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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 -
Journal of Applied Physiology... Jan 2010In obese people, the presence of adipose tissue around the rib cage and abdomen and in the visceral cavity loads the chest wall and reduces functional residual capacity... (Review)
Review
In obese people, the presence of adipose tissue around the rib cage and abdomen and in the visceral cavity loads the chest wall and reduces functional residual capacity (FRC). The reduction in FRC and in expiratory reserve volume is detectable, even at a modest increase in weight. However, obesity has little direct effect on airway caliber. Spirometric variables decrease in proportion to lung volumes, but are rarely below the normal range, even in the extremely obese, while reductions in expiratory flows and increases in airway resistance are largely normalized by adjusting for lung volumes. Nevertheless, the reduction in FRC has consequences for other aspects of lung function. A low FRC increases the risk of both expiratory flow limitation and airway closure. Marked reductions in expiratory reserve volume may lead to abnormalities in ventilation distribution, with closure of airways in the dependent zones of the lung and ventilation perfusion inequalities. Greater airway closure during tidal breathing is associated with lower arterial oxygen saturation in some subjects, even though lung CO-diffusing capacity is normal or increased in the obese. Bronchoconstriction has the potential to enhance the effects of obesity on airway closure and thus on ventilation distribution. Thus obesity has effects on lung function that can reduce respiratory well-being, even in the absence of specific respiratory disease, and may also exaggerate the effects of existing airway disease.
Topics: Animals; Functional Residual Capacity; Humans; Lung Diseases; Models, Biological; Obesity; Pulmonary Ventilation; Respiratory Mechanics
PubMed: 19875713
DOI: 10.1152/japplphysiol.00694.2009 -
Journal of Clinical Hypertension... Jan 2013In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with... (Review)
Review
In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and the American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients.
Topics: Antihypertensive Agents; Cardiovascular Diseases; Evidence-Based Medicine; Humans; Hypertension; Life Style; Obesity; Risk; United States
PubMed: 23282121
DOI: 10.1111/jch.12049 -
Current Diabetes Reports Jun 2019The aim of this review is to summarize the current data available on the metabolic effects of fecal microbiota transplantation (FMT) including obesity and glucose... (Review)
Review
PURPOSE OF REVIEW
The aim of this review is to summarize the current data available on the metabolic effects of fecal microbiota transplantation (FMT) including obesity and glucose metabolism in humans.
RECENT FINDINGS
Gut microbiota dysbiosis is a frequent characteristic observed in obesity and related metabolic diseases. Pieces of evidence mostly generated in mouse models suggest that rescuing this dysbiosis associates with improved metabolism. In humans, dietary or bariatric surgery interventions are often accompanied by complete or partial restoration of this dysbiosis together with weight reduction and metabolic amelioration. FMT is an interesting option to modify gut microbiota and has been associated with improved clinical outcomes, albeit only used in routine care for Clostridium difficile infection. However, there are only limited data on using FMT in the metabolic context. FMT from lean donors significantly improves insulin sensitivity in obese subjects with metabolic syndrome. However, there is a wide range of clinical responses. Interestingly in subjects with high microbial gene richness at baseline and when FMT donors that are metabolically compromised are used, no metabolic improvement is seen. Moreover, more studies evaluating the effect of FMT in patients with overt type 2 diabetes are warranted. Furthermore, interventions (in the receiver prior to FMT) aiming to enhance FMT response also need evaluation.
Topics: Animals; Clostridium Infections; Diabetes Mellitus; Fecal Microbiota Transplantation; Feces; Humans; Obesity; Treatment Outcome
PubMed: 31250122
DOI: 10.1007/s11892-019-1180-z -
World Journal of Gastroenterology Jan 2016Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic... (Review)
Review
Obesity plays relevant pathophysiological role in the development of health problems, arising as result of complex interaction of genetic, nutritional, and metabolic factors. Due to the role of adipose tissue in lipid and glucose metabolism, and low grade inflammation, it is necessary to classify obesity on the basis of body fat composition and distribution, rather than the simply increase of body weight, and the Body Mass Index. The new term of adiposopathy (''sick fat'') clearly defines the pathogenic role of adipose tissue. Four phenotypes of obese individuals have been described: (1) normal weight obese (NWO); (2) metabolically obese normal weight; (3) metabolically healthy obese; and (4) metabolically unhealthy obese or "at risk" obese. Moreover, sarcopenic obesity has been related to all the phenotypes. The category of normal weight lean, represented by metabolically healthy normal weight has been classified to distinguish from NWO. It is crucial to recommend a bariatric surgery taking into account adiposopathy and sick fat that occurs with the expansion of fat mass, changing the inflammatory and metabolic profile of the patient. Body fat percentage and genetic polymorphism have to be evaluated to personalize the best bariatric surgery intervention.
Topics: Adipokines; Adipose Tissue; Adiposity; Anthropometry; Bariatric Surgery; Body Weight; Decision Support Techniques; Energy Metabolism; Female; Humans; Inflammation Mediators; Male; Obesity; Obesity, Metabolically Benign; Patient Selection; Phenotype; Predictive Value of Tests; Risk Factors; Sarcopenia; Sex Factors; Terminology as Topic
PubMed: 26811617
DOI: 10.3748/wjg.v22.i2.681 -
American Journal of Public Health Jun 2010Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science...
Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health.
Topics: Health Behavior; Humans; Obesity; Prejudice; Public Health; Quality of Health Care; Social Justice; Stereotyping
PubMed: 20075322
DOI: 10.2105/AJPH.2009.159491 -
Chest Sep 2012Obesity prevalence continues to increase globally, with figures exceeding 30% of some populations. Patients who are obese experience alterations in baseline pulmonary... (Review)
Review
Obesity prevalence continues to increase globally, with figures exceeding 30% of some populations. Patients who are obese experience alterations in baseline pulmonary mechanics, including airflow obstruction, decreased lung volumes, and impaired gas exchange. These physiologic changes have implications in many diseases, including ARDS. The unique physiology of patients who are obese affects the presentation and pathophysiology of ARDS, and patients who are obese who have respiratory failure present specific management challenges. Although more study is forthcoming, ventilator strategies that focus on transpulmonary pressure as a measure of lung stress show promise in pilot studies. Given the increasing prevalence of obesity and the variable effects of obesity on respiratory mechanics and ARDS pathophysiology, we recommend an individualized approach to the management of the obese patient with ARDS.
Topics: Comorbidity; Disease Management; Humans; Obesity; Prevalence; Respiratory Distress Syndrome; Respiratory Mechanics; Risk Factors
PubMed: 22948584
DOI: 10.1378/chest.12-0117 -
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 -
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 -
Diabetes Research and Clinical Practice Aug 2023The effect of fecal microbiota transplantation (FMT) on microbiota engraftment in patients with metabolic syndrome remains unclear. This systematic review employed a... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The effect of fecal microbiota transplantation (FMT) on microbiota engraftment in patients with metabolic syndrome remains unclear. This systematic review employed a meta-analysis of RCTs for assessment on the role of FMT in treating obesity and metabolic syndrome, and its impact on clinically relevant parameters.
METHOD
Major databases and grey literatures were searched identifying RCTs comparing FMT of lean donors with placebo in obese/metabolic syndrome patients. Studies using any form of placebo were included. Variations in the parameters before and after treatment were calculated followed by meta-analyses.
RESULT
Ten studies met the inclusion criteria and a total of 334 patients were included for further analysis. Clinically significant parameters associated with obesity and metabolic syndrome were explored and FMT was identified significantly and negatively associated with most indices of abdominal adiposity including caloric intake, fasting glucose, HOMA-IR, systolic blood pressure, diastolic blood pressure, total cholesterol, HDL, LDL, triglycerides and CRP, Obesity parameters including fasting glucose and acetic acid were increased following FMT.
CONCLUSION
FMT is more advantageous for obese patients with elevated blood pressure, disordered glucose and insulin metabolism, and elevated blood lipids. The study of metabolic factors in obese patients will be our starting point in the future.
Topics: Humans; Fecal Microbiota Transplantation; Metabolic Syndrome; Obesity; Glucose; Lipids
PubMed: 37356723
DOI: 10.1016/j.diabres.2023.110803