利拉鲁肽联合达格列净对超重或肥胖2型糖尿病患者肾功能、氧化应激以及内脏脂肪含量的影响

摘要 目的：探讨利拉鲁肽联合达格列净对超重或肥胖2型糖尿病（T2DM）患者肾功能、氧化应激以及内脏脂肪含量的影响。方法：选取我院于2018年1月~2020年5月期间接收的108例超重或肥胖T2DM患者,按照随机数字表法分为对照组（n=54）和观察组（n=54）。对照组给予利拉鲁肽治疗,观察组给予利拉鲁肽联合达格列净治疗,均治疗12周。对比两组肾功能[血胱抑素 C（CysC）、血肌酐（Scr）、血尿酸（SUA）]、氧化应激[丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-PX）、超氧化物歧化酶（SOD）]、体质量指数（BMI）、腰围、血糖指标[空腹血糖（FBG）、餐后2 h血糖（2hPBG）、糖化血红蛋白（HbA1c）]以及体成分指标（全身脂肪百分比、内脏脂肪含量）,记录两组治疗期间不良反应情况。结果：两组治疗后BMI、腰围、2hPBG、FBG、HbA1c均下降,且观察组较对照组低（P<0.05）。两组治疗后MDA均下降,且观察组较对照组低（P<0.05）,两组治疗后SOD、GSH-PX均升高,且观察组较对照组高（P<0.05）。两组治疗后全身脂肪百分比、内脏脂肪含量均下降,且观察组较对照组低（P<0.05）。两组治疗前后CysC、Scr、SUA组内及组间对比均无统计学差异（P>0.05）。两组不良反应发生率对比无统计学差异（P>0.05）。结论：超重或肥胖T2DM患者利拉鲁肽治疗基础上联合达格列净,降糖效果确切,减轻机体氧化应激,降低内脏脂肪含量,对肾功能无显著影响,且不增加不良反应发生率。     

Tasa estimada de disposición de glucosa en pacientes menores de 18 años con diabetes mellitus tipo 1 y sobrepeso-obesidad

ObjectiveTo assess the estimated glucose disposal rate (eGDR), insulin dose, and lipoprotein profile in children with type 1 diabetes mellitus (T1DM) and overweight or obesity as compared to children with T1DM and normal weight.MethodsA total of 115 patients (aged 5-16 years) with T1DM on intensive insulin therapy were recruited. The following parameters were measured: weight, height, body mass index, waist and hip circumference, insulin dose, eGDR, glycosylated hemoglobin, blood pressure, and lipoprotein profile. Results were stratified by sex and age.ResultsNo significant differences were found in eGDR between children with normal weight, overweight, and obesity. However, obese children older than 11 years had lower eGDR values (9.3 ± 1.3 vs 10.1 ± 0.8 mg kg^-1min^-1; p < 0.01). Insulin dose was higher in overweight and obese children, especially in IU/m²/day (37.7 vs 36.1 vs 29.4 respectively; p < 0.01). Obese children had higher low-density lipoprotein cholesterol levels than children with overweight and normal weight (106.5 vs 91.7 vs 91.5 mg/dL respectively; p < 0.01). No correlation was found between waist circumference and the different markers of insulin resistance.ConclusionsValues of eGDR values were lower in obese children with T1DM older than 11 years, and this may therefore be considered a marker of insulin resistance. Insulin dose was higher in diabetic patients with overweight or obesity, specially in IU/m²/day. Obese children with T1DM had a lipoprotein profile of cardiovascular risk.     

Effect modification of body mass index on the association between ovarian cysts and endometrial cancer

BackgroundOvarian cysts represent a common condition among women. Epidemiologic studies are inconsistent in determining if women with cysts are more likely to develop endometrial cancer (EC) regardless of overweight/obesity. We investigated the combined role of cysts and body mass index (BMI) on EC risk.MethodsWe pooled data from three case-control studies conducted in Italy and Switzerland on 920 women with EC and 1700 controls. The prevalence of cysts was 5% among both cases and controls, with 63% of cases being overweight/obese. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression models, adjusting for potential confounders. We conducted stratified analyses according to BMI, and estimated the interaction between cysts and BMI; we carried out additional analyses according to age at diagnosis of cysts.ResultsOverall, history of cysts was not associated to EC (OR=1.27, 95% CI=0.82–1.97, P = 0.29). Normal weight women reporting cysts had an increased risk of EC (OR=2.49, 95% CI=1.31–4.74), while no such effect was found among overweight/obese women (OR=0.65, 95% CI=0.36–1.18; P for interaction=0.004). The association was limited to women below 65 years of age and was stronger in those who reported cysts at age 48 or older.ConclusionsCysts appeared to be a risk factor for EC in lean women but not in overweight/obese ones; these results are consistent with an effect of cysts and obesity on EC along common pathways.     

Overweight trends among Polish schoolchildren before and after the transition from communism to capitalism

This study aims to reveal the secular trends in body mass index (BMI) and the prevalence of overweight and obesity among Polish schoolchildren between the years 1966–2012, during which intense socio-political changes took place. Four surveys were conducted in several districts of Poland looking at 69,746 schoolchildren aged 7–18. Significant increase in mean BMI as well as in the prevalence of overweight and obesity was observed. During this time the highest increase in both mean BMI and excess weight was observed between 1988 and 2012, i.e. after the political transformation, resulting in the improvement of living conditions. However, with respect to girls in late adolescence, between these years, the mean BMI as well as the prevalence of overweight were leveling off, while the percentage of boys with excess body fat in the same developmental category significantly increased in 2012. In the years 1966–1978 and 1978–1988 the pattern of changes in the prevalence of overweight and obesity reflected the social and economic circumstances, i.e. temporary economic improvements, or deepening political crises and food shortage. In conclusion, the weight status of schoolchildren strongly reflects socio-political changes that took place in Poland, as well as in most of the Central European countries in the last half century.     

特定人群超重及肥胖与相关疾病患病分析

目的：分析特定人群超重患病率,以及超重与高血压、糖尿病、血脂异常、脂肪肝等相关疾病的关系,为及早预防慢性非传染性疾病奠定基础。方法：对平房地区采取长效避孕措施的603名户籍农村已婚育龄妇女进行健康体检,按体重指数（BMI）分为正常组、超重组和肥胖组,比较各组间高血压、高血糖、高血脂、脂肪肝等相关疾病检出率的差异。结果：特定人群超重发病率及超重相关疾病检出率的差异均具有统计学意义（P〈0．01）。结论：平房地区特定人群超重及肥胖发病率未明显高于国内平均水平及全市水平。但超重及肥胖与高血压、糖尿病、血脂异常、脂肪肝等疾病存在较大相关关系,为了进一步降低心脑血管高危因素和死亡率。需采取早期、有效的措施控制超重和肥胖倾向。     

特定人群超重及肥胖与相关疾病患病分析

目的:分析特定人群超重患病率,以及超重与高血压、糖尿病、血脂异常、脂肪肝等相关疾病的关系,为及早预防慢性非传染性疾病奠定基础。方法:对平房地区采取长效避孕措施的603名户籍农村已婚育龄妇女进行健康体检,按体重指数(BMI)分为正常组、超重组和肥胖组,比较各组间高血压、高血糖、高血脂、脂肪肝等相关疾病检出率的差异。结果:特定人群超重发病率及超重相关疾病检出率的差异均具有统计学意义(P<0.01)。结论:平房地区特定人群超重及肥胖发病率未明显高于国内平均水平及全市水平。但超重及肥胖与高血压、糖尿病、血脂异常、脂肪肝等疾病存在较大相关关系,为了进一步降低心脑血管高危因素和死亡率,需采取早期、有效的措施控制超重和肥胖倾向。     

Geography of underweight and overweight among women in India: A multilevel analysis of 3204 neighborhoods in 26 states

We investigated the geographic distribution and the relationship with neighborhood wealth of underweight and overweight in India. Using multilevel modeling techniques, we calculated state-specific smoothed shrunken state residuals of overweight and underweight, neighborhood and state variation of nutritional status, and the relationships between neighborhood wealth and nutritional status of 76,681 women living in 3204 neighborhoods in 26 Indian states. We found a substantial variation in overweight and underweight at the neighborhood and state levels, net of what could be attributed to individual-level factors. Neighborhood wealth was associated with increased levels of overweight and decreased levels of underweight, and was found to modify the relationship between personal living standard and nutritional status. These findings suggest that interventions to address the double burden of undernutrition and overnutrition in India must take into account state and neighborhood characteristics in order to be successful.     

Childhood influences on youth obesity

We develop a model to estimate the influence of child and parental characteristics on the likelihood that a child will become an obese or overweight youth. We use this model to test whether it is possible to forecast obesity and overweight among youth. Comparing Receiver Operating Characteristic (ROC) scores from these forecasts, we find that a model using childhood covariates does as well in forecasting youth obesity and overweight as a model using the covariate values contemporaneous with the youth obesity and overweight outcomes. The datasets used in this paper, the National Longitudinal Survey of Youth (NLSY79) and the NLSY79 Children and Young Adults, provide data from 1986 to 2002, allowing for the study of a child's transition to and from obesity or overweight over a long period. Explanatory variables that significantly influence the likelihood of youth obesity or overweight outcomes include the mother's obesity status and education, the youth's mental health, and certain demographic features including race, sex, and family size. These factors provide potential targets for policies that could be implemented early in life among children most likely to become obese or overweight.     

Combined effects of aging and obesity on postural control,muscle activity and maximal voluntary force of muscles mobilizing ankle joint

ObjectiveThe aim of the study was to investigate the influence of age and/or obesity on postural control, ankle muscle activities during balance testing and force production capacities.Materials and methods4 groups; control group (CG; n = 25; age = 31.8 ± 7.5 years; BMI = 21.4 ± 2.5 kg/m²), obese group (OG; n = 25; age = 34.4 ± 9.5 years; BMI = 39.6 ± 5.4 kg/m²), elderly group (EG; n = 15; age = 77.1 ± 8.4 years; BMI = 24.4 ± 1.3 kg/m²) and obese elderly group (ObEG; n = 12; age = 78.6 ± 6.6 years; BMI = 34.5 ± 3.1 kg/m²) performed maximal voluntary contraction (MVC) before testing to calculate the maximal relative force of ankle plantar flexor (PF) and dorsal flexor (DF) muscles. Center of pressure (CoP) parameters and the electromyography (EMG) activity of PF and DF muscles were collected during MVC, quiet standing and limit of stability (LoS) testing along antero-posterior and medio-lateral axes.ResultsMaximal relative force was higher in EG and ObEG than CG and OG, respectively (p < 0.001). CoP parameters, distance traveled along the antero-posterior axis and EMG activity of PF were higher in OG, EG and ObEG compared to CG (p < 0.001) and in EG compared to ObEG (p < 0.05).The EMG activity of PF was positively correlated with CoP parameters in OG and ObEG (r > 0.6; p < 0.05). Maximal relative force of PF (r > −0.6; p < 0.05) was negatively correlated with CoP parameters in ObEG and EG.ConclusionObesity-related postural control alteration is associated with increased activity of PF. This neuromuscular adaptation may reflect deteriorations of the proprioceptive system and is likely additional to age-related muscular impairments. This may be a mechanism by which obesity increases postural control alterations in elderly.     

Evolution of obesity by social status in France, 1981-2003

Although France is less affected by the rise in obesity than neighboring countries, the prevalence of obesity has increased, changing the distribution of this pathology in the population. We analyze this evolution by social status, education, income and gender, region of residence, using the three French national Health Surveys conducted in 1981, 1992 and 2003. The average body weight of both women and men has increased in France since 1981 and accelerated since the 1990s. This trend is obtained among all age groups. Nevertheless, this process did not affect all socioeconomic groups similarly. Geographical differences increased between north-east, where the prevalence of obesity is higher, and the Mediterranean region, where it is lower. Likewise, the gap between social and occupational categories has greatly widened: obesity has increased much faster among farmers and blue-collar workers than among managers and professionals. In contrast to women, poorer men are not more likely to be more obese than others. Our findings suggest that differences in BMI values increased substantially among social groups in France, in particular among women.