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Kishore BK. Reverse epidemiology of obesity paradox: Fact or fiction? Physiol Rep 2024; 12:e70107. [PMID: 39472276 PMCID: PMC11521792 DOI: 10.14814/phy2.70107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 10/16/2024] [Accepted: 10/16/2024] [Indexed: 11/02/2024] Open
Abstract
Obesity paradox refers to the clinical observation that when acute cardiovascular decompensation occurs, patients with obesity may have a survival benefit. This apparently runs counter to the epidemiology of obesity, which may increase the risk for non-communicable diseases (NCDs). The scientific community is split on obesity paradox, with some supporting it, while others call it BMI paradox. This review: (a) defines the obesity paradox, and its proposed role in overall mortality in NCDs; (b) delineates evidence for and against obesity paradox; (c) presents the importance of using different indices of body mass to assess the risk in NCDs; (d) examines the role of metabolically healthy obesity in obesity paradox, and emerging importance of cardio-respiratory fitness (CRF) as an independent predictor of CVD risk and all-cause mortality in patients with/without obesity. Evidence suggests that the development of obesity and insulin resistance are influenced by genetic (or ethnic) make up and dietary habits (culture) of the individuals. Hence, this review presents lean diabetes, which has higher total CVD and non-CVD mortality as compared to diabetics with obesity and the possibility of maternal factors programming cardiometabolic risk during fetal development, which may lead to a paradigm shift in our understanding of obesity.
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Affiliation(s)
- Bellamkonda K. Kishore
- Division of Nephrology and Hypertension, Department of Internal MedicineUniversity of Utah HealthSalt Lake CityUtahUSA
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Syed-Abdul MM. Lipid Metabolism in Metabolic-Associated Steatotic Liver Disease (MASLD). Metabolites 2023; 14:12. [PMID: 38248815 PMCID: PMC10818604 DOI: 10.3390/metabo14010012] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Metabolic-associated steatotic liver disease (MASLD) is a cluster of pathological conditions primarily developed due to the accumulation of ectopic fat in the hepatocytes. During the severe form of the disease, i.e., metabolic-associated steatohepatitis (MASH), accumulated lipids promote lipotoxicity, resulting in cellular inflammation, oxidative stress, and hepatocellular ballooning. If left untreated, the advanced form of the disease progresses to fibrosis of the tissue, resulting in irreversible hepatic cirrhosis or the development of hepatocellular carcinoma. Although numerous mechanisms have been identified as significant contributors to the development and advancement of MASLD, altered lipid metabolism continues to stand out as a major factor contributing to the disease. This paper briefly discusses the dysregulation in lipid metabolism during various stages of MASLD.
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Affiliation(s)
- Majid Mufaqam Syed-Abdul
- Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON M5G 1L7, Canada
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Niltwat S, Limwongse C, Charatcharoenwitthaya N, Bunditvorapoom D, Bandidniyamanon W, Charatcharoenwitthaya P. Familial clustering of nonalcoholic fatty liver disease in first-degree relatives of adults with lean nonalcoholic fatty liver disease. Liver Int 2023; 43:2713-2726. [PMID: 37804066 DOI: 10.1111/liv.15758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND AND AIMS The heritability of nonalcoholic fatty liver disease (NAFLD) in lean individuals is undetermined. This familial aggregation study aimed to evaluate familial linkage for NAFLD and the risk of NAFLD among first-degree relatives of probands with lean NAFLD. METHODS This study prospectively recruited cohorts of probands with lean NAFLD, probands with obese NAFLD, and lean probands with non-NAFLD and their respective first-degree relatives. A total of 257 participants were evaluated for liver steatosis, defined by the controlled attenuation parameter ≥288 dB/m2 , metabolic characteristics, and the PNPLA3, TM6SF2, and MBOAT7 polymorphisms. RESULTS The prevalence of NAFLD in first-degree relatives of lean NAFLD probands (39.9%) was similar to that in the obese NAFLD group (36.9%) and was significantly higher than in lean persons without NAFLD (19.1%). First-degree relatives of probands with NAFLD who were male, and had central obesity, hypertriglyceridaemia, insulin resistance, and the PNPLA3 rs738409C>G allele had a significantly higher prevalence of NAFLD. After multivariable adjustment for gender, metabolic characteristics, and the PNPLA3 rs738409C>G allele, first-degree relatives of probands with lean NAFLD (odds ratio [OR], 5.13; 95% CI, 1.77-14.86) and obese NAFLD (OR, 3.20; 95% CI, 1.14-8.99) exhibited an increased risk of NAFLD compared with those of lean controls without NAFLD. CONCLUSIONS Our well-phenotype cohorts revealed familial clustering of NAFLD and higher risks of NAFLD in first-degree relatives of probands with lean or obese NAFLD. The findings encourage clinicians caring for NAFLD patients to be more vigilant for NAFLD in their family members.
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Affiliation(s)
- Sorachat Niltwat
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Division of Gastroenterology, Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Chanin Limwongse
- Division of Medical Genetics, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Duangkamon Bunditvorapoom
- Division of Medical Genetics, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wimolrak Bandidniyamanon
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phunchai Charatcharoenwitthaya
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Syed-Abdul MM. Expanding Pharmacists' Role in the Management of Non-Alcoholic Fatty Liver Disease. PHARMACY 2023; 11:151. [PMID: 37736923 PMCID: PMC10514885 DOI: 10.3390/pharmacy11050151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 09/20/2023] [Indexed: 09/23/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) stands as an increasingly pressing global health challenge, underscoring the need for timely identification to facilitate effective treatment and prevent the progression of chronic liver disorders. Given the projected scarcity of specialized healthcare professionals, particularly hepatologists and gastroenterologists, the role of pharmacists emerges as pivotal in NAFLD management. This article sheds light on the potential of pharmacists within community pharmacy settings, not as diagnostic entities, but as facilitators in recognizing and screening individuals at elevated NAFLD risk using validated non-invasive tools like portable devices and calculators. By prioritizing patient education, referrals, and continuous monitoring, pharmacists can refine NAFLD management, ultimately advancing patient outcomes. Enhancing pharmacists' impact in early NAFLD detection and management can be facilitated through collaborations with healthcare institutions and the incorporation of patient self-assessment tools. This collaborative approach holds promise for further promoting improved liver health within the community.
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Affiliation(s)
- Majid Mufaqam Syed-Abdul
- Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON M5G 1L7, Canada
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Jin W, Jin H, Su X, Che M, Wang Q, Gu L, Ni Z. Development and validation of the prediction model for mortality in patients with diabetic kidney disease in intensive care unit: a study based on medical information Mart for intensive care. Ren Fail 2023; 45:2257808. [PMID: 37724537 PMCID: PMC10512753 DOI: 10.1080/0886022x.2023.2257808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023] Open
Abstract
We aimed to explore factors associated with mortality of diabetic kidney disease (DKD), and to establish a prediction model for predicting the mortality of DKD. This was a cohort study. In total, 1,357 DKD patients were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, with 505 DKD patients being identified from the MIMIC-III as the testing set. The outcome of the study was 1-year mortality. COX proportional hazard models were applied to screen the predictive factors. The prediction model was conducted based on the predictive factors. A receiver operating characteristic (ROC) curve with the area under the curve (AUC) was calculated to evaluate the performance of the prediction model. The median follow-up time was 365.00 (54.50,365.00) days, and 586 patients (43.18%) died within 1 year. The predictive factors for 1-year mortality in DKD included age, weight, sepsis, heart rate, temperature, Charlson Comorbidity Index (CCI), Simplified Acute Physiology Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA), lymphocytes, red cell distribution width (RDW), serum albumin, and metformin. The AUC of the prediction model for predicting 1-year mortality in the training set was 0.771 [95% confidence interval (CI): 0.746-0.795] and the AUC of the prediction model in the testing set was 0.795 (95% CI: 0.756-0.834). This study establishes a prediction model for predicting mortality of DKD, providing a basis for clinical intervention and decision-making in time.
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Affiliation(s)
- Wei Jin
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Haijiao Jin
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Xinyu Su
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Miaolin Che
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Qin Wang
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Leyi Gu
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Zhaohui Ni
- Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
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Biernacka-Bartnik A, Kocełak P, Owczarek AJ, Choręza PS, Markuszewski L, Madej P, Puzianowska-Kuźnicka M, Chudek J, Olszanecka-Glinianowicz M. The cut-off value for HOMA-IR discriminating the insulin resistance based on the SHBG level in women with polycystic ovary syndrome. Front Med (Lausanne) 2023; 10:1100547. [PMID: 36968815 PMCID: PMC10037532 DOI: 10.3389/fmed.2023.1100547] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION The study aimed to estimate the cut-off value for homeostatic model assessment for insulin resistance (HOMA-IR) discriminating the insulin resistance based on the sex hormones binding globulin (SHBG) level in women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS Data from medical records of 854 Caucasian women diagnosed with PCOS were analyzed. Anthropometric data, fasting plasma glucose, insulin and SHBG levels were measured. HOMA-IR was calculated with a standard formula. The cut-off value was calculated using receiver-operating characteristics. RESULTS Circulating SHBG levels below the normal range (26.1 nmol/L) were found in 25.4% of study participants. This subgroup had a significantly higher BMI, fasting glucose and insulin concentrations and HOMA-IR values. Empirical optimal cut-off values for HOMA-IR corresponding to low SHBG levels was ≥2.1 [area under the curve (AUC) 0.73, accuracy 0.65, sensitivity 72.3%, specificity 63.1%, positive predictive value (PPV) 40.0%, negative predictive value (NPV) 87.0%]. CONCLUSIONS Our study suggests that the cut-off point for HOMA-IR discriminating the insulin resistance based on the SHBG level, in young Caucasian women with polycystic ovary syndrome is 2.1, and is consistent with the cut-off value adopted by the European Group for the Study of Insulin Resistance (above 2.0).
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Affiliation(s)
- Aleksandra Biernacka-Bartnik
- Department of Gynecological Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Piotr Kocełak
- Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aleksander Jerzy Owczarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Piotr Stanisław Choręza
- Department of Statistics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Leszek Markuszewski
- Faculty of Medical Sciences and Health Sciences, University of Humanities and Technology in Radom, Radom, Poland
| | - Paweł Madej
- Department of Gynecological Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Monika Puzianowska-Kuźnicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Center of Postgraduate Education, Warsaw, Poland
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Niriella MA, Dassanayake U, de Silva HJ. 'Mistakes in managing non-alcoholic fatty liver disease and how to avoid them'. Scand J Gastroenterol 2023; 58:223-226. [PMID: 36111679 DOI: 10.1080/00365521.2022.2123252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease. NAFLD is estimated to affect 25% of the global population. Therefore, it is widely encountered in primary care. A proportion of patients with NAFLD need a specialist referral, evaluation and follow-up.There have been many updated guidelines on the management of NAFLD in the past few years. Given the burden of NAFLD in the community and its cardiovascular and liver-related adverse outcomes, knowledge of evidence-based standards of care for these patients is essential for any practitioner managing patients with NAFLD. As an asymptomatic disease in the early stages, NAFLD can lead to many mistakes in its management.We aim to highlight some common mistakes in managing NAFLD and attempt to provide evidence-based recommendations.
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Choi MK, Park YMM, Shivappa N, Hong OK, Han K, Steck SE, Hebert JR, Merchant AT, Sandler DP, Lee SS. Inflammatory potential of diet and risk of mortality in normal-weight adults with central obesity. Clin Nutr 2023; 42:208-215. [PMID: 36603461 PMCID: PMC10284332 DOI: 10.1016/j.clnu.2022.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Inflammatory potential of diet may contribute to poor health outcomes in individuals with metabolic disorders. In a representative sample of the U.S. population, we investigated the association between consuming a pro-inflammatory diet and mortality risk in adults with normal range of body mass index (BMI) but with central obesity. METHODS This prospective cohort study included 3521 adults 20-90 years of age with normal BMI who participated in the National Health and Nutrition Examination Survey III, 1988-1994 and did not have a history of cardiovascular disease (CVD) or cancer and did not change their dietary intake in the year preceding baseline measurements. Mortality from all causes, CVD, and cancer was ascertained from the National Death Index. Normal-weight central obesity (NWCO, n = 1777) was defined as those with BMI 18.5 to <25 kg/m2 and waist-to-hip ratio (WHR) ≥0.85 in women and ≥0.90 in men. Severe central obesity was defined as WHR ≥0.92 in women and ≥1.00 in men. The dietary inflammatory index (DII®) was computed based on baseline dietary intake using 24-h dietary recalls, and associations with mortality were estimated using multivariable Cox proportional hazards regression. RESULTS In individuals with NWCO, DII score (i.e., more pro-inflammatory diet) was associated with increased risk of CVD mortality (HRT3 vs T1, 1.89 [95% CI, 1.01-3.53], P trend = 0.04; HR 1 SD increase 1.29 [95% CI, 1.06-1.57]). This association was stronger with more severe central obesity (HRT3 vs T1, 2.79 [95% CI, 1.10-7.03], P trend = 0.03; HR 1 SD increase 1.52 [95% CI, 1.05-2.21]). DII score was not associated with increased risk of mortality in normal-weight individuals without central obesity or with risk of cancer mortality in either group. CONCLUSION Among individuals in the normal-weight range of BMI, a pro-inflammatory diet assessed by high DII scores was associated with increased risk of CVD mortality in those with central obesity.
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Affiliation(s)
- Moon Kyung Choi
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, CA, USA
| | - Yong-Moon Mark Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, AR, USA; Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Oak-Kee Hong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Susan E Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Connecting Health Innovations, LLC, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Kotlyarov S. Immune and metabolic cross-links in the pathogenesis of comorbid non-alcoholic fatty liver disease. World J Gastroenterol 2023; 29:597-615. [PMID: 36742172 PMCID: PMC9896611 DOI: 10.3748/wjg.v29.i4.597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 01/20/2023] Open
Abstract
In recent years, there has been a steady growth of interest in non-alcoholic fatty liver disease (NAFLD), which is associated with negative epidemiological data on the prevalence of the disease and its clinical significance. NAFLD is closely related to the metabolic syndrome and these relationships are the subject of active research. A growing body of evidence shows cross-linkages between metabolic abnormalities and the innate immune system in the development and progression of NAFLD. These links are bidirectional and largely still unclear, but a better understanding of them will improve the quality of diagnosis and management of patients. In addition, lipid metabolic disorders and the innate immune system link NAFLD with other diseases, such as atherosclerosis, which is of great clinical importance.
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Affiliation(s)
- Stanislav Kotlyarov
- Department of Nursing, Ryazan State Medical University, Ryazan 390026, Russia
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Salvatore T, Galiero R, Caturano A, Rinaldi L, Criscuolo L, Di Martino A, Albanese G, Vetrano E, Catalini C, Sardu C, Docimo G, Marfella R, Sasso FC. Current Knowledge on the Pathophysiology of Lean/Normal-Weight Type 2 Diabetes. Int J Mol Sci 2022; 24:ijms24010658. [PMID: 36614099 PMCID: PMC9820420 DOI: 10.3390/ijms24010658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Since early times, being overweight and obesity have been associated with impaired glucose metabolism and type 2 diabetes (T2D). Similarly, a less frequent adult-onset diabetes in low body mass index (BMI) people has been known for many decades. This form is mainly found in developing countries, whereby the largest increase in diabetes incidence is expected in coming years. The number of non-obese patients with T2D is also on the rise among non-white ethnic minorities living in high-income Western countries due to growing migratory flows. A great deal of energy has been spent on understanding the mechanisms that bind obesity to T2D. Conversely, the pathophysiologic features and factors driving the risk of T2D development in non-obese people are still much debated. To reduce the global burden of diabetes, we need to understand why not all obese people develop T2D and not all those with T2D are obese. Moreover, through both an effective prevention and the implementation of an individualized clinical management in all people with diabetes, it is hoped that this will help to reduce this global burden. The purpose of this review is to take stock of current knowledge about the pathophysiology of diabetes not associated to obesity and to highlight which aspects are worthy of future studies.
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Affiliation(s)
- Teresa Salvatore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Livio Criscuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Anna Di Martino
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Gaetana Albanese
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Christian Catalini
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Giovanni Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
- Mediterrannea Cardiocentro, I–80122 Napoli, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I–80138 Naples, Italy
- Correspondence:
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Kobylińska M, Antosik K, Decyk A, Kurowska K, Skiba D. Body Composition and Anthropometric Indicators in Children and Adolescents 6-15 Years Old. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811591. [PMID: 36141862 PMCID: PMC9517036 DOI: 10.3390/ijerph191811591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 06/07/2023]
Abstract
The problem of overweight and obesity among children and adolescents has now become a major public health challenge worldwide. The aim of this study was to assess the effect of age and gender on body composition components and anthropometric indices of children and adolescents aged 6-15 years; in addition, the study aimed to assess body composition indices in relation to BMI (Body Mass Index) levels. The study was conducted at the end of 2019 and in the first quarter of 2020 among 181 pupils attending primary schools. Waist circumference, hip circumference, body weight, and body height were measured. The collected data were used to calculate and then to analyse BMI, WHR (Waist-Hip Ratio), and WHtR (Waist to Height Ratio) indices. Body composition was determined with the use of the Bioelectrical Impedance Analysis (BIA). The analyses' statistics were performed using IBM SPSS Statistics 24 and Excel. The statistical methods used included Chi2 tests of independence, one-factor analysis of variance, and two-factor analysis of variance taking into account the level of α = 0.05. Based on the results, there were no statistically significant differences in the gender and age distributions of the BMI groups. However, the analysis of interaction effects confirmed that there were statistically significant differences according to pubertal age and gender in body fat, muscle mass, hydration, and WHR. Body composition in boys and girls before the age of 12 is similar while, after the age of 12, there are differences between boys and girls in terms of body composition so there is a need to deepen the assessment of body mass, especially in adolescents at the age of puberty, by body composition analysis using the BIA method.
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Xu R, Pan J, Zhou W, Ji G, Dang Y. Recent advances in lean NAFLD. Biomed Pharmacother 2022; 153:113331. [PMID: 35779422 DOI: 10.1016/j.biopha.2022.113331] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 02/09/2023] Open
Abstract
As the predominant type of chronic liver disease, the growing prevalence of nonalcoholic fatty liver disease (NAFLD) has become a concern worldwide. Although obesity plays the most pivotal role in NAFLD, approximately 10-20% of individuals with NAFLD who are not overweight or obese (BMI < 25 kg/m2, or BMI < 23 kg/m2 in Asians) have "lean NAFLD." Lean individuals with NAFLD have a lower prevalence of diabetes, hypertension, hypertriglyceridemia, central obesity, and metabolic syndrome than nonlean individuals with NAFLD, but higher fibrosis scores and rates of cardiovascular morbidity and all-cause mortality in advanced stages. The pathophysiological mechanisms of lean NAFLD remain poorly understood. Studies have shown that lean NAFLD is more correlated with factors such as environmental, genetic susceptibility, and epigenetic regulation. This review will examine the way in which the research progress and characteristic of lean NAFLD, and explore the function of epigenetic modification to provide the basis for the clinical treatment and diagnosis of lean NAFLD.
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Affiliation(s)
- Ruohui Xu
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Jiashu Pan
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China; Department of Digestive Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Wenjun Zhou
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Guang Ji
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
| | - Yanqi Dang
- Institute of Digestive Diseases, Longhua Hospital, China-Canada Center of Research for Digestive Diseases (ccCRDD), Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
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14
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Sureka B, George T, Garg MK, Banerjee M, Deora S, Sukhla R, Goel A, Garg PK, Yadav T, Khera PS. Cutoff values of body fat composition to predict metabolic risk factors with normal waist circumference in Asian Indian population. Eur Radiol 2022; 33:711-719. [DOI: 10.1007/s00330-022-09009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
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15
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Mohammadian Khonsari N, Khashayar P, Shahrestanaki E, Kelishadi R, Mohammadpoor Nami S, Heidari-Beni M, Esmaeili Abdar Z, Tabatabaei-Malazy O, Qorbani M. Normal Weight Obesity and Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:857930. [PMID: 35399938 PMCID: PMC8987277 DOI: 10.3389/fendo.2022.857930] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/14/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Obesity is one of the most significant causes of morbidity and mortality worldwide. Current studies suggest a new type of obesity, normal weight obesity (NWO), which is defined as having a normal body mass index (BMI), but a high-fat percentage increases the risk of cardiometabolic risk factors (CMRFs). This systematic review and meta-analysis aimed to pool the association between NWO with CMRFs. METHODS A systematic search of the literature in all available electronic databases, including Scopus, Web of Science, EMBASE, and PubMed, was performed until October 2021. All English studies that assessed the association of NWOs [compared to normal weight non-obese (NWNO)] and the CMRFs were included. Two investigators extracted data and performed a quality assessment. The heterogeneity between studies was assessed with I-squared and Cochran's Q tests. Odds ratio (OR) was used as an effect size to pool the association of NWO with CMRFs. RESULTS Twenty-five articles that met the inclusion criteria entered the study. The total number of participants was 177,792, with an age range of 13 to 75 years. Most studies were conducted on the general population (adults) and were from China. The result of fixed-effect model meta-analysis indicated an increased odds of hyperglycemia (OR:1.50, 95%:1.23, 1.76), high TG (OR:1.90, 95% CH:1.44, 2.35), low HDL (OR: 1.28, 95% CI:1.06, 1.49) and diabetes (OR:1.39, 95% CI:1.30, 1.49). Moreover, the random effect meta-analysis showed that NWO increased the odds of dyslipidemia (OR:1.83, 95% CI:1.61, 20.4), HTN (OR:1.40, 95% CI:1.28, 1.51) and metabolic syndrome (OR:1.92, 95% CI:1.58, 2.26). Moreover, the mean of all CMRFs except plasma glucose in NWO subjects was statistically higher than NWNO subjects (p-value<0.05). CONCLUSION The present study showed that NWO increased the odds of CMRFs. These findings indicate the inadequacy of the BMI measurement and the need for body fat assessment for a better obesity risk assessment.
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Affiliation(s)
| | - Patricia Khashayar
- Center for Microsystems Technology, Imec & Ghent University, Zwijnaarde-Gent, Belgium
| | - Ehsan Shahrestanaki
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Mohammadpoor Nami
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Motahar Heidari-Beni
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Esmaeili Abdar
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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16
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Xu X, Bhagavathula AS, Zhang Y, Ryan PM, Rahmani J, Qi X. Sex Differences in the TyG Index and Cardiovascular Risk Factors in Metabolically Obese Normal Weight Phenotype. Int J Endocrinol 2022; 2022:1139045. [PMID: 35371258 PMCID: PMC8970881 DOI: 10.1155/2022/1139045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/06/2022] [Accepted: 02/09/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index is a novel surrogate marker of insulin resistance and increases cardiovascular disease risk. We sought to explore sex differences in the relationship between TyG and cardiovascular (CV) risk factors in metabolically obese normal weight (MONW) phenotype. METHOD We analyzed data of 1208 healthy men and nonpregnant women enrolled in a population-based longitudinal study from January 2017-June 2020. MONW phenotype was defined by normal body mass index (BMI: 18-<25 kg/m2) with at least one of the following metabolic disorders (MONW phenotype): elevated blood pressure (BP), hypertriglyceridemia, hyperglycemia, and low HDL cholesterol. Multiple logistic regression analysis was performed to assess the association between elevated TyG index and the CV risk factors in women and men and was presented in odds ratio (OR) with 95% confidence interval (CI). RESULTS Of 1208 subjects, 350 (29%) were MONW phenotype (mean age (years): male: 43.5 ± 12.4 and female: 43.1 ± 12.7) and 858 were metabolically healthy normal weight (MHNW; n = 858 (71%)). MONW women had higher mean values of the TyG index (8.03 ± 5.07) than men (7.47 ± 4.68). Multivariate analysis revealed that the elevated TyG index is significantly associated with MONW phenotype in women (adjusted OR: 8.73, 95% CI: 5.62-13.57) and men (aOR: 5.90, 95% CI: 4.23-8.23). TyG was found to be an excellent predictor of MONW status in both women (receiver operating characteristic (ROC) area under the curve (AUC): 0.979, 95% CI: 0.969-0.988) and men (ROC-AUC: 0.968, 95% CI: 0.952-0.983). CONCLUSION Our study revealed that the TyG index may represent a cost-effective and informative screening tool for the high-risk MONW phenotype.
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Affiliation(s)
- Xiaoyang Xu
- Physical Examination Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | | | - Yong Zhang
- Physical Examination Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- School of Public Health and Health Management, Chongqing Medical University, Chongqing, China
| | - Paul M. Ryan
- School of Medicine, University College Cork, Cork, Ireland
| | - Jamal Rahmani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Xiaoya Qi
- Physical Examination Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, China
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17
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Ahilan V, Krishna VG, Prasad HK, Narayanasamy K, Krishnamoorthy N. Utility of wrist circumference in recognition of metabolic syndrome in overweight and obese South Indian children and adolescents. J Pediatr Endocrinol Metab 2022; 35:65-71. [PMID: 34758245 DOI: 10.1515/jpem-2021-0376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/15/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe the utility of wrist circumference in the identification of cardiometabolic risk in overweight and obese children. METHODS A cross-sectional study was conducted in the obesity clinic of a tertiary care referral hospital over a two year period. All children and adolescents aged 5-17 years with nutritional overweight and obesity were recruited. Data pertaining to chronological age, sex, risk factors and family history were collected. Clinical assessment of anthropometry: Weight, height, body mass index (BMI), Tanner's stage, wrist circumference, blood pressure, waist circumference and triceps skinfold thickness done as per standard criteria. Biochemical assessment of blood glucose, serum insulin, lipid profile, and Homeostatic Model for Insulin Resistance performed after 12 h of fasting. RESULTS We recruited 118 subjects (mean age 10.9 years, 71.1% males, 87.3% obese and 12.7% overweight); 30 (25.4%) had metabolic syndrome. The mean z scores of wrist circumference of children who presented with and without metabolic syndrome was 2.7 ± 0.8 and 2.1 ± 0.7, respectively (p<0.05). We observed a fair positive correlation between wrist circumference z score and BMI z score, (r=0.5; p<0.05). On receiver operating characteristic curve analysis, 97th percentile of wrist circumference predicted metabolic syndrome among overweight and obese children with a sensitivity of 86.7% and specificity of 37.5% (AUC=0.675). CONCLUSIONS Wrist circumference with 97th percentile as a cut-off is a useful tool to identify metabolic syndrome amongst overweight and obese children and adolescents.
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Affiliation(s)
- Vidhya Ahilan
- Department of Pediatrics, ESI Medical College, Chennai, India
| | - Varun Govind Krishna
- Department of Pediatric Endocrinology, Mehta Multispeciality Hospitals India Pvt Ltd, Chennai, India
| | - Hemchand Krishna Prasad
- Department of Pediatric Endocrinology, Mehta Multispeciality Hospitals India Pvt Ltd, Chennai, India
| | - Kannan Narayanasamy
- Department of Pediatrics, Mehta Multispeciality Hospitals India Pvt Ltd, Chennai, India
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18
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Zhu L, Yang WJ, Spence CB, Bhimla A, Ma GX. Lean Yet Unhealthy: Asian American Adults Had Higher Risks for Metabolic Syndrome than Non-Hispanic White Adults with the Same Body Mass Index: Evidence from NHANES 2011-2016. Healthcare (Basel) 2021; 9:1518. [PMID: 34828564 PMCID: PMC8618667 DOI: 10.3390/healthcare9111518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 01/22/2023] Open
Abstract
(1) Background: Despite having consistently lower rates of obesity than other ethnic groups, Asian Americans (AAs) are more likely to be identified as metabolically obese, suggesting an ethnic-specific association between BMI and cardiometabolic outcomes. The goal of this study was to provide an estimate of metabolic syndrome (MetS) prevalence among AAs using national survey data and to compare this rate to that of non-Hispanic Whites (NHWs) over the BMI continuum. (2) Methods: Using the NHANES 2011-2016 data, we computed age-adjusted, gender-specific prevalence of MetS and its individual components for three BMI categories. Furthermore, we conducted multivariate binary logistic regression to examine the risk of MetS in AAs compared to NHWs, controlling for sociodemographic and lifestyle factors. The analysis sample consisted of 2121 AAs and 6318 NHWs. (3) Results: Among AAs, the prevalence of MetS and its components increased with higher BMI levels, with overall prevalence being 5.23% for BMI < 23, 38.23% for BMI of 23-27.4, and 77.68% for BMI ≥ 27.5 in men; and 18.61% for BMI < 23, 47.82% for BMI of 23-27.4, and 67.73% for BMI ≥ 27.5 in women. We also found that for those with a BMI > 23, AAs had a higher predicted risk of MetS than their NHW counterparts of the same BMI level, in both men and women. (4) Conclusions: Our findings support the use of lower BMI ranges for defining overweight and obesity in Asian populations, which would allow for earlier and more appropriate screening for MetS and may better facilitate prevention efforts.
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Affiliation(s)
- Lin Zhu
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
| | - Wei J. Yang
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
| | - Cody B. Spence
- Department of Sociology, College of Liberal Arts, Temple University, 1114 W. Berks St., Philadelphia, PA 19122, USA;
| | - Aisha Bhimla
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
| | - Grace X. Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA; (W.J.Y.); (A.B.); (G.X.M.)
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, 3440 N. Broad St., Philadelphia, PA 19140, USA
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19
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Cannata F, Vadalà G, Ambrosio L, Napoli N, Papalia R, Denaro V, Pozzilli P. The impact of type 2 diabetes on the development of tendinopathy. Diabetes Metab Res Rev 2021; 37:e3417. [PMID: 33156563 DOI: 10.1002/dmrr.3417] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/11/2020] [Accepted: 09/23/2020] [Indexed: 12/29/2022]
Abstract
Tendinopathy is a chronic and often painful condition affecting both professional athletes and sedentary subjects. It is a multi-etiological disorder caused by the interplay among overload, ageing, smoking, obesity (OB) and type 2 diabetes (T2D). Several studies have identified a strong association between tendinopathy and T2D, with increased risk of tendon pain, rupture and worse outcomes after tendon repair in patients with T2D. Moreover, consequent immobilization due to tendon disorder has a strong impact on diabetes management by reducing physical activity and worsening the quality of life. Multiple investigations have been performed to analyse the causal role of the individual metabolic factors occurring in T2D on the development of tendinopathy. Chronic hyperglycaemia, advanced glycation end-products, OB and insulin resistance have been shown to contribute to the development of diabetic tendinopathy. This review aims to explore the relationship between tendinopathy and T2D, in order to define the contribution of metabolic factors involved in the degenerative process and to discuss possible strategies for the clinical management of diabetic tendinopathy.
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Affiliation(s)
- Francesca Cannata
- Department of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | - Gianluca Vadalà
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Luca Ambrosio
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Nicola Napoli
- Department of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
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20
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Korac B, Kalezic A, Pekovic-Vaughan V, Korac A, Jankovic A. Redox changes in obesity, metabolic syndrome, and diabetes. Redox Biol 2021; 42:101887. [PMID: 33579666 PMCID: PMC8113039 DOI: 10.1016/j.redox.2021.101887] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/13/2022] Open
Abstract
"Life is an instantaneous encounter of circulating matter and flowing energy" (Jean Giaja, Serbian physiologist), is one of the most elegant definitions not only of life but the relationship of redox biology and metabolism. Their evolutionary liaison has created inseparable yet dynamic homeostasis in health, which, when disrupted, leads to disease. This interconnection is even more pertinent today, in an era of increasing metabolic diseases of epidemic proportions such as obesity, metabolic syndrome, and diabetes. Despite great advances in understanding the molecular mechanisms of redox and metabolic regulation, we face significant challenges in preventing, diagnosing, and treating metabolic diseases. The etiological association and temporal overlap of these syndromes present significant challenges for the discrimination of appropriate clinical biomarkers for diagnosis, treatment, and outcome prediction. These multifactorial, multiorgan metabolic syndromes with complex etiopathogenic mechanisms are accompanied by disturbed redox equilibrium in target tissues and circulation. Free radicals and reactive species are considered both a causal factor and a consequence of disease status. Thus, determining the subtypes and levels of free radicals and reactive species, oxidatively damaged biomolecules (lipids, proteins, and nucleic acids) and antioxidant defense components as well as redox-sensitive transcription factors and fluxes of redox-dependent metabolic pathways will help define existing and establish novel redox biomarkers for stratifying metabolic diseases. This review aims to discuss diverse redox/metabolic aspects in obesity, metabolic syndrome, and diabetes, with the imperative to help establish a platform for emerging and future redox-metabolic biomarkers research in precision medicine. Future research warrants detailed investigations into the status of redox biomarkers in healthy subjects and patients, including the use of emerging 'omic' profiling technologies (e.g., redox proteomes, lipidomes, metabolomes, and transcriptomes), taking into account the influence of lifestyle (diet, physical activity, sleep, work patterns) as well as circadian ~24h fluctuations in circulatory factors and metabolites.
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Affiliation(s)
- Bato Korac
- Department of Physiology, Institute for Biological Research "Siniša Stanković"- National Institute of Republic of Serbia, University of Belgrade, 11000, Belgrade, Serbia; Center for Electron Microscopy, Faculty of Biology, University of Belgrade, 11000, Belgrade, Serbia.
| | - Andjelika Kalezic
- Department of Physiology, Institute for Biological Research "Siniša Stanković"- National Institute of Republic of Serbia, University of Belgrade, 11000, Belgrade, Serbia
| | - Vanja Pekovic-Vaughan
- Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, William Henry Duncan Building, University of Liverpool, L7 8TX, Liverpool, UK
| | - Aleksandra Korac
- Center for Electron Microscopy, Faculty of Biology, University of Belgrade, 11000, Belgrade, Serbia
| | - Aleksandra Jankovic
- Department of Physiology, Institute for Biological Research "Siniša Stanković"- National Institute of Republic of Serbia, University of Belgrade, 11000, Belgrade, Serbia.
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21
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Arthur RS, Dannenberg AJ, Rohan TE. The association of prediagnostic circulating levels of cardiometabolic markers, testosterone and sex hormone-binding globulin with risk of breast cancer among normal weight postmenopausal women in the UK Biobank. Int J Cancer 2021; 149:42-57. [PMID: 33567105 DOI: 10.1002/ijc.33508] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/07/2021] [Accepted: 02/03/2021] [Indexed: 01/22/2023]
Abstract
Emerging evidence suggests that normal weight postmenopausal women with a relative excess of body fat are at increased breast cancer risk. However, little is known about the associations between obesity-related blood markers and risk of breast cancer among these individuals. In this prospective study comprising 58 629 normal weight postmenopausal women (body mass index between 18.5 kg/m2 and 24.9 kg/m2 ) who were enrolled in the UK Biobank cohort between 2006 and 2010, we examined the associations of glycated hemoglobin, triglycerides, high-density lipoprotein cholesterol, C-reactive protein (CRP), testosterone and sex hormone-binding globulin (SHBG) with risk of breast cancer. A total of 1268 postmenopausal breast cancer cases were ascertained during a median follow-up period of 7 years. Women with CRP, total testosterone and free testosterone (FT) levels in the highest quintile had increased risk of breast cancer compared to those in the lowest quintile (HRQ5 vs Q1 : 1.35, 95% confidence interval [CI]: 1.12-1.63, HR Q5 vs Q1 : 1.47, 95% CI: 1.20-1.80 and HR Q5 vs Q1 : 1.53, 95% CI: 1.23-1.90, respectively), whereas those with SHBG in the highest quintile had reduced risk (HR Q5 vs Q1 : 0.70, 95% CI: 0.56-0.88). These associations were attenuated but persisted after additional adjustment for BMI, fat mass index (whole body fat mass [kg]/height [m2 ]) or waist circumference and after mutual adjustment for testosterone, CRP and/or SHBG. Our study suggests that the risk of postmenopausal breast cancer among normal weight women is increased in association with relatively high levels of CRP and testosterone and with relatively low levels of SHBG.
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Affiliation(s)
- Rhonda S Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Andrew J Dannenberg
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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22
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Wong WK, Chan WK. Nonalcoholic Fatty Liver Disease: A Global Perspective. Clin Ther 2021; 43:473-499. [PMID: 33526312 DOI: 10.1016/j.clinthera.2021.01.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022]
Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD) has been increasing over the years and is now as high in Asia as in the Western world, so much so that it should no longer be considered a Western disease. In fact, China is expected to have the largest increase in the number of NAFLD cases in the coming years. The increase in prevalence of NAFLD in Asia lags behind that of the Western world; thus, there will be a lag in more severe liver disease in Asia despite a similar prevalence of the disease. NAFLD is more prevalent among patients with diabetes mellitus, which is also an important risk factor for more severe liver disease. Patients with diabetes mellitus thus represent an important target for screening for NAFLD and more severe liver disease. Although the PNPLA3 gene polymorphism is the most studied in NAFLD, it is increasingly clear that the cumulative effect of multiple genes likely predisposes to NAFLD and more severe liver disease in the different ethnic groups, and polygenic risk scores are emerging. Lean NAFLD has been largely reported in Asia but is increasingly recognized worldwide. Multiple risk factors have been identified for the disease that manifests in metabolically unhealthy normal weight individuals; however, it responds to lifestyle intervention, similar to the disease in obese individuals. Lastly, the newer term "metabolic dysfunction-associated fatty liver disease" provides a more accurate reflection of the disease, giving more focus to clinicians and researchers in tackling this increasingly common and challenging disease.
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Affiliation(s)
- Wei-Kei Wong
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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23
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Bilic-Curcic I, Cigrovski Berkovic M, Virovic-Jukic L, Mrzljak A. Shifting perspectives - interplay between non-alcoholic fatty liver disease and insulin resistance in lean individuals. World J Hepatol 2021; 13:80-93. [PMID: 33584988 PMCID: PMC7856866 DOI: 10.4254/wjh.v13.i1.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/22/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) has become a significant public health burden affecting not only obese individuals but also people with normal weight. As opposed to previous beliefs, this particular subset of patients has an increased risk of all-cause mortality and worse outcomes than their obese counterparts. The development of NAFLD in lean subjects seems to be interconnected with metabolic phenotype, precisely visceral fat tissue, sarcopenia, and insulin resistance. Here, we summarize available data focusing on the co-dependent relationship between metabolic phenotype, insulin resistance, and development of NAFLD in lean individuals, suggesting more appropriate tools for measuring body fat distribution for the screening of patients at risk.
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Affiliation(s)
- Ines Bilic-Curcic
- Department of Pharmacology, Faculty of Medicine, University of J. J. Strossmayer Osijek, Osijek 31000, Croatia
- Clinical Hospital Center Osijek, Osijek 31000, Croatia
| | - Maja Cigrovski Berkovic
- Department of Kinesiological Anthropology and Methodology, Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia
- Clinical Hospital Dubrava, Zagreb 10000, Croatia
| | - Lucija Virovic-Jukic
- Department of Medicine, Division of Gastroenterology and Hepatology, Sisters of Charity University Hospital, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Anna Mrzljak
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
- Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia.
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24
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Kuroe K, Furuta M, Takeuchi K, Takeshita T, Suma S, Shinagawa T, Shimazaki Y, Yamashita Y. Association between periodontitis and fibrotic progression of non-alcoholic fatty liver among Japanese adults. J Clin Periodontol 2021; 48:368-377. [PMID: 33368494 DOI: 10.1111/jcpe.13415] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/06/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022]
Abstract
AIM Non-alcoholic fatty liver (NAFL) is known to develop into liver fibrosis, which increases the risk of liver cirrhosis and liver cancer. The association between periodontal condition and fibrotic progression of NAFL is unclear. This study aimed to clarify this longitudinal association. MATERIALS AND METHODS Among 4812 participants aged 35-64 years undergoing annual health check-ups between 2003 and 2004, and follow-up 5 years later, 392 participants were diagnosed with NAFL. After excluding participants with liver fibrosis at baseline, 341 participants were followed up for 5 years. NAFL disease fibrosis score of ≥-1.455 was used to evaluate the probability of the presence of liver fibrosis. RESULTS During the follow-up period, 10.6% of participants progressed to liver fibrosis. A higher clinical attachment level (CAL) tended to be associated with the incidence of liver fibrosis in the logistic regression analysis (odds ratio [OR] 1.82, 95% confidence interval [CI], 0.94-3.49, p = .074). The stratified analysis by obesity revealed a significant association with higher CAL in obese participants (OR 2.87, 95% CI, 1.23-6.69, p = .015), but not in non-obese participants. CONCLUSION Higher CAL was associated with an increased probability of liver fibrosis in obese adults with NAFL.
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Affiliation(s)
- Kei Kuroe
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shino Suma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takashi Shinagawa
- Department of Dentistry and Oral Surgery, Heisei Yokohama Hospital, Yokohama, Japan
| | - Yoshihiro Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Olabumuyi A, Abdus-Salam A, Ogunnorin B, Kuti M. Lipid profile in breast cancer patients: A case-control study done at a public tertiary hospital in Ibadan Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_23_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bellissimo MP, Bettermann EL, Tran PH, Crain BH, Ferranti EP, Binongo JN, Hartman TJ, Jones DP, Ziegler TR, Alvarez JA. Physical Fitness but Not Diet Quality Distinguishes Lean and Normal Weight Obese Adults. J Acad Nutr Diet 2020; 120:1963-1973.e2. [PMID: 33011149 PMCID: PMC7686254 DOI: 10.1016/j.jand.2020.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 06/27/2020] [Accepted: 07/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with normal weight obesity (NWO) have increased cardiometabolic disease and mortality risk, but factors contributing to NWO development are unknown. OBJECTIVE The objective of this study was to determine whether diet quality scores and physical fitness levels differed between adults classified as lean, NWO, and overweight-obese. Secondary objectives of the study were to compare clinical biomarkers and food groups and macronutrient intakes between the three groups, and to test for associations between body composition components with diet quality scores and physical fitness levels. DESIGN This is a secondary data analysis from a cross-sectional study that included metropolitan university and health care system employees. Body composition was measured by dual energy x-ray absorptiometry. Individuals with a body mass index <25 kg/m2 and body fat >23% for men and >30% for women were classified as having NWO. Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension score, and Mediterranean Diet Score were calculated from Block food frequency questionnaires. Physical fitness was assessed by measuring maximal oxygen uptake (VO2 maximum) during treadmill testing. PARTICIPANTS/SETTING This study included 693 adults (65% women, mean age 48.9 ± 11.5 years) enrolled between 2007 and 2013 in Atlanta, GA. MAIN OUTCOME MEASURES The main outcome measures were Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Mediterranean Diet Score diet quality scores and maximal oxygen uptake. STATISTICAL ANALYSES Multiple linear regression analyses with post hoc comparisons were used to investigate group differences in fitness, diet quality, and biomarkers. Regression analyses were also used to examine relationships between diet quality scores and fitness with body composition. RESULTS VO2 maximum was significantly lower in the NWO compared with the lean group (36.2 ± 0.8 mL/min/kg vs 40.2 ± 1.0 mL/min/kg; P < 0.05). Individuals with NWO reported similar diet quality to lean individuals and more favorable Alternate Healthy Eating Index and Dietary Approaches to Stop Hypertension scores than individuals with overweight-obesity (P < 0.05). Diet quality scores and physical fitness levels were inversely associated with percent body fat and visceral adipose tissue (P < 0.05), regardless of weight status. Individuals with NWO exhibited higher fasting blood insulin concentrations, insulin resistance, low-density lipoprotein cholesterol, and triglyceride levels, and significantly lower high-density lipoprotein cholesterol levels than lean individuals (P < 0.05). CONCLUSIONS Physical fitness was significantly decreased in individuals with NWO compared with lean individuals. Higher diet quality was associated with decreased total and visceral fat but did not distinguish individuals with NWO from lean individuals.
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Affiliation(s)
- Moriah P. Bellissimo
- Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University; Atlanta, GA, USA
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
| | - Erika L. Bettermann
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Phong H. Tran
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Benjamin H. Crain
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Erin P. Ferranti
- Nell Hodgson School of Nursing, Emory University; Atlanta, GA, USA
| | - Jose N. Binongo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University; Atlanta, GA, USA
| | - Terryl J. Hartman
- Department of Epidemiology, Rollins School of Public Health, Emory University; Atlanta, GA, USA
| | - Dean P. Jones
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Clinical Biomarkers Laboratory, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
| | - Thomas R. Ziegler
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
- Section of Endocrinology, Atlanta Veterans Affairs Medical Center; Decatur, GA, USA
| | - Jessica A. Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine; Atlanta, GA, USA
- Emory Center for Clinical and Molecular Nutrition, Emory University; Atlanta, GA, USA
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Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review. Public Health Nutr 2020; 24:870-881. [PMID: 33256881 DOI: 10.1017/s1368980020004863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. DESIGN The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. SETTING School, university and population. PARTICIPANTS Adolescents between 10 and 19 years old. RESULTS A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. CONCLUSIONS The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).
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Nedyalkova M, Madurga S, Ballabio D, Robeva R, Romanova J, Kichev I, Elenkova A, Simeonov V. Diabetes mellitus type 2: Exploratory data analysis based on clinical reading. OPEN CHEM 2020. [DOI: 10.1515/chem-2020-0086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AbstractDiabetes mellitus type 2 (DMT2) is a severe and complex health problem. It is the most common type of diabetes. DMT2 is a chronic metabolic disorder that affects the way your body metabolizes sugar. With DMT2, your body either resists the effects of insulin or does not produce sufficient insulin to continue normal glucose levels. DMT2 is a disease that requires a multifactorial approach of controlling that includes lifestyle change and pharmacotherapy. Less than ideal management increases the risk of developing complications and comorbidities such as cardiovascular disease and numerous social and economic penalties. That is why the studies dedicated to the pathophysiological mechanisms and the treatment of DMT2 are extremely numerous and diverse. In this study, exploratory data analysis approaches are applied for the treatment of clinical and anthropometric readings of patients with DMT2. Since multivariate statistics is a well-known method for classification, modeling and interpretation of large collections of data, the major aim of the present study was to reveal latent relations between the objects of the investigation (group of patients and control group) and the variables describing the objects (clinical and anthropometric parameters). In the proposed method by the application of hierarchical cluster analysis and principal component analysis it is possible to identify reduced number of parameters which appear to be the most significant discriminant parameters to distinguish between four patterns of patients with DMT2. However, there is still lack of multivariate statistical studies using DMT2 data sets to assess different aspects of the problem like optimal rapid monitoring of the patients or specific separation of patients into patterns of similarity related to their health status which could be of help in preparation of data bases for DMT2 patients. The outcome from the study could be of custom for the selection of significant tests for rapid monitoring of patients and more detailed approach to the health status of DMT2 patients.
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Affiliation(s)
- Miroslava Nedyalkova
- Department of Inorganic Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Ohridski”, 1164 Sofia, 1, Ave. J. Bourchier, Bulgaria
| | - Sergio Madurga
- Department of Physical Chemistry and the Research Institute of Theoretical and Computational Chemistry (IQTCUB) of the University of Barcelona (UB), 08028 Barcelona, C/Martí i Franquès, 1, Spain
| | - Davide Ballabio
- Department of Earth and Environmental Sciences, Chemometrics and QSAR Research Group, University of Milano-Bicocca, Piazza della Scienza, 1, 20126 Milano, Italy
| | - Ralitsa Robeva
- Faculty of Medicine, Medical University – Sofia, Department of Endocrinology, 1431 Sofia, USHATE Acad. Iv. Penchev, Bulgaria
| | - Julia Romanova
- Department of Inorganic Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Ohridski”, 1164 Sofia, 1, Ave. J. Bourchier, Bulgaria
| | - Ilia Kichev
- Department of Inorganic Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Ohridski”, 1164 Sofia, 1, Ave. J. Bourchier, Bulgaria
| | - Atanaska Elenkova
- Faculty of Medicine, Medical University – Sofia, Department of Endocrinology, 1431 Sofia, USHATE Acad. Iv. Penchev, Bulgaria
| | - Vasil Simeonov
- Department of Analytical Chemistry, Faculty of Chemistry and Pharmacy, University of Sofia “St. Kl. Ohridski”, 1164 Sofia, 1, Ave. J. Bourchier, Bulgaria
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Cifre M, Palou A, Oliver P. Impaired CPT1A Gene Expression Response to Retinoic Acid Treatment in Human PBMC as Predictor of Metabolic Risk. Nutrients 2020; 12:E2269. [PMID: 32751185 PMCID: PMC7468959 DOI: 10.3390/nu12082269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/20/2020] [Accepted: 07/27/2020] [Indexed: 01/05/2023] Open
Abstract
Ex vivo human peripheral blood mononuclear cell (PBMC) systems offer the possibility to test transcriptomic effects of food bioactive compounds with potential health effects. We investigated all-trans retinoic acid (ATRA) effect on mRNA expression of key lipid metabolism and inflammatory genes in PBMCs from normal-weight (NW) and overweight-obese (OW-OB) men with different metabolic syndrome-related features. PBMCs were incubated with 10 µM ATRA and mRNA levels of selected genes were analyzed using real-time RT-qPCR. Human ex vivo PBMCs responded to ATRA treatment, but the response for some genes was dependent on body mass index (BMI), with a lower response in PBMC from OW-OB than from NW donors. Moreover, gene expression response was affected by circulating high-density lipoprotein (HDL)-cholesterol levels. Particularly, the response to ATRA of CPT1A, previously reported as a sensitive metabolic risk predictive biomarker, was dependent on HDL levels and not on BMI, being impaired in those individuals with lower HDL levels, specifically in OW-OB. Thus, PBMCs' insensitivity to ATRA, which can be considered as indicative of impaired metabolism, was observed in individuals with higher metabolic risk (OW-OB with low HDL levels). In conclusion, an ex vivo human PBMC system indicates that ATRA response could be influenced by metabolic syndrome features. Moreover, our study reinforces the role of CPT1A as a marker of metabolic risk and points to plasmatic HDL-cholesterol levels as a parameter to take into consideration when the effects of nutritional factors and/or dietary interventions on humans are under study. Further studies including women are required to detect potential gender differences in the observed effects.
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Affiliation(s)
- Margalida Cifre
- Nutrigenomics and Obesity Group, University of the Balearic Islands, 07122 Palma, Spain; (M.C.); (P.O.)
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), 28029 Madrid, Spain
| | - Andreu Palou
- Nutrigenomics and Obesity Group, University of the Balearic Islands, 07122 Palma, Spain; (M.C.); (P.O.)
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
| | - Paula Oliver
- Nutrigenomics and Obesity Group, University of the Balearic Islands, 07122 Palma, Spain; (M.C.); (P.O.)
- CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
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Stanley A, Schuna J, Yang S, Kennedy S, Heo M, Wong M, Shepherd J, Heymsfield SB. Distinct phenotypic characteristics of normal-weight adults at risk of developing cardiovascular and metabolic diseases. Am J Clin Nutr 2020; 112:967-978. [PMID: 32687153 PMCID: PMC7762762 DOI: 10.1093/ajcn/nqaa194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The normal-weight BMI range (18.5-24.9 kg/m2) includes adults with body shape and cardiometabolic disease risk features of excess adiposity, although a distinct phenotype developed on a large and diverse sample is lacking. OBJECTIVE To identify demographic, behavioral, body composition, and health-risk biomarker characteristics of people in the normal-weight BMI range who are at increased risk of developing cardiovascular and metabolic diseases based on body shape. METHODS Six nationally representative waist circumference index (WCI, weight/height0.5) prediction formulas, with BMI and age as covariates, were developed using data from 17,359 non-Hispanic (NH) white, NH black, and Mexican-American NHANES 1999-2006 participants. These equations were then used to predict WCI in 5594 NHANES participants whose BMI was within the normal weight range. Men and women in each race/Hispanic-origin group were then separated into high, medium, and low tertiles based on the difference (residual) between measured and predicted WCI. Characteristics were compared across tertiles; P values for significance were adjusted for multiple comparisons. RESULTS Men and women in the high WCI residual tertile, relative to their BMI and age-equivalent counterparts in the low tertile, had significantly lower activity levels; higher percent trunk and total body fat (e.g. NH white men, X ± SE, 25.3 ± 0.2% compared with 20.4 ± 0.2%); lower percent appendicular lean mass (skeletal muscle) and bone mineral content; and higher plasma insulin and triglycerides, higher homeostatic model assessment of insulin resistance (e.g. NH white men, 1.45 ± 0.07 compared with 1.08 ± 0.06), and lower plasma HDL cholesterol. Percent leg fat was also significantly higher in men but lower in women. Similar patterns of variable statistical significance were present within sex and race/ethnic groups. CONCLUSIONS Cardiometabolic disease risk related to body shape in people who are normal weight according to BMI is characterized by a distinct phenotype that includes potentially modifiable behavioral health risk factors.
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Affiliation(s)
- Abishek Stanley
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - John Schuna
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, South Carolina, SC, USA
| | - Michael Wong
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
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Vusirikala A, Thomas T, Bhala N, Tahrani AA, Thomas GN, Nirantharakumar K. Impact of obesity and metabolic health status in the development of non-alcoholic fatty liver disease (NAFLD): A United Kingdom population-based cohort study using the health improvement network (THIN). BMC Endocr Disord 2020; 20:96. [PMID: 32605642 PMCID: PMC7325099 DOI: 10.1186/s12902-020-00582-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND With the obesity epidemic reaching crisis levels, there has been attention around those who may be resilient to the effects of obesity, termed metabolically healthy obesity (MHO), who initially present without associated metabolic abnormalities. Few longitudinal studies have explored the relationship between MHO and non-alcoholic fatty liver disease (NAFLD), which we address using over 4 million primary care patient records. METHODS A retrospective population-based longitudinal cohort was conducted using The Health Improvement Network (THIN) database incorporating adults with no history of NAFLD or alcohol excess at baseline. Individuals were classified according to BMI category and metabolic abnormalities (diabetes, hypertension and dyslipidaemia). Diagnosis of NAFLD during follow-up was the primary outcome measure. NAFLD was identified by Read codes. RESULTS During a median follow-up period of 4.7 years, 12,867 (0.3%) incident cases of NAFLD were recorded in the cohort of 4,121,049 individuals. Compared to individuals with normal weight and no metabolic abnormalities, equivalent individuals who were overweight, or obese were at significantly greater risk of incident NAFLD (Adjusted HR 3.32 (95%CI 2.98-3.49), and 6.92 (6.40-7.48, respectively). Metabolic risk factors further increased risk, including in those with normal weight and 1 (2.27, 1.97-2.61) or = < 2 (2.39, 1.99-2.87) metabolic abnormalities. CONCLUSIONS MHO individuals are at greater risk of developing NAFLD compared to those with normal weight. This finding supports that the MHO phenotype is a temporary state, and weight must be considered a risk factor even before other risk factors develop. Being normal weight with metabolic abnormalities was also associated with risk of NAFLD.
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Affiliation(s)
- A Vusirikala
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - T Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | - N Bhala
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - A A Tahrani
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Department of Diabetes and Endocrinology, University Hospitals Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
| | - G N Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - K Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
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Kolb R, Zhang W. Obesity and Breast Cancer: A Case of Inflamed Adipose Tissue. Cancers (Basel) 2020; 12:E1686. [PMID: 32630445 PMCID: PMC7352736 DOI: 10.3390/cancers12061686] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity is associated with an increased risk of estrogen receptor-positive breast cancer in postmenopausal women and a worse prognosis for all major breast cancer subtypes regardless of menopausal status. While the link between obesity and the pathogenesis of breast cancer is clear, the molecular mechanism of this association is not completely understood due to the complexity of both obesity and breast cancer. The aim of this review is to highlight the association between obesity and breast cancer and discuss the literature, which indicates that this association is due to chronic adipose tissue inflammation. We will discuss the epidemiological data for the association between breast cancer incidence and progression as well as the potential molecular mechanisms for this association. We will focus on the role of inflammation within the adipose tissue during the pathogenesis of breast cancer. A better understanding of how obesity and adipose tissue inflammation affects the pathogenesis of breast cancer will lead to new strategies to reduce breast cancer risk and improve patient outcomes for obese patients.
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Affiliation(s)
- Ryan Kolb
- Department of Pathology, Immunology and Laboratory Medicine, Gainesville, FL 32610, USA;
- University of Florida Health Cancer Center, Gainesville, FL 32610, USA
| | - Weizhou Zhang
- Department of Pathology, Immunology and Laboratory Medicine, Gainesville, FL 32610, USA;
- University of Florida Health Cancer Center, Gainesville, FL 32610, USA
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Obesity and Body Composition in Preschool Children with Different Levels of Actigraphy-Derived Physical Activity-A Cross-Sectional Study. J Clin Med 2020; 9:jcm9041210. [PMID: 32340122 PMCID: PMC7230783 DOI: 10.3390/jcm9041210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 12/26/2022] Open
Abstract
Detailed associations between physical activity (PA) and body composition in preschoolers remain unclear. The aim of this study was to assess body composition among preschool children differentiated according to their levels of PA and to assess whether meeting the current PA recommendations is associated with a lower risk of obesity, determined by body mass index (BMI) and body fat percentage (BFP). Free-living PA was measured using accelerometers for 7 days in children aged 5 to 6 years. Bioelectrical impedance analysis was used to estimate body composition. Significant differences in content of BFP, fat-free mass (FFM), and total body water (TBW) were found between boys meeting and not meeting moderate-to-vigorous PA (MVPA) recommendations. Meeting the MVPA recommendation was associated with a twofold lower risk of obesity determined by BFP in boys but not in girls. In contrast, the total number of recommended steps per day was not related to adiposity in boys or girls. No statistically significant differences were observed in body composition indices and quintiles of MVPA. Boys in the 3rd–5th quintiles of steps per day presented significantly lower BFP and higher muscle mass and TBW than their peers in quintile 1. However, different associations were observed between body composition indices and quintiles of PA.
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Brown JC, Zhang S, Ou FS, Venook AP, Niedzwiecki D, Lenz HJ, Innocenti F, O’Neil BH, Shaw JE, Polite BN, Denlinger CS, Atkins JN, Goldberg RM, Ng K, Mayer RJ, Blanke CD, O’Reilly EM, Fuchs CS, Meyerhardt JA. Diabetes and Clinical Outcome in Patients With Metastatic Colorectal Cancer: CALGB 80405 (Alliance). JNCI Cancer Spectr 2020; 4:pkz078. [PMID: 32259016 PMCID: PMC7043296 DOI: 10.1093/jncics/pkz078] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/16/2019] [Accepted: 09/20/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Diabetes is a prognostic factor for some malignancies, but its association with outcome in patients with advanced or metastatic colorectal cancer (CRC) is less clear. METHODS This cohort study was nested within a randomized trial of first-line chemotherapy and bevacizumab and/or cetuximab for advanced or metastatic CRC. Patients were enrolled at 508 community and academic centers throughout the National Clinical Trials Network. The primary exposure was physician-documented diabetes at the time of enrollment. The primary endpoint was overall survival (OS); secondary endpoints were progression-free survival (PFS) and adverse events. Tests of statistical significance were two-sided. RESULTS Among 2326 patients, 378 (16.3%) had diabetes. The median follow-up time was 6.0 years. We observed 1973 OS events and 2173 PFS events. The median time to an OS event was 22.7 months among those with diabetes and 27.1 months among those without diabetes (HR = 1.27, 95% CI = 1.13 to 1.44; P < .001). The median time to a PFS event was 9.7 months among those with diabetes and 10.8 months among those without diabetes (HR = 1.16, 95% CI = 1.03 to 1.30; P = .02). Patients with diabetes were more likely to experience no less than grade 3 hypertension (8.1% vs 4.4%; P = .054) but were not more likely to experience other adverse events, including neuropathy. CONCLUSIONS Diabetes is associated with an increased risk of mortality and tumor progression in patients with advanced or metastatic CRC. Patients with diabetes tolerate first-line treatment with chemotherapy and monoclonal antibodies similarly to patients without diabetes.
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Affiliation(s)
| | - Sui Zhang
- Dana-Farber/Partners Cancer Care, Boston, MA
| | - Fang-Shu Ou
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN
| | - Alan P Venook
- University of California, San Francisco, San Francisco, CA
| | | | | | | | - Bert H O’Neil
- Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN
| | | | - Blase N Polite
- Pritzker School of Medicine, University of Chicago, Chicago, IL
| | | | - James N Atkins
- Southeast Clinical Oncology Research Consortium NCORP, Winston-Salem, NC
| | | | - Kimmie Ng
- Dana-Farber/Partners Cancer Care, Boston, MA
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Wyszyńska J, Leszczak J, Podgórska-Bednarz J, Czenczek-Lewandowska E, Rachwał M, Dereń K, Baran J, Drzał-Grabiec J. Body Fat and Muscle Mass in Association with Foot Structure in Adolescents: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E811. [PMID: 32012971 PMCID: PMC7037056 DOI: 10.3390/ijerph17030811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/18/2020] [Accepted: 01/24/2020] [Indexed: 12/31/2022]
Abstract
Prior studies have investigated associations between body mass index (BMI) and foot structure; however, these studies are limited only to the evaluation of the longitudinal arch of the foot and do not evaluate associations with body composition. Therefore, this study examined associations between body fat percentage (BFP) and muscle mass percentage with foot structure in adolescents. This study was conducted with 158 healthy subjects aged from 11 to 13 years. Body fat percentage and muscle mass percentage were estimated using bioelectrical impedance analysis. A podoscope was used to calculate Clarke's angle (CL), the Wejsflog index (WI), hallux valgus angle (ALPHA), and the angle of the varus deformity of the fifth toe (BETA). Lower values of CL were found in participants with excessive BFP (p = 0.021). No differences were observed in the values of the Wejsflog, ALFA or BETA indices between normal and excessive BFP groups. Participants with the lowest muscle mass percentage were significantly more likely to have lower values of CL and WI (p = 0.014 and p < 0.001, respectively). Excess BFP appeared to have a significant effect on the longitudinal arch and low muscle mass percentage on the longitudinal and transverse arches of the foot in adolescents. There was no association between fat and muscle content with positions of the big and fifth toes.
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Affiliation(s)
- Justyna Wyszyńska
- Institute of Health Sciences, Medical College, University of Rzeszów, ul. Kopisto 2a, 35-959 Rzeszów, Poland; (J.L.); (J.P.-B.); (E.C.-L.); (M.R.); (K.D.); (J.B.); (J.D.-G.)
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Mayoral LPC, Andrade GM, Mayoral EPC, Huerta TH, Canseco SP, Rodal Canales FJ, Cabrera-Fuentes HA, Cruz MM, Pérez Santiago AD, Alpuche JJ, Zenteno E, Ruíz HM, Cruz RM, Jeronimo JH, Perez-Campos E. Obesity subtypes, related biomarkers & heterogeneity. Indian J Med Res 2020; 151:11-21. [PMID: 32134010 PMCID: PMC7055173 DOI: 10.4103/ijmr.ijmr_1768_17] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Indexed: 12/13/2022] Open
Abstract
Obesity is a serious medical condition worldwide, which needs new approaches and recognized international consensus in treating diseases leading to morbidity. The aim of this review was to examine heterogeneous links among the various phenotypes of obesity in adults. Proteins and associated genes in each group were analysed to differentiate between biomarkers. A variety of terms for classification and characterization within this pathology are currently in use; however, there is no clear consensus in terminology. The most significant groups reviewed include metabolically healthy obese, metabolically abnormal obese, metabolically abnormal, normal weight and sarcopenic obese. These phenotypes do not define particular genotypes or epigenetic gene regulation, or proteins related to inflammation. There are many other genes linked to obesity, though the value of screening all of those for diagnosis has low predictive results, as there are no significant biomarkers. It is important to establish a consensus in the terminology used and the characteristics attributed to obesity subtypes. The identification of specific molecular biomarkers is also required for better diagnosis in subtypes of obesity.
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Affiliation(s)
- Laura Perez-Campos Mayoral
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Gabriel Mayoral Andrade
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Eduardo Perez-Campos Mayoral
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | | | - Socorro Pina Canseco
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Francisco J. Rodal Canales
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Héctor Alejandro Cabrera-Fuentes
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore, Singapore
- Institute of Biochemistry, Medical School, Justus-Liebig University, Giessen, Germany
| | | | | | - Juan José Alpuche
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Edgar Zenteno
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Hector Martínez Ruíz
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Ruth Martínez Cruz
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Julia Hernandez Jeronimo
- Research Centre-Faculty of Medicine, National Autonomous University of Mexico-Benito Juárez Autonomous University of Oaxaca, Mexico
| | - Eduardo Perez-Campos
- National Technological Institute of Mexico, ITOaxaca, Oaxaca, Mexico
- Clinical Pathology Laboratory ‘Dr. Eduardo Pérez Ortega’ Oaxaca, Mexico
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Van Hulst A, Ybarra M, Mathieu ME, Benedetti A, Paradis G, Henderson M. Determinants of new onset cardiometabolic risk among normal weight children. Int J Obes (Lond) 2019; 44:781-789. [PMID: 31767973 PMCID: PMC7101278 DOI: 10.1038/s41366-019-0483-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 09/18/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To identify determinants for the development of "normal weight metabolically unhealthy" (NWMU) profiles among previously metabolically healthy normal weight children. METHODS The QUALITY cohort comprises youth 8-10 years of age with a parental history of obesity (n = 630). Of these, normal weight children with no metabolic risk factors were identified and followed up 2 years later (n = 193). Children were classified as NWMU if they remained normal weight but developed at least one cardiometabolic risk factor. They were classified as normal weight metabolically healthy otherwise. Multivariable logistic regression models were used to identify whether adiposity (anthropometrics and DXA), lifestyle habits (physical activity, screen time, vegetables, and fruit- and sugar-sweetened beverages intake), fitness, and family history of cardiometabolic disease were associated with new onset NWMU. RESULTS Of the 193 normal weight and metabolically healthy children at baseline, 45 (23%) became NWMU 2 years later (i.e., 48% had elevated HDL cholesterol, 13% had elevated triglycerides, and 4% had impaired fasting glucose). Changes in adiposity between baseline and follow-up were associated with an increased risk of NWMU for all adiposity measures examined (e.g., for ∆zBMI OR = 3.95; 95% CI: 1.76, 8.83). Similarly, a 2-year change in screen time was associated with incident NWMU status (OR = 1.24; 95% CI 1.04, 1.49). CONCLUSIONS Children who increase their adiposity levels as they enter puberty, despite remaining normal weight, are at risk of developing cardiometabolic risk factors. Studies examining long-term consequences of NWMU profiles in pediatrics are needed to determine whether changes in screening practice are warranted.
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Affiliation(s)
| | - Marina Ybarra
- CHU Sainte-Justine Research Centre, Montreal, QC, Canada.,Institut Armand Frappier, Laval, QC, Canada
| | - Marie-Eve Mathieu
- CHU Sainte-Justine Research Centre, Montreal, QC, Canada.,Department of Kinesiology, Université de Montréal, Montreal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Gilles Paradis
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Mélanie Henderson
- CHU Sainte-Justine Research Centre, Montreal, QC, Canada. .,Department of Pediatrics, Université de Montréal, Montreal, QC, Canada.
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Zhao Z, Huo L, Wang L, Wang L, Fu Z, Li Y, Wu X. Survival of Chinese people with type 2 diabetes and diabetic kidney disease: a cohort of 12 -year follow-up. BMC Public Health 2019; 19:1498. [PMID: 31706298 PMCID: PMC6842464 DOI: 10.1186/s12889-019-7859-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/28/2019] [Indexed: 01/13/2023] Open
Abstract
Background The prevalence of type 2 diabetes has grown significantly in China. However, little is known about the survival outcome of people with type 2 diabetes and diabetic kidney disease (DKD). The purpose of this study is to examine the survival of this population and the risk factors for mortality in one suburb cohort of Beijing, China. Methods Four hundred and forty-five people with DKD (48.8% male, age at onset of diabetes 48.8 ± 11.0 years, age at enrollment 57.5 ± 11.6 years) were enrolled in one suburb of Beijing, China between January 1st, 2003 and December 31st, 2015. Mortality ascertainment was censored by December 31st, 2015. Survival analysis was performed by Kaplan–Meier analysis, and Cox proportional hazards regression models were served for risk factor analysis of mortality. The Chiang method was used to estimate life expectancy by age. Results A total of 78 deaths were identified during the 3232 person-years of follow-up. Multivariate Cox regression analysis showed significantly higher risks of mortality with respect to older age, higher systolic blood pressure (SBP), lower body mass index (BMI) and lower estimated glomerular filtration rate (eGFR). The life expectancy at age of 50 was estimated to be 12.3 (95%, CI: 9.0–16.1) years. Circulatory disease was the leading cause of death in this population (accounting for 43.6% of all deaths), followed by diabetic complications (33.3%) and respiratory disease (6.4%). Conclusions Data from one Chinese cohort from 2003 through 2015 showed that people with DKD faced higher risk of death and shorter life expectancy. Factors significantly increasing risk of death included older age, higher SBP, lower BMI and lower eGFR. There is an urgent need to early detection, closely monitoring and effective intervention on DKD.
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Affiliation(s)
- Zihou Zhao
- First Clinical Medical College, Nanjing Medical University, Nanjing, 210029, People's Republic of China
| | - Lili Huo
- Department of Endocrinology, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, People's Republic of China
| | - Lianying Wang
- Department of Endocrinology, Capital University Beijing Friendship Hospital Pinggu Campus, No.59 Xinping North Road, Pinggu District, Beijing, 101200, People's Republic of China
| | - Lijuan Wang
- Department of Endocrinology, Capital University Beijing Friendship Hospital Pinggu Campus, No.59 Xinping North Road, Pinggu District, Beijing, 101200, People's Republic of China
| | - Zuodi Fu
- Department of Endocrinology, Capital University Beijing Friendship Hospital Pinggu Campus, No.59 Xinping North Road, Pinggu District, Beijing, 101200, People's Republic of China
| | - Yufeng Li
- Department of Endocrinology, Capital University Beijing Friendship Hospital Pinggu Campus, No.59 Xinping North Road, Pinggu District, Beijing, 101200, People's Republic of China
| | - Xiaohong Wu
- Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, People's Republic of China.
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Karkhaneh M, Qorbani M, Ataie-Jafari A, Mohajeri-Tehrani MR, Asayesh H, Hosseini S. Association of thyroid hormones with resting energy expenditure and complement C3 in normal weight high body fat women. Thyroid Res 2019; 12:9. [PMID: 31666810 PMCID: PMC6813955 DOI: 10.1186/s13044-019-0070-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 10/03/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A high body fat percentage has a specific effect on activation of the hypothalamic-pituitary-thyroid axis. On the other hand, a slight change in thyroid hormones can affect metabolism and body composition as well as immune function. This study aims to examine the relationship between adiposity, thyroid hormone levels and immunity by comparing resting energy expenditure (REE), serum thyroid hormone levels and complement C3 in normal-weight high body fat (normal weight obesity) women and normal-weight normal body fat women. METHODS In this case-control study, 40 women with normal body weight (BMI < 24.9 kg/m2) and body fat mass (FM) ≥ 30% (normal-weight obesity (NWO) group), and 30 non-obese women (BMI < 24.9 kg/m2) and FM < 30% (non-normal weight obesity (non-NWO) group) were recruited from a sport club in Tehran. Body composition was analyzed using bioimpedance analyzer. Blood samples were collected and analyzed for fasting serum concentration of thyroid hormones (including total T3 and total T4), thyroid-stimulating hormone (TSH), and serum complement C3. REE was measured by an indirect calorimetry. RESULTS Serum T3 and T4 and also complement C3 were higher in the NWO group than in the non-NWO group. Body fat percentages had significant positive correlation with T3 (r; 0.344, P < 0.05), T4 (r; 0.294, P < 0.05), and complement C3 (r; 0.417, P < 0.05). Serum T3 and T4 were also positively correlated with C3 concentration (r; 0.417, p < 0.001) and (r; 0.349, p < 0.05); respectively, but there was no significant correlation between TSH and C3. REE was not significantly different between the two groups. REE only had a significant positive correlation with fat-free mass (r; 0.421, P < 0.001). CONCLUSION An increase in body fat even in the presence of a normal body weight can be accompanied by the changes in thyroid function and inflammatory markers such as complement C3.
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Affiliation(s)
- Maryam Karkhaneh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Asal Ataie-Jafari
- Department of Nutrition, Faculty of Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohamad Reza Mohajeri-Tehrani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Saeed Hosseini
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost street, Naderi street, Keshavarz Blv, Tehran, Iran
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Yu X, Wang L, Zhang W, Ming J, Jia A, Xu S, Li Q, Ji Q. Fasting triglycerides and glucose index is more suitable for the identification of metabolically unhealthy individuals in the Chinese adult population: A nationwide study. J Diabetes Investig 2019; 10:1050-1058. [PMID: 30417578 PMCID: PMC6626942 DOI: 10.1111/jdi.12975] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/29/2018] [Accepted: 11/04/2018] [Indexed: 01/07/2023] Open
Abstract
AIMS/INTRODUCTION Metabolic unhealth can be defined by the components of metabolic syndrome, which is closely connected to insulin resistance. We aimed to determine a simple index to identify metabolic unhealth in the Chinese adult population. MATERIALS AND METHODS A total of 30,291 individuals were screened from the China National Diabetes and Metabolic Disorders Study carried out from June 2007 to May 2008. Metabolic unhealth was defined using components of metabolic syndrome, except waist circumference. We compared the three surrogate indices of insulin resistance: the product of fasting triglycerides and glucose (TyG), triglycerides divided by high-density lipoprotein cholesterol and the metabolic score for insulin resistance for the evaluation of metabolic status. RESULTS All indices had high sensitivity and specificity for the identification of metabolic unhealth, especially the TyG index with an area under the curve of 0.863 for men and 0.867 for women. Participants were divided into subgroups for further analysis. The TyG index also showed high diagnostic values, especially for younger individuals and men with normal waist circumference. Sex-specific cut-offs for three indices were also used to define metabolic unhealth. The TyG index showed the highest agreement with κ values of 0.603 and 0.605 for men and women between the components of metabolic syndrome and three indices. CONCLUSIONS We propose that the TyG index, just read in one blood laboratory test report, is simpler and more suitable for the identification of metabolically unhealthy individuals as well as who have high risk of cardiometabolic diseases of the Chinese adult population.
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Affiliation(s)
- Xinwen Yu
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Li Wang
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Wencheng Zhang
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Jie Ming
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Aihua Jia
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
- Department of EndocrinologyThe First Hospital of YulinYulinChina
| | - Shaoyong Xu
- Department of EndocrinologyXiangyang Central Hospital of Hubei University of Arts and ScienceXiangyangChina
- Department of Health StatisticsFaculty of Preventive MedicineThe Fourth Military Medical UniversityXi'anChina
| | - Qiaoyue Li
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
| | - Qiuhe Ji
- Department of EndocrinologyXijing HospitalThe Fourth Military Medical UniversityXi'anChina
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Urrunaga-Pastor D, De La Fuente-Carmelino L, Toro-Huamanchumo CJ, Pérez-Zavala M, Benites-Zapata VA. Association between waist circumference and waist-to-height ratio with insulin resistance biomarkers in normal-weight adults working in a private educational institution. Diabetes Metab Syndr 2019; 13:2041-2047. [PMID: 31235134 DOI: 10.1016/j.dsx.2019.04.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 04/22/2019] [Indexed: 12/18/2022]
Abstract
AIM To assess the association between elevated waist circumference (WC) and high waist-to-height ratio (WHtR) with insulin resistance biomarkers. METHODS We conducted an analytical cross-sectional study in normal-weight adults. Participants were divided in two groups according to WC or WHtR levels. We considered values of WC ≥ 90 in male participants and WC ≥ 80 in adult women as elevated, and values of WHtR≥0.50 as high, for both genders. Our outcomes were high triglycerides to HDL-cholesterol (TG/HDL-C) ratio and elevated triglycerides and glucose index (TGI). We considered values of TG/HDL-C ratio ≥ 3 as high and TGI values ≥ 8.37 as elevated. We elaborated crude and adjusted Poisson generalized linear models to evaluate the proposed associations and explored the gender interaction using stratified models. We reported the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS We analyzed 355 participants. The prevalence of elevated WC and high WHtR was 17.2% (n = 61) and 33.2% (n = 118), respectively, while the prevalence of high TG/HDL-C ratio and elevated TGI was 24.8% (n = 88) and 12.7% (n = 45), respectively. In the adjusted regression model, elevated WC was associated with high TG/HDL-C ratio only in female participants (aPR = 3.61; 95%CI: 1.59-8.20). Similarly, high WHtR was associated with high TG/HDL-C ratio in women (aPR = 2.54; 95%CI:1.08-5.97). We found an association with statistically marginal significance between elevated WC and elevated TGI in women (aPR = 1.54; 95%CI: 0.95-2.50); as well as for the association between high WHtR and elevated TGI in male participants (aPR = 1.87; 95%CI: 1.00-3.50). CONCLUSION Elevated WC and high WHtR were associated with a high TG/HDL-C ratio in women. It is necessary to perform prospective follow-up studies in the Peruvian population in order to corroborate our results.
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Affiliation(s)
- Diego Urrunaga-Pastor
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Luciana De La Fuente-Carmelino
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Carlos J Toro-Huamanchumo
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Miriam Pérez-Zavala
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
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Jovanović J, Šarac I, Jovanović S, Sokolović D, Govedarović N, Jovanović J. The relationship between occupational stress, health status, and temporary and permanent work disability among security guards in Serbia. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:425-441. [PMID: 30735105 DOI: 10.1080/10803548.2019.1579458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Purpose. This study aimed to examine the influence of occupational stress on health status and work disability among security guards in Serbia. Methods. Three hundred and ninty nine male security guards (aged 25-65 years) were examined during regular medical preventive check-ups at the Institute of Occupational Health. Data on their health status and permanent and temporary work disability were obtained, and correlations with the levels of occupational stress (measured by occupational stress index [OSI] questionnaire) were analysed. Results. A high prevalence of health impairments, including diabetes (38.8%), dyslipidaemia (82.7%), hypertension (69.9%) and metabolic syndrome (77.7%), was found. Highly significant correlations were shown between reported levels of total stress at work (total OSI score) and measured values of glucose, lipids, blood pressure, heart rate, Framingham cardiovascular risk scale, occurrence of diabetes and impaired fasting glucose, dyslipidaemia, hypertension, metabolic syndrome, coronary heart disease, cerebrovascular insults, degenerative eye-fundus changes, and temporary and permanent work disability. All of these correlations remained significant even after adjustments for age, body mass index and smoking status. Regression analysis confirmed the independent effect of occupational stress on the analysed parameters. Conclusions. There is a significant independent impact of occupational stress on development of health impairments and work disability among security guards.
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Affiliation(s)
| | - Ivana Šarac
- Centre for Research Excellence in the Field of Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Serbia
| | | | | | | | - Jovica Jovanović
- Department of Occupational Health, University of Niš, Serbia.,Institute of Occupational Medicine Niš, University of Niš, Serbia
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Estimation of weight status and weight-loss efforts in Korean adults with non-obesity considering metabolic syndrome. Eat Weight Disord 2019; 24:135-142. [PMID: 29427265 DOI: 10.1007/s40519-018-0484-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/20/2018] [Indexed: 01/22/2023] Open
Abstract
PURPOSE To examine whether metabolic syndrome (MetS) is related to estimation of weight status and weight-loss efforts in Korean adults with non-obesity. METHODS In 4345 men and 6387 women in non-obese Koreans (age 49.2 ± 16.7 years, BMI < 25 kg/m2) participating in the 2011-2013 Korean National Health and Nutrition Examination Survey, the presence/absence of MetS using the harmonized criteria, and weight perception and weight-loss efforts using questionnaires were assessed. Estimation of weight status was determined as underestimation, correct estimation, and overestimation based on differences between perceived weight categories and BMI-based categories. RESULTS 15.7% in men and 12.6% in women with BMI < 25 kg/m2 had the MetS. After adjusting for sociodemographic factors, health-related behaviors, treatment of cardiovascular diseases and cardiovascular risk factors, and BMI-based categories, correct estimation and overestimation of weight status in men [odds ratio (95% CI), 1.58 (1.29-1.92); 2.82 (1.48-5.38)], and women [1.53 (1.26-1.86); 1.59 (1.09-2.31)] were positively associated with the presence of MetS compared to those with underestimation of weight status. After adjusting for weight estimation, sociodemographic factors, health-related behaviors, and treatment of cardiovascular diseases and cardiovascular risk factors, weight-loss efforts were positively associated with the presence of MetS [1.66 (1.33-2.08) in men, 1.31 (1.07-1.61) in women] in all subjects, and number of MetS components [1.28 (1.02-1.62) per 1 more component] in those with MetS. CONCLUSIONS In non-obese individuals, correct estimation and overestimation of weight status may be more likely to identify individuals with MetS and concurrent MetS may increase weight-loss efforts regardless of weight estimation. LEVEL OF EVIDENCE Level III, evidence obtained from a case-control observational study.
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Golabi P, Paik J, Fukui N, Locklear CT, de Avilla L, Younossi ZM. Patients With Lean Nonalcoholic Fatty Liver Disease Are Metabolically Abnormal and Have a Higher Risk for Mortality. Clin Diabetes 2019; 37:65-72. [PMID: 30705499 PMCID: PMC6336127 DOI: 10.2337/cd18-0026] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
IN BRIEF Nonalcoholic fatty liver disease (NAFLD) is an increasingly recognized and common cause of chronic liver disease worldwide. Although most patients with NAFLD are obese, a smaller group of NAFLD patients are lean. This study explored the long-term outcomes of lean patients with NAFLD in the United States. Compared to lean individuals without NAFLD, lean people with NAFLD were significantly more likely to be older and male and had higher comorbidities (i.e., diabetes, hyperlipidemia, hypertension, metabolic syndrome, chronic kidney disease, and cardiovascular disease). The presence of NAFLD in lean individuals was independently associated with increased risk of all-cause and cardiovascular mortality.
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Affiliation(s)
- Pegah Golabi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA
| | - James Paik
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA
| | - Natsu Fukui
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA
| | - Cameron T. Locklear
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA
| | - Leyla de Avilla
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA
| | - Zobair M. Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA
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Chung S. Body composition analysis and references in children: clinical usefulness and limitations. Eur J Clin Nutr 2018; 73:236-242. [PMID: 30258101 DOI: 10.1038/s41430-018-0322-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022]
Abstract
The prevalence of obesity is increasing over the world. Especially in Asians compared to Caucasians, there has been a significant increase in the population with major chronic diseases. This has developed over a shorter time period which is associated with socioeconomic changes in recent decades and a greater predisposition to cardiometabolic disorders. Many Asians could be classified has having normal weight but with obesity as evidenced by body composition (BC) and fat distribution. Overweight in Asian adults is classified as a BMI > 23 kg/m2 and obesity as a BMI > 25 kg/m2. An effective strategy to manage the obesity epidemic by focusing on childhood obesity is needed because of the huge impact that obesity exerts on population health. However, monitoring tools are limited to anthropometry such as BMI and BMI z-scores which define overweight and obese as a BMI exceeding the 85th and 95th percentiles, respectively, on reference growth charts. To overcome the limitations of BMI, reference values for BC components have been produced using various techniques. The use of BC charts for children in personalized therapeutic approach has increased, although there is a lack of a consensus on a single reference technique. Zones on BC charts and the personalized values of BC components could be practical, especially for the detection of metabolically unhealthy normal weight (MUN) children. BC charts should be included in the growth chart package and BC monitoring through the entire life course will help us understand the association between growth, aging, health and disease.
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Affiliation(s)
- Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
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Ding WQ, Liu JT, Shang YX, Gao B, Zhao XY, Zhao HP, Wu WJ. DXA-measured visceral fat mass and lean body mass reflect abnormal metabolic phenotypes among some obese and nonobese Chinese children and adolescents. Nutr Metab Cardiovasc Dis 2018; 28:618-628. [PMID: 29699814 DOI: 10.1016/j.numecd.2018.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIM The exact constellation of body composition characteristics among metabolically unhealthy obese (MUO) and nonobese (MUNO) children and adolescents remains unclear. The purpose of this study was to identify the major body composition determinants of metabolically unhealthy phenotypes among Chinese children and adolescents. METHODS AND RESULTS We used data from a cross-sectional survey in 2015 that included 1983 children and adolescents aged 6-18 years. Subjects were classified into two phenotypes based on a combination of body mass index (BMI) and metabolic syndrome components. Body composition was measured by dual-energy X-ray absorptiometry (DXA). Among all boys and among adolescent boys, those with MUNO phenotypes displayed significantly higher indices of body composition except for fat mass (FM) percentage and trunk-to-legs FM ratio compared with the metabolically healthy nonobese phenotype (all P < 0.05). MUO individuals had higher arm FM, lean body mass (LBM), and trunk lean mass compared to metabolically healthy obese individuals (all P < 0.05). Visceral fat mass (VFM) and BMI were the major independent determinants of MUNO (VFM, 6- to 9-year-old boys, OR = 1.02, 95% CI = 1.00-1.03, P = 0.021; BMI, 6- to 9-year-old girls, OR = 1.90, 95% CI = 1.31-2.84, P = 0.001; and adolescent boys, OR = 1.34, 95% CI = 1.23-1.44, P < 0.001). LBM was the major independent predictor of MUO among adolescent boys (OR = 1.90, 95% CI = 1.03-1.17, P = 0.003). CONCLUSIONS Among children and adolescents, the metabolically unhealthy phenotype was associated with excess of body composition, but with significant differences observed based on age and sex. VFM and LBM derived by DXA can predict the metabolically unhealthy phenotype effectively in specific sex and age groups.
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Affiliation(s)
- W Q Ding
- Department of Children and Adolescents Health Care, School of Public Health, Ningxia Medical University, Ningxia, China.
| | - J T Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Y X Shang
- Department of Children and Adolescents Health Care, School of Public Health, Ningxia Medical University, Ningxia, China
| | - B Gao
- Department of Cardiology, Zhongwei Municipal Hospital, Ningxia, China
| | - X Y Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - H P Zhao
- Department of Children and Adolescents Health Care, School of Public Health, Ningxia Medical University, Ningxia, China
| | - W J Wu
- Department of AIDS/STD/TB Control and Prevention, Yinchuan Center for Diseases Prevention and Control, Ningxia, China
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Chooi YC, Ding C, Chan Z, Choo J, Sadananthan SA, Michael N, Lee Y, Velan SS, Magkos F. Moderate Weight Loss Improves Body Composition and Metabolic Function in Metabolically Unhealthy Lean Subjects. Obesity (Silver Spring) 2018; 26:1000-1007. [PMID: 29676049 DOI: 10.1002/oby.22185] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/26/2018] [Accepted: 03/12/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Individuals who have "metabolically obese normal weight" (MONW) have an increased risk for cardiometabolic disease. Moderate weight loss has multiple benefits in people with obesity, but its effects in lean people are unknown. Thus, the effects of diet-induced 5% weight loss on body composition and metabolic function in MONW subjects were evaluated. METHODS Total body fat, visceral adipose tissue (VAT) and subcutaneous abdominal adipose tissue (SAT) volumes, intrahepatic and intramyocellular lipid contents, insulin sensitivity (hyperinsulinemic-euglycemic clamp), glucose tolerance, and postprandial insulin secretion and clearance rates (mixed meal with minimal modeling) were measured before and after 4.8% ± 0.5% weight loss in 11 MONW Asians (48 ± 3 years old, six men and five women, BMI 22.7 ± 0.4 kg/m2 ). RESULTS Weight loss decreased total fat mass by ∼9%, VAT and SAT volumes by ∼11% and ∼17%, respectively, and intrahepatic fat by ∼50% (all P < 0.05). Fasting plasma insulin, triglyceride, and total low- and high-density lipoprotein cholesterol concentrations were also reduced (P < 0.05). Insulin sensitivity indexes (M-value and M/I ratio) increased by 21% to 26% (both P < 0.05); β-cell responsivity and postprandial insulin secretion rate did not change, but insulin clearance rate increased by 16% (P < 0.05). CONCLUSIONS Diet-induced moderate weight loss improves body composition, lipid profile, and insulin sensitivity and thereby reduces cardiometabolic risk in MONW Asians.
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Affiliation(s)
- Yu Chung Chooi
- Clinical Nutrition Research Centre, Agency for Science, Technology and Research, National University Health System, Singapore
| | - Cherlyn Ding
- Clinical Nutrition Research Centre, Agency for Science, Technology and Research, National University Health System, Singapore
| | - Zhiling Chan
- Clinical Nutrition Research Centre, Agency for Science, Technology and Research, National University Health System, Singapore
| | - John Choo
- Clinical Nutrition Research Centre, Agency for Science, Technology and Research, National University Health System, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Yijun Lee
- Clinical Nutrition Research Centre, Agency for Science, Technology and Research, National University Health System, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Agency for Science, Technology and Research, Singapore
| | - Faidon Magkos
- Clinical Nutrition Research Centre, Agency for Science, Technology and Research, National University Health System, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Relationship between body mass index and renal function deterioration among the Taiwanese chronic kidney disease population. Sci Rep 2018; 8:6908. [PMID: 29720598 PMCID: PMC5932053 DOI: 10.1038/s41598-018-24757-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 03/22/2018] [Indexed: 01/06/2023] Open
Abstract
This study investigated the characteristics of patients with different chronic kidney disease (CKD) stages according to various body mass index (BMI) categories and determined the influence of BMI in renal function deterioration. We conducted a multicenter, longitudinal cohort study based on the Epidemiology and Risk Factors Surveillance of CKD project (2008–2013) and National Health Insurance Research Database (2001–2013). A total of 7357 patients with CKD aged 20–85 years from 14 hospitals were included in the study. A higher male sex, diabetes mellitus (DM) and hypertension were noted among overweight and obese CKD patients, while more cancer prevalence was noted among underweight CKD patients. Charlson comorbidity index was significantly higher and correlated with BMI among late CKD patients. Patients with BMI < 18.5 kg/m2 exhibited non-significantly higher events of eGFR decline events in both early and late CKD stages than other BMI groups. BMI alone is not a determinant of CKD progression among our Taiwanese CKD patients. Obesity should be re-defined and body weight manipulation should be individualized in CKD patients.
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Ding C, Chan Z, Chooi YC, Choo J, Sadananthan SA, Chang A, Sasikala S, Michael N, Velan SS, Magkos F. Regulation of glucose metabolism in nondiabetic, metabolically obese normal-weight Asians. Am J Physiol Endocrinol Metab 2018; 314:E494-E502. [PMID: 29351481 DOI: 10.1152/ajpendo.00382.2017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Type 2 diabetes in Asia occurs largely in the absence of obesity. The metabolically obese normal-weight (MONW) phenotype refers to lean subjects with metabolic dysfunction that is typically observed in people with obesity and is associated with increased risk for diabetes. Previous studies evaluated MONW subjects who had greater body mass index (BMI) or total body fat than respective control groups, making interpretation of the results difficult. We evaluated insulin sensitivity (hyperinsulinemic-euglycemic clamp); insulin secretion (mixed meal with oral minimal modeling); intra-abdominal, muscle, and liver fat contents (magnetic resonance); and fasting and postprandial glucose and insulin concentrations in 18 MONW subjects and 18 metabolically healthy controls matched for age (43 ± 3 and 40 ± 3 yr; P = 0.52), BMI (both 22 ± 1 kg/m2; P = 0.69), total body fat (17 ± 1 and 16 ± 1 kg; P = 0.33), and sex (9 men and 9 women in each group). Compared with controls, MONW subjects had an approximately twofold greater visceral adipose tissue volume and an approximately fourfold greater intrahepatic fat content (but similar muscle fat), 20-30% lower glucose disposal rates and insulin sensitivity, and 30-40% greater insulin secretion rates (all P < 0.05). The disposition index, fasting glucose, and HbA1c concentrations were not different between groups, whereas postprandial glucose and insulin concentrations were ~15% and ~65% greater, respectively, in MONW than control subjects (both P < 0.05). We conclude that the MONW phenotype is associated with accumulation of fat in the intra-abdominal area and the liver, profound insulin resistance, but also a robust β-cell insulin secretion response that compensates for insulin resistance and helps maintain glucose homeostasis.
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Affiliation(s)
- Cherlyn Ding
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Zhiling Chan
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Yu Chung Chooi
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - John Choo
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
| | - Amanda Chang
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - S Sasikala
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
- Laboratory of Molecular Imaging, Singapore Bioimaging Consortium, Agency for Science Technology, and Research, Singapore
| | - Faidon Magkos
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System , Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore
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Blaslov K, Kruljac I, Mirošević G, Kirigin Biloš LS, Vrkljan M. The possible role of stress induced hormonal disbalance in the patophysiology of insulin resistane in lean individuals. Med Hypotheses 2018; 114:8-10. [PMID: 29602470 DOI: 10.1016/j.mehy.2018.02.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/25/2018] [Indexed: 12/19/2022]
Abstract
Insulin resistance (IR) is a common denominator of metabolic and hemodynamic disorders simultaneously present in one person and responsible for elevated risk of developing type 2 diabetes (T2DM) and cardiovascular incidents. According to the latest research, IR is present in 25-45% of the general population. Therefore, the mechanism of its development is in the center of scientific and professional interest. Established or acquired factors, or combinations thereof, which disturb any step of the physiological insulin action mechanism: its binding to the cellular receptor, through the complex cascade of intracellular signaling pathways might cause IR. Although the adiposity and its underlying risk factors are considered to be the primary cause of IR, it is present in a great porportion in lean individuals as well. There are insights of the possible role of psychological factors: exposure to stress and deprssion to IR development, although the mechanism of this relationship has not been comperhensively studied. Data driven from cell cultures and experimental animal models suggest that there is an elevated level of counter-regulatory insulin hormones: growth hormone, prolactin and cortisol due to acute stress exposure. However, the relationship between these psychological disorders with the hyperreactivity of the axis of the hypothalamic-pituitaryadrenal axis as the underlying mechanism in the patophysiology of IR in lean individuals has not been systematically investigated. Based on the aforementioned, we hypothesise that this mechanism would be responsible for the formation of IR, and consequently, T2DM in lean individuals. The possible effect of the amount of stress in conjunction with the serum concentration of growth hormone, cortisol, prolactin and dehydroepiandrostendone to the abnormal 5-h oral glucose tollerance test results could contribute to the primary prevention of diabetes and its complications.
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Affiliation(s)
- K Blaslov
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia; University of Zagreb School of medicine, Zagreb, Croatia.
| | - I Kruljac
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia; University of Zagreb School of medicine, Zagreb, Croatia
| | - G Mirošević
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | - Lora S Kirigin Biloš
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | - M Vrkljan
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia; University of Zagreb School of medicine, Zagreb, Croatia
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