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Nature Metabolism Aug 2019The discovery of leptin changed the view of adipose tissue from that of a passive vessel that stores fat to that of a dynamic endocrine organ that actively regulates... (Review)
Review
The discovery of leptin changed the view of adipose tissue from that of a passive vessel that stores fat to that of a dynamic endocrine organ that actively regulates behaviour and metabolism. Secreted by adipose tissue, leptin functions as an afferent signal in a negative feedback loop, acting primarily on neurons in the hypothalamus and regulating feeding and many other functions. The leptin endocrine system serves a critical evolutionary function by maintaining the relative constancy of adipose tissue mass, thereby protecting individuals from the risks associated with being too thin (starvation and infertility) or too obese (predation). In this Review, the biology of leptin is summarized, and a conceptual framework is established for studying the pathogenesis of obesity, which, analogously to diabetes, can result from either leptin hyposecretion or leptin resistance. Herein, these two states are distinguished with the terms 'type 1 obesity' and 'type 2 obesity': type 1 obesity describes a subset of obese individuals with low endogenous plasma leptin levels who respond to leptin therapy, whereas type 2 obesity describes most obese individuals, who are leptin resistant but might respond to leptin therapy in combination with other drugs, such as leptin sensitizers.
Topics: Adipose Tissue; Animals; Energy Metabolism; Humans; Leptin; Models, Genetic; Obesity
PubMed: 32694767
DOI: 10.1038/s42255-019-0095-y -
International Journal of Molecular... Feb 2024Obesity or excessive weight gain is identified as the most important and significant risk factor in the development and progression of type 2 diabetes mellitus (DM) in... (Review)
Review
Obesity or excessive weight gain is identified as the most important and significant risk factor in the development and progression of type 2 diabetes mellitus (DM) in all age groups. It has reached pandemic dimensions, making the treatment of obesity crucial in the prevention and management of type 2 DM worldwide. Multiple clinical studies have demonstrated that moderate and sustained weight loss can improve blood glucose levels, insulin action and reduce the need for diabetic medications. A combined approach of diet, exercise and lifestyle modifications can successfully reduce obesity and subsequently ameliorate the ill effects and deadly complications of DM. This approach also helps largely in the prevention, control and remission of DM. Obesity and DM are chronic diseases that are increasing globally, requiring new approaches to manage and prevent diabetes in obese individuals. Therefore, it is essential to understand the mechanistic link between the two and design a comprehensive approach to increase life expectancy and improve the quality of life in patients with type 2 DM and obesity. This literature review provides explicit information on the clinical definitions of obesity and type 2 DM, the incidence and prevalence of type 2 DM in obese individuals, the indispensable role of obesity in the pathophysiology of type 2 DM and their mechanistic link. It also discusses clinical studies and outlines the recent management approaches for the treatment of these associated conditions. Additionally, in vivo studies on obesity and type 2 DM are discussed here as they pave the way for more rigorous development of therapeutic approaches.
Topics: Humans; Diabetes Mellitus, Type 2; Quality of Life; Obesity; Risk Factors; Weight Loss
PubMed: 38339160
DOI: 10.3390/ijms25031882 -
Frontiers in Cellular and Infection... 2022The clinical efficacy of fecal microbiota transplantation (FMT) in patients with non-alcoholic fatty liver disease (NAFLD) and the variant effects of FMT on lean and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND AIMS
The clinical efficacy of fecal microbiota transplantation (FMT) in patients with non-alcoholic fatty liver disease (NAFLD) and the variant effects of FMT on lean and obese NAFLD patients remain elusive. Our study aimed to determine the clinical efficacy and safety of FMT for patients with NAFLD, elucidating its different influences on lean and obese patients with NAFLD.
METHODS
We performed a randomized and controlled clinical trial. Patients in the non-FMT group were administered oral probiotics. In the FMT group, patients were randomized to receive FMT with donor stool (heterologous) colonoscopy, followed by three enemas over 3 days. Both groups were also required to maintain a healthy diet and keep regular exercise for more than 40 min every day. They returned to the hospital for reexamination 1 month after treatment.
RESULTS
FMT can decrease the fat accumulation in the liver by improving the gut microbiota dysbiosis, thus attenuating fatty liver disease. Significant differences in the clinical features and gut microbiota between lean and obese NAFLD patients were unveiled. Moreover, FMT had better effects on gut microbiota reconstruction in lean NAFLD than in obese NAFLD patients.
CONCLUSIONS
FMT could successfully improve the therapeutic effects on patients with NAFLD, and its clinical efficacy was higher in lean NAFLD than in obese NAFLD patients.
Topics: Dysbiosis; Fecal Microbiota Transplantation; Gastrointestinal Microbiome; Humans; Non-alcoholic Fatty Liver Disease; Obesity
PubMed: 35860380
DOI: 10.3389/fcimb.2022.759306 -
Disease-a-month : DM Dec 2023
Topics: Humans; Obesity; Gastrointestinal Neoplasms
PubMed: 37248137
DOI: 10.1016/j.disamonth.2023.101591 -
Biological Research For Nursing Jan 2022The worldwide prevalence of obesity and low back pain (LBP) has recently dramatically increased and is mainly indicated among postpartum women, leading to a range of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The worldwide prevalence of obesity and low back pain (LBP) has recently dramatically increased and is mainly indicated among postpartum women, leading to a range of adverse health consequences.
OBJECTIVE
This study aimed to investigate the effects of 6 weeks of Dynamic Neuromuscular Stabilization training (DNS) in obese postpartum women with LBP.
METHOD
This was a pretest-posttest study design. The study was conducted with 40 obese postpartum women with LBP randomized to receive DNS ( = 20) or General Exercise (GE, = 20) 6 times a week for 6 weeks. The data were gathered before and after the 6-week intervention.
RESULTS
Forty participants completed the study (mean ± , age 29.30 ± 3.77 years; weight 88.10 ± 6.09 kg; height 165.40 ± 6.31 cm; and BMI, 32.19 ± 1.07 kg/m). The overall group-by-time interaction was significant for Numeric Pain-Rating Scale, Modified Oswestry Disability Questionnaire, Fear-Avoidance Beliefs Questionnaire, Inspiration and Expiration Breath Hold Time, and Respiratory Rate outcomes. The global rating of change was significantly different between groups ( < .05). The rate of improvement was higher in the DNS group compared to the GE group in all 6 tests.
CONCLUSION
The present study confirms that DNS is applicable in obese postpartum women with LBP and effectively improved NPRS, MODQ, FABQ, BHT, and RR. It is clinically suggested that DNS is imperative based on ideal ontogenetic patterns to attain optimal results for obese postpartum women with LBP.
Topics: Adult; Exercise Therapy; Female; Humans; Low Back Pain; Obesity; Postpartum Period; Surveys and Questionnaires
PubMed: 34555964
DOI: 10.1177/10998004211044828 -
Reviews in Endocrine & Metabolic... Oct 2023In this thematic issue on phenotyping the obesities, prominent international experts offer an insightful and comprehensive collection of articles covering the current... (Review)
Review
In this thematic issue on phenotyping the obesities, prominent international experts offer an insightful and comprehensive collection of articles covering the current knowledge in the field. In order to actually capture all the polyhedral determinants of the diverse types of obesity, the granularity of the phenotypic information acquired must be expanded in the context of a personalized approach. Whilst the use of precision medicine has been successfully implemented in areas like cancer and other diseases, health care providers are more reluctant to embrace detailed phenotyping to guide diagnosis, treatment and prevention in obesity. Given its multiple complex layers, phenotyping necessarily needs to go beyond the multi-omics approach and incorporate all the diverse spheres that conform the reality of people living with obesity. Potential barriers, difficulties, roadblocks and opportunities together with their interaction in a syndemic context are analyzed. Plausible lacunae are also highlighted in addition to pointing to the need of redefining new conceptual frameworks. Therefore, this extraordinary collection of state-ofthe-art reviews provides useful information to both experienced clinicians and trainees as well as academics to steer clinical practice and research in the management of people living with obesity irrespective of practice setting or career stage.
Topics: Humans; Utopias; Obesity
PubMed: 37537402
DOI: 10.1007/s11154-023-09829-x -
Recherche En Soins Infirmiers 2022Introduction : At least one preoperative shower is recommended to avoid surgical site infection. Caregivers must explain the showering technique, help the patient if...
Introduction : At least one preoperative shower is recommended to avoid surgical site infection. Caregivers must explain the showering technique, help the patient if necessary, and assess skin cleanliness after showering.Context : Showering may be more difficult for obese patients because of inadequate equipment and difficulties moving, as well as insufficient explanation regarding the showering technique and an insufficient skin cleanliness assessment from caregivers.Objective : to assess whether patients and/or caregivers report difficulties in the preoperative shower process that could be linked to patient obesity. Methods : pilot qualitative survey with semi-structured interviews conducted with 9 obese surgery patients and 11 surgery caregivers.Results : Patients did not report feelings of discrimination. They described no problem with equipment, but declared having received little explanation on the showering technique and no visual skin cleanliness assessment. Caregivers reported equipment as inadequate, they stated having delivered detailed information, but found the skin cleanliness assessment difficult.Discussion : The lack of skin cleanliness assessment by caregivers after preoperative showering is new information. Limits : preliminary study with a small number of interviews and no non-obese patients.Conclusion : the subject warrants additional work with both quantitative and qualitative surveys to better understand the difficulties with preoperative showering.
Topics: Baths; Caregivers; Humans; Obesity; Preoperative Care; Surgical Wound Infection
PubMed: 35724044
DOI: 10.3917/rsi.147.0092 -
Current Hypertension Reviews 2020The relationship between obesity and hypertension has been established in both adults and children. The combination of obesity, hypertension and other cardiovascular... (Review)
Review
BACKGROUND
The relationship between obesity and hypertension has been established in both adults and children. The combination of obesity, hypertension and other cardiovascular risk factors significantly increases the likelihood of adverse cardiovascular effects and raises concerns about aggressive treatment strategies.
OBJECTIVE
Despite the impressive elements which indicate an important role for excessive weight gain in increasing blood pressure, not all obese patients are hypertensive. A subgroup of obese people may not develop hypertension. Furthermore, masked hypertension occurs more common among obese patients, and body fat distribution has a major role in the development of hypertension.
METHOD
We conducted a research of the relevant literature regarding obesity-induced hypertension and possible treatment strategies.
RESULTS
Successful weight loss is correlated with blood pressure reduction and requires a multidisciplinary approach that includes personalized dietary interventions combined with regular exercise and cognitive behavioral therapy.
CONCLUSION
Pharmacological therapy may be considered as part of a comprehensive obesity management strategy. More research and new treatment therapies are required in this field.
Topics: Anti-Obesity Agents; Antihypertensive Agents; Blood Pressure; Comorbidity; Diet, Healthy; Exercise; Humans; Hypertension; Obesity; Risk Factors; Risk Reduction Behavior; Treatment Outcome; Weight Loss
PubMed: 30987571
DOI: 10.2174/1573402115666190415154603 -
La Tunisie Medicale Apr 2023Obesity is linked to a potential decline in functional capacity and muscle strength, especially within weight-bearing joints. However, up to now, no study has managed to...
INTRODUCTION
Obesity is linked to a potential decline in functional capacity and muscle strength, especially within weight-bearing joints. However, up to now, no study has managed to demonstrate a relationship between these factors that is sufficiently strong.
AIM
This study aims to present a mixed physical activity regimen for obese individuals.
METHODS
Data were gathered from 20 obese participants and 13 controls. The «obese» group had a BMI ≥ 25.0 kg/m², while the «control» group had a BMI < 25.0 kg/m². The exercise program consisted of walking, running, and muscle stretching, with 2 sessions weekly. Training began at the fat oxidation threshold, gradually extending sessions. From the ninth session, the program alternated between fat and anaerobic threshold sessions, aiming for 4 periods of 12 minutes at the anaerobic threshold.
RESULTS
Significant body composition changes were observed in obese individuals but not controls. Obese women lost 1.7±0.6 kg (p=0.006), while obese men lost 5.8±2.1 kg (p=0.02). Fat mass reduction was 2.6±0.6 kg (p<0.001) for women and 4.9±1.1 kg (p=0.003) for men. Exercise tolerance improved in obese subjects, reaching higher fat and anaerobic thresholds post-training. Performance increased by+14.3% (p=0.03) at the fat threshold and +12.1% at the anaerobic threshold (p=0.02), with minimal change in heart rate (3.9-4.3%, p>0.05).
CONCLUSION
This study demonstrates two outcomes: a tailored exercise regimen for obese individuals enhances body composition, surpassing prior studies. Additionally, the program elevates performance at fat and anaerobic thresholds, accompanied by slightly increased heart rates. This suggests improved fat oxidation capacity in obese individuals.
Topics: Male; Humans; Female; Obesity; Exercise; Body Composition; Muscle Strength; Body Mass Index
PubMed: 38372533
DOI: No ID Found -
Seminars in Cancer Biology Jun 2023Urologic cancers (UC) account for 13.1% of all new cancer cases and 7.9% of all cancer-related deaths. A growing body of evidence has indicated a potential causal link... (Review)
Review
Urologic cancers (UC) account for 13.1% of all new cancer cases and 7.9% of all cancer-related deaths. A growing body of evidence has indicated a potential causal link between obesity and UC. The aim of the present review is to appraise in a critical and integrative manner evidence from meta-analyses and mechanistic studies on the role of obesity in four prevalent UC (kidney-KC, prostate-PC, urinary bladder-UBC, and testicular cancer-TC). Special emphasis is given on Mendelian Randomization Studies (MRS) corroborating a genetic causal association between obesity and UC, as well as on the role of classical and novel adipocytokines. Furthermore, the molecular pathways that link obesity to the development and progression of these cancers are reviewed. Available evidence indicates that obesity confers increased risk for KC, UBC, and advanced PC (20-82%, 10-19%, and 6-14%, respectively), whereas for TC adult height (5-cm increase) may increase the risk by 13%. Obese females tend to be more susceptible to UBC and KC than obese males. MRS have shown that a higher genetic-predicted BMI may be causally linked to KC and UBC but not PC and TC. Biological mechanisms that are involved in the association between excess body weight and UC include the Insulin-like Growth Factor axis, altered availability of sex hormones, chronic inflammation and oxidative stress, abnormal secretion of adipocytokines, ectopic fat deposition, dysbiosis of the gastrointestinal and urinary tract microbiomes and circadian rhythm dysregulation. Anti-hyperglycemic and non-steroidal anti-inflammatory drugs, statins, and adipokine receptor agonists/antagonists show potential as adjuvant cancer therapies. Identifying obesity as a modifiable risk factor for UC may have significant public health implications, allowing clinicians to tailor individualized prevention strategies for patients with excess body weight.
Topics: Male; Adult; Female; Humans; Testicular Neoplasms; Obesity; Risk Factors; Urologic Neoplasms; Adipokines
PubMed: 36893965
DOI: 10.1016/j.semcancer.2023.03.002