OR(95%CI):1.616(1.001,2.625)].Conclusion:The intake level of dietary sugar of adults in the Baoding area is high,and the problem of overweight and obesity is serious.The level of dietary total sugar intake may be a risk factor for overweight and obesity,but there are gender differences.

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.

Research on the correlation of serum plasminogen activator inhibitor-1 level to vascular complications in type 2 diabetes mellitus patients with overweight or obesity

Objective:To explore the relationship between serum plasminogen activator inhibitor(PAI-1)level and Type 2 Diabetes Mellitus(T2DM)accompanied by overweight or obesity by observing not only the changes of PAI-1 level in T2DM patients with overweight or obesity,but also glucose and lipid metabolism related indicators,the changes of the inflammatory cytokines secreted by adipocytes,and then making an analysis on the correlation to PAI-1.Methods:36 cases of healthy examinees were selected as normal control group(NC group),and the experimental group can be divided into T2DM group(54 cases),Overweight/Obesity group(35 cases)and T2DM+Overweight/Obesity group(48 cases).Glucose and lipid metabolism related indicators such as fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),glycated hemoglobin(HbA1c),fasting insulin(FINS),insulin resistance index(IR),body weight index(BMI)and inflammatory cytokines interleukin-6(IL-6),tumor necrosis factor(TNF-α)and PAI-1 were observed and compared between groups,and then made an analysis to explore the correlation of these factors to PAI-1.Results:(1)Compared with NC group,the levels of FBG,HbA1c,FINS and IR were increased in T2DM group,and the difference was of statistical significance.However,there was no statistically significant difference in TG,TC,LDL-C and BMI between NC group and T2DM group;the levels of FINS,IR,TG,LDL-C,TC and BMI were elevated in Overweight/Obesity group,and the difference was of statistical significance.However,there was no statistically significant difference in FBG and HbA1c;the levels of FBG,HbA1c,FINS,IR,TG,LDL-C,TC and BMI were up-regulated in T2DM+Overweight/Obesity group,and the difference was of statistical significance.Compared with T2DM group,the levels of TG,TC,LDL-C and BMI were increased in Overweight/Obesity group,and the difference was of statistical significance,however,the levels of FBG,HbA1c,FINS and IR were decreased,and the difference was statistically significant;The levels of FINS,IR,TG,TC,LDL-C and BMI were elevated in T2DM+Overweight/Obesity group,and the difference was of statistical significance,however,there was no statistically significant difference in FBG and HbA1c.Compared with Overweight/Obesity group,the levels of FBG,FINS,IR,HbA1c and LDL-C were increased in T2DM+Overweight/Obesity group,and the difference was of statistical significance.However,the difference in TG,TC and BMI was not statistically significant.(2)Compared with NC group,the levels of IL-6,TNF-αand PAI-1 were increased in T2DM group,Overweight/Obesity group and T2DM+Overweight/Obesity group,and the difference was statistically significant.Compared with T2DM group,the levels of IL-6 and TNF-αwere elevated in Overweight/Obesity group,and the difference was of statistical significance,but there was no statistically significant difference in PAI-1;the levels of IL-6,TNF-αand PAI-1 were up-regulated in T2DM+Overweight/Obesity group,and the difference was statistically significant.Compared with Overweight/Obesity group,there was no statistically significant difference in IL-6 and TNF-αbetween T2DM+Overweight/Obesity group and Overweight/Obesity group,but the level of PAI-1 was increased in T2DM+Overweight/Obesity group,and the difference was of statistical significance.(3)Multivariate Logistic Regression Analysis showed that HbA1c,IR,TG,BMI,IL-6 and TNF-αwere independently associated with the level of PAI-1(all p<.05).Conclusions:(1)The level of PAI-1 is higher in type 2 diabetes mellitus patients with overweight or obesity than that in patients only with type 2 diabetes mellitus,and it is one of causes that result in vascular complications.(2)The increase in the level of PAI-1 is considered to be associated with IL-6 and TNF-αsecreted by adipocytes.

Serum Bcl-2 concentrations in overweight-obese subjects with nonalcoholic fatty liver disease

AIM： To shed some light on the relationship between anti-apoptotic serum Bcl-2 concentrations and metabolic status, anthropometric parameters, inflammation indi- ces, and non-alcoholic fatty liver disease severity were investigated in 43 young individuals with fatty liver （FL） and 41 with nonalcoholic steatohepatitis （NASH）. METHODS： Circulating levels of Bcl-2 were detected in 84 patients with ultrasonographic findings of ＂bright liver＂ and/or hyper-transaminasemia of unknown origin and/or increase in T-glutamyl-transpeptidase （T-GT） strictly in the absence of other acute or chronic liver disease, whose age was not advanced, who gave consent to liver biopsy and were then divided on the basis of the histological results into two groups （43 with FL and 41 with NASH）. Twenty lean subjects, apparently healthy and young, were chosen as controls.RESULTS： Serum Bcl-2 concentrations were significantly higher in the FL group than in the NASH group. Insulin resistance and γ-GT activity were significantly higher in NASH subjects. Apoptotic hepatocytes were significantly more numerous in NASH patients. NASH patients presented with larger spleens and augmented C-reactive protein （CRP） concentrations than healthy subjects. Steatosis grade at histology was similar in both NASH and FL populations. The number of apoptotic cells was significantly related to anti-apoptotic Bcl-2 protein values in FL patients. Bcl-2 serum levels positively correlated to body mass index （BMI） values （P ~ 0.0001） but not to age of the population. Triglycerides/HDL ratio correlated well to waist circumference in males （P = 0.0008）. γ-GT activity was associated with homeostatic metabolic assessment （HOMA） （P = 0.0003） and with serum ferritin （P = 0.02）. Bcl-2 concentrations were not related to either spleen size or CRP values. NASH patients pre- sented a weak negative correlation between Iobular inflammation and Bcl-2 levels. A prediction by low values of serum Bcl-2 towards a greater presence of metabolically unhealthy overweight/obese patients （MUOs） was evidenced. HOMA, BMI and uric acid, in that sequence, best predicted serum Bcl-2 concentrations. CONCLUSION： IvlUOs could be detected by Bcl-2 levels. By favoring the life span of hepatocytes, and enhancing triglyceride formation, the anti-apoptotic process inhibits free fatty acids toxicity in FL.

Associations of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain with Offspring Obesity Risk

Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth.The present study aimed to conduct offspring body mass index-for-age Z-scores(BMIZ)trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.Methods A total of 7949 mother-child pairs were enrolled in this study.The weight and length of children were measured at birth,6,12,and 24 months of age to calculate BMIZ.Results The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6,12,and 24 months of age.In contrast,excessive GWG was positively linked to offspring BMIZ,the stable high BMIZ trajectory pattern,and risks of overweight/obesity in the first 24 months of age.These two risk factors also had a significant synergistic effect on macrosomia at birth,but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.Conclusion The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood.The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.

Advanced therapy of overweight or obese polycystic ovary syndrome:a prospective study

Objective:To investigate the effects of orlistat combined with drospirenone/ethinylestradiol tablets(DRSP/EE)on anthropometric indices,sexual hormones,hepatorenal function parameters of overweight or obese patients with polycystic ovary syndrome(PCOS).Methods:75 overweight or obese PCOS patients[body mass index(BMI)>24 kg/m^(2)]were recruited within the Department of Gynecological Endocrinology,Beying Obstetrics and Gynecology Hospital,Capital Medical University,from April 2019 to January 2020,for a prospective,randomized,open-labelled comparing study.They were numbered one by one according to the order of recruitement and randomly divided into two groups,group 1 included 50 patients,orlistat plus DRSP/EE;group 2 included 25 patients treated with DRSP/EE alone.Both groups got the same comprehensive intervention in terms of individualized,standardized managment and monitoring of life-style like diet and exercise.The changes of anthropometric indices,sexual hormones,hepatorenal function parameters before and after three months of treatment in the two groups were compared.Results:After three months of treatment,body weight,waist circumference(WC),hip circumference(HC)and BMI of both groups were significantly decreased(P<0.05).The decrease of body weight,WC,HC and BMI in group 1 was significantly greater than those in group 2(P<0.05).Free testosterone and sex hormone-binding globulin in both groups were significantly changed(P<0.05).There was no significant difference in the hepatorenal function parameters between the two groups after three months treatment(P>0.05).Conclusion:To our knowledge our study is the first to investigate the effects of orlistat combined with DRSP/EE in overweight or obese PCOS patients comparing with the effect of using DRSP/EE alone.Orlistat combined with DRSP/EE was better than use DRSP/EE alone in getting weight loss,which provides an evidence for the choice of rational drug use in clinical practice.

Increased BMR in Overweight and Obese Patients with Type 2 Diabetes may Result from an Increased Fat-free Mass

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.