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Acta Bio-medica : Atenei Parmensis Aug 2022Obesity has been associated with reduced fertility, although the dynamics and mechanisms which link excess weight to reduced fertility are not yet fully clarified. Obese...
Obesity has been associated with reduced fertility, although the dynamics and mechanisms which link excess weight to reduced fertility are not yet fully clarified. Obese women, especially those with central obesity, are less likely to conceive per cycle. Obese women suffer from perturbations of the hypothalamus-pituitary-ovary axis, disturbances of the menstrual cycle and are up to three times more likely to suffer from oligo/anovulation. A delicate hormonal balance regulates follicular development and the maturation of oocytes and it has been observed that obesity can alter the hormonal environment: adipocytes, in fact, are responsible for the production of a hormone called leptin (present in high quantities in obese women) which has been associated with reduced fecundity. In addition to compromising ovulation, obesity negatively affects the development and implantation of the endometrium. The expression of polycystic ovary syndrome (PCOS) is regulated, in part, by weight, so obese women with PCOS often have a more severe phenotype and higher subfertility rates. Furthermore, obesity impairs women's response to medically assisted procreation (MAP) treatments. The authors have set out to delineate a broad-ranging overview of obesity's impact on female fertility, by drawing upon sources spanning the 1994-2022 period. Assisted reproductive technology (ART) procedures are also discussed as they relate to obese patients. In addition the dynamics by which maternal obesity reportedly affects fetal, neonatal and child development have also been briefly enunciated.
Topics: Anovulation; Female; Fertility; Humans; Infertility, Female; Obesity; Polycystic Ovary Syndrome; Pregnancy
PubMed: 36043953
DOI: 10.23750/abm.v93i4.13466 -
The Journal of Clinical Investigation Oct 2019Obesity originates from an imbalance between caloric intake and energy expenditure that promotes adipose tissue expansion, which is necessary to buffer nutrient excess.... (Review)
Review
Obesity originates from an imbalance between caloric intake and energy expenditure that promotes adipose tissue expansion, which is necessary to buffer nutrient excess. Patients with higher visceral fat mass are at a higher risk of developing severe complications such as type 2 diabetes and cardiovascular and liver diseases. However, increased fat mass does not fully explain obesity's propensity to promote metabolic diseases. With chronic obesity, adipose tissue undergoes major remodeling, which can ultimately result in unresolved chronic inflammation leading to fibrosis accumulation. These features drive local tissue damage and initiate and/or maintain multiorgan dysfunction. Here, we review the current understanding of adipose tissue remodeling with a focus on obesity-induced adipose tissue fibrosis and its relevance to clinical manifestations.
Topics: Adipocytes; Adipose Tissue; Animals; Fibrosis; Humans; Inflammation; Metabolic Diseases; Mice; Myofibroblasts; Neovascularization, Physiologic; Obesity; Stem Cells
PubMed: 31498150
DOI: 10.1172/JCI129192 -
BioMed Research International 2019Libya is following the trend observed in developing countries of steadily becoming more obese, such that obesity in Libya has reached epidemic proportions in the... (Randomized Controlled Trial)
Randomized Controlled Trial
Libya is following the trend observed in developing countries of steadily becoming more obese, such that obesity in Libya has reached epidemic proportions in the twenty-first century. The prevalence of obesity in Libya has more than doubled in the last three decades, with the numbers of overweight and obese adults being continuing to grow. Therefore, this study aimed to estimate and describe the prevalence of overweight and obesity among Libyan men and women. A cross-sectional survey was conducted to examine the prevalence of overweight and obesity among the Libyan population. A multistage sampling technique was employed to select 401 Libyan adults randomly from the Benghazi electoral register. Qualified nurses were allocated to take anthropometric measurements (including visceral fat and Body Mass Index (BMI)) from participants using the Segmental Body Composition Analyser and a portable Stadiometer. The response rate achieved in this cross-sectional study was 78%. Four hundred and one Libyan adult, aged 20-65 years, participated; 253 were female (63%). The prevalence of obesity, overweight, and normal weight among Libyan adults was 42.4%, 32.9%, and 24.7%, respectively. The results also revealed that approximately 75.3% of Libyan adults were overweight and obese, and the prevalence of overweight and obesity in women was significantly higher than that in men (the prevalence of overweight was 33.2% in women compared to 32.4% in men, while the prevalence of obesity was 47.4% in women compared to 33.8% in men, respectively). The findings of this study confirmed that obesity and overweight are the fastest growing issues and have become one of the most serious public health challenges confronting the Libyan authorities. As the obesity epidemic in Libya continues to escalate, with a complete absence of prevention interventions to reduce obesity, more research is desperately needed to follow the trend of gender difference in the prevalence of overweight and obesity among Libyans adults across the Libyan state to improve the effective interventions for preventing obesity.
Topics: Adult; Aged; Cross-Sectional Studies; Female; Humans; Libya; Male; Middle Aged; Obesity; Prevalence; Sex Factors
PubMed: 31392214
DOI: 10.1155/2019/8531360 -
Handbook of Experimental Pharmacology 2022Older medications approved for chronic weight management (orlistat, naltrexone/bupropion, liraglutide 3 mg and, in the USA, phentermine/topiramate) have not been widely...
Older medications approved for chronic weight management (orlistat, naltrexone/bupropion, liraglutide 3 mg and, in the USA, phentermine/topiramate) have not been widely adopted by health care providers. Those medications produce only modest additional weight loss when used to augment lifestyle intervention. However, semaglutide 2.4 mg weekly has recently emerged and produces much more weight loss - on average 15% weight loss at 1 year. Semaglutide's enhanced efficacy and that its class (GLP-1 receptor analogs) is well-known may result in more clinicians adopting pharmacotherapy. Furthermore, the first dedicated cardiovascular outcome trial powered for superiority testing an anti-obesity medication (SELECT) is underway with semaglutide 2.4 mg. A positive outcome will further promote the concept that weight management should be a primary target for cardiometabolic disease control. In phase 3, tirzepatide and cagrilintide/semaglutide combination are showing promise for even greater weight loss efficacy. Another recently approved medication takes a personalized medicine approach; setmelanotide is approved as a therapy for those with some of the ultra-rare genetic diseases characterized by severe, early onset obesity. This chapter reviews the currently available and anticipated medications for chronic weight management as well as those approved for the genetic and syndromic obesities.
Topics: Anti-Obesity Agents; Humans; Islet Amyloid Polypeptide; Obesity; Phentermine; Weight Loss
PubMed: 34783910
DOI: 10.1007/164_2021_560 -
Revue Medicale de Liege Feb 2021Obesity is a chronic disease that is difficult to manage and is often punctuated by treatment failure. Screening for eating disorders, the prevalence of which is high in...
Obesity is a chronic disease that is difficult to manage and is often punctuated by treatment failure. Screening for eating disorders, the prevalence of which is high in overweight patients, is essential in order to minimize the risk of relapse and the «yoyo» phenomenon. As the reason for consulting obese subjects is rare to be eating disorders from the outset, it is necessary to assess this behaviour from the first consultations, in order to propose a specific therapeutic approach aimed at stable weight loss in the long term.
Topics: Binge-Eating Disorder; Feeding and Eating Disorders; Humans; Obesity; Overweight
PubMed: 33543861
DOI: No ID Found -
The Nursing Clinics of North America Dec 2021
Topics: Global Health; Health Care Costs; Health Policy; Humans; Nurse's Role; Obesity; Overweight
PubMed: 34749902
DOI: 10.1016/j.cnur.2021.08.004 -
Current Problems in Cardiology Jan 2024Cardiovascular disease (CVD) is a leading global cause of death, with preventable risk factors like obesity contributing most to it. Obesity's association with CVD... (Review)
Review
Cardiovascular disease (CVD) is a leading global cause of death, with preventable risk factors like obesity contributing most to it. Obesity's association with CVD originate from factors like inflammation, insulin resistance, and altered lipid profiles. Obesity also raises the risk of atrial fibrillation (AF) and sudden cardiac death. Semaglutide, a GLP-1 receptor agonist, initially used for weight loss and diabetes, emerged as a breakthrough in CVD prevention. The SELECT trial assessed semaglutide's impact on major adverse cardiovascular events (MACE). In this double-blind, placebo-controlled trial, 17,604 adults with CVD and obesity were given a weekly 2.4 mg dose of semaglutide or placebo. The trial observed a significant 20% reduction in MACE risk for those receiving semaglutide, demonstrating its potential in obesity-associated CVD prevention. This shift marks a transformative approach to obesity management and CVD prevention. However, further research is needed to fully comprehend semaglutide's cardiovascular benefits and potential risks.
Topics: Adult; Humans; Hypoglycemic Agents; Diabetes Mellitus, Type 2; Cardiovascular Diseases; Obesity; Randomized Controlled Trials as Topic
PubMed: 37640171
DOI: 10.1016/j.cpcardiol.2023.102060 -
International Journal of Molecular... Nov 2020In obese individuals, atherogenic dyslipidemia is a very common and important factor in the increased risk of cardiovascular disease. Adiposity-associated dyslipidemia... (Review)
Review
In obese individuals, atherogenic dyslipidemia is a very common and important factor in the increased risk of cardiovascular disease. Adiposity-associated dyslipidemia is characterized by low high-density lipoprotein cholesterol (HDL-C) levels and an increase in triglyceride-rich lipoproteins. Several factors and mechanisms are involved in lowering HDL-C levels in the obese state and HDL quantity and quality is closely related to adiponectin levels and the bioactive lipid sphingosine-1-phosphate. Recent studies have shown that obesity profoundly alters HDL metabolism, resulting in altered HDL subclass distribution, composition, and function. Importantly, weight loss through gastric bypass surgery and Mediterranean diet, especially when enriched with virgin olive oil, is associated with increased HDL-C levels and significantly improved metrics of HDL function. A thorough understanding of the underlying mechanisms is crucial for a better understanding of the impact of obesity on lipoprotein metabolism and for the development of appropriate therapeutic approaches. The objective of this review article was to summarize the newly identified changes in the metabolism, composition, and function of HDL in obesity and to discuss possible pathophysiological consequences.
Topics: Animals; Bariatric Surgery; Cardiovascular Diseases; Humans; Lipoproteins, HDL; Models, Biological; Obesity; Risk Factors
PubMed: 33256096
DOI: 10.3390/ijms21238985 -
Frontiers in Cellular and Infection... 2022The prevalence of obesity is increasingly common in the United States, with ~25% of women of reproductive age being overweight or obese. Metaflammation, a chronic low... (Review)
Review
The prevalence of obesity is increasingly common in the United States, with ~25% of women of reproductive age being overweight or obese. Metaflammation, a chronic low grade inflammatory state caused by altered metabolism, is often present in pregnancies complicated by obesity. As a result, the fetuses of mothers who are obese are exposed to an in-utero environment that has altered nutrients and cytokines. Notably, both human and preclinical studies have shown that children born to mothers with obesity have higher risks of developing chronic illnesses affecting various organ systems. In this review, the authors sought to present the role of cytokines and inflammation during healthy pregnancy and determine how maternal obesity changes the inflammatory landscape of the mother, leading to fetal reprogramming. Next, the negative long-term impact on offspring's health in numerous disease contexts, including offspring's risk of developing neuropsychiatric disorders (autism, attention deficit and hyperactive disorder), metabolic diseases (obesity, type 2 diabetes), atopy, and malignancies will be discussed along with the potential of altered immune/inflammatory status in offspring as a contributor of these diseases. Finally, the authors will list critical knowledge gaps in the field of developmental programming of health and diseases in the context of offspring of mothers with obesity, particularly the understudied role of hematopoietic stem and progenitor cells.
Topics: Child; Cytokines; Diabetes Mellitus, Type 2; Female; Humans; Inflammation; Obesity; Obesity, Maternal; Pregnancy
PubMed: 36189369
DOI: 10.3389/fcimb.2022.940937 -
Annales D'endocrinologie Feb 2022Rare genetic forms of obesity are linked to impaired energy balance (i.e., eating behaviour and energy expenditure) involving hypothalamic pathways. More than 60 genes... (Review)
Review
Rare genetic forms of obesity are linked to impaired energy balance (i.e., eating behaviour and energy expenditure) involving hypothalamic pathways. More than 60 genes coding for proteins located in the hypothalamic leptin/melanocortin pathway contribute to the development of these rare forms of obesity. The ambition of the French National Protocol for the Diagnosis and Care (PNDS) of Obesity of Rare Causes was to establish practical recommendations for assessment and management at all ages. This report is available on the website of the French Health Authority (HAS). In addition to severe obesity, patients often display obesity-related comorbidities and neuropsychological/psychiatric disorders. These complex conditions make clinical management particularly challenging. Early diagnosis is critical for the organization of coordinated specialized multidisciplinary care, with mandatory interaction between caregivers, social partners and families. Strategies to prevent aggravation of obesity consist in limiting access to food, establishing a reassuring daily eating environment, and the practice of sustained adapted supervised daily physical activity. The implementation of genetic diagnosis in clinical practice now enables a personalized medicine approach with access to new drug therapies, and improves the analysis of the risk/benefit ratio of bariatric surgery.
Topics: Bariatric Surgery; Energy Metabolism; Humans; Hypothalamus; Leptin; Obesity; Obesity, Morbid
PubMed: 34953778
DOI: 10.1016/j.ando.2021.12.003