Obesity, Metabolic Syndrome and Disorders of Energy Balance

Zebrafish navigating the metabolic maze: insights into human disease - assets, challenges and future implications

Zebrafish (Danio rerio) have become indispensable models for advancing our understanding of multiple metabolic disorders such as obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome. This review provides a comprehensive analysis of zebrafish as a powerful tool for dissecting the genetic and molecular mechanisms of these diseases, focusing on key genes, like pparγ, lepr, ins, and srebp. Zebrafish offer distinct advantages, including genetic tractability, optical transparency in early development, and the conservation of key metabolic pathways with humans. Studies have successfully used zebrafish to uncover conserved metabolic mechanisms, identify novel disease pathways, and facilitate high-throughput screening of potential therapeutic compounds. The review also highlights the novelty of using zebrafish to model multifactorial metabolic disorders, addressing challenges such as interspecies differences in metabolism and the complexity of human metabolic disease etiology. Moving forward, future research will benefit from integrating advanced omics technologies to map disease-specific molecular signatures, applying personalized medicine approaches to optimize treatments, and utilizing computational models to predict therapeutic outcomes. By embracing these innovative strategies, zebrafish research has the potential to revolutionize the diagnosis, treatment, and prevention of metabolic disorders, offering new avenues for translational applications. Continued interdisciplinary collaboration and investment in zebrafish-based studies will be crucial to fully harnessing their potential for advancing therapeutic development.

Critical Review on Anti-Obesity Effects of Anthocyanins Through PI3K/Akt Signaling Pathways

Obesity is a global health crisis and is one of the major reasons for the rising prevalence of metabolic disorders such as type 2 diabetes, cardiovascular diseases, and certain cancers. There has been growing interest in the search for natural molecules with potential anti-obesity effects; among the phytochemicals of interest are anthocyanins, which are flavonoid pigments present in many fruits and vegetables. Anthocyanins influence obesity via several signaling pathways. The PI3K/Akt signaling pathway plays a major role with a focus on downstream targets such as GLUT4, FOXO, GSK3β, and mTOR, which play a central role in the regulation of glucose metabolism, lipid storage, and adipogenesis. The influence of critical factors such as oxidative stress and inflammation also affect the pathophysiology of obesity. However, the studies reviewed have certain limitations, including variations in experimental models, bioavailability challenges, and a lack of extensive clinical validation. While anthocyanin shows tremendous potential, challenges such as poor bioavailability, stability, and regulatory matters must be overcome for successful functional food inclusion of anthocyanins. The future of anthocyanin-derived functional foods lies in their ability to overcome hurdles. Therefore, this review highlights the molecular mechanisms of obesity through the PI3K/Akt signaling pathways and explores how anthocyanins can modulate these signaling pathways to address obesity and related metabolic disorders. It also addresses some ways to solve the challenges, like bioavailability and stability, while emphasizing future possibilities for anthocyanin-based functional foods in obesity management.

Prevalence of metabolic syndrome and its association with selected factors among people with psychiatric conditions in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Metabolic syndrome is a cluster of metabolic risk factors, including glucose intolerance, dyslipidemia, central obesity, high triglyceride levels, and low levels of high-density lipoprotein. It is the commonest type of co-morbidity among people with psychiatric conditions particularly in low and middle-income countries due to poor health care systems and financial burden. Metabolic syndrome among people with psychiatric conditions may be due to prolonged use of psychiatric medications, diminished quality of life, and personal and behavioral-related factors. Except for single studies with fluctuating reports, there is no nationwide study conducted on the prevalence of metabolic syndrome among people with psychiatric conditions in Ethiopia. Thus, this review aims to estimate the pooled prevalence of metabolic syndrome and its association with selected factors among people with psychiatric conditions in Ethiopia.

METHODS

We conducted a thorough search of PubMed, Scopus, Wiley online library, African journals online, and Google Scholar. For analysis, STATA version 14 software was used. A funnel plot and Egger's regression test statistic were used to find the potential reporting bias. A fixed effect model was used to contrast summary effects, odds ratios, and 95% confidence intervals all over research findings. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of each included study.

RESULTS

Eight articles were included in the final review after retrieving 9,714 articles through electronic database searching. By using the national cholesterol education adult treatment panel criteria, the pooled prevalence of metabolic syndrome among people with psychiatric conditions in Ethiopia was found to be 37.33% (95%CI: 24.52-50.14). Being female AOR = 2.66; 95% CI: 0.89, 7.92), urban residency (AOR = 2.84; 95% CI: 0.56, 14.45), physical inactivity (AOR = 3.80; 95% CI: 1.61, 8.98), alcohol consumption (AOR = 4.53; 95% CI: 1.62, 12.71) and body mass index higher than the normal range (AOR = 4.66; 95% CI: 1.22, 17.85) were the factors significantly associated with metabolic syndrome among people with psychiatric conditions. According to the review, schizophrenic-form disorder, delusional disorder, major depressive disorder, schizophrenia, bipolar disorder, and schizoaffective disorder were the frequently reported psychiatric conditions.

CONCLUSION

This systematic review and meta-analysis revealed that the magnitude of metabolic syndrome among people with psychiatric conditions in Ethiopia was high and female gender, physical inactivity, alcohol consumption, and body mass index higher than the normal range were the factors that determined the occurrence of metabolic syndrome. Thus, policymakers, clinicians, and other concerned stakeholders must reinforce effective strategies in the control, timely screening, prevention, and management of metabolic syndrome among people with psychiatric conditions.

PROTOCOL REGISTRATION

PROSPERO CRD42023405293.

The Effects of Weight Loss and Aerobic Exercise on Cortisol and Cortisol Suppression in Postmenopausal Women with Overweight and Obesity

PURPOSE

The goal of this study was to explore the complex relationship between obesity, dietary content, weight loss, and cortisol concentrations in postmenopausal women with overweight and obesity.

METHODS

Women completed basal cortisol testing, a dexamethasone suppression test (DST), DXA scan, 3-hour oral glucose tolerance test (OGTT), and food records before (n = 60) and a subset after 6-months of weight loss (WL; n = 15) or aerobic exercise training+weight loss (AEX+WL, n = 34).

RESULTS

At baseline, plasma cortisol concentrations decreased significantly after DST in the entire group, a 54% suppression which was associated with basal glucose. Basal glucose levels and glucose AUC from the OGTT are associated with basal cortisol levels (r = 0.44 and r = 0.29, p < 0.05 respectively). The intervention resulted in significant weight loss (-8%) but no significant changes in basal cortisol or changes in cortisol from basal to DST were observed.

CONCLUSION

Additional research is necessary to better comprehend cortisol regulation in postmenopausal women particularly in response to effective weight reduction interventions.

Investigating the Effects of Gossypetin on Cardiovascular Function in Diet-Induced Pre-Diabetic Male Sprague Dawley Rats

Gossypetin (GTIN) is a naturally occurring flavonoid recognised for its pharmacological properties. This study examined the effects of GTIN on cardiovascular function in a diet-induced pre-diabetic rat model, which has not been previously studied. Pre-diabetes was induced using a high-fat high-carbohydrate (HFHC) diet supplemented with 15% fructose water for 20 weeks. Thereafter, the pre-diabetic animals were sub-divided into five groups (n = 6), where they were either orally treated with GTIN (15 mg/kg) or metformin (MET) (500 mg/kg), both in the presence and absence of dietary intervention for 12 weeks. The results demonstrated that the pre-diabetic (PD) control group exhibited significantly higher plasma triglyceride, total cholesterol, low-density lipoprotein and very low-density lipoprotein levels, along with decreased high-density lipoprotein (HDL) levels in comparison to the non-pre-diabetic (NPD) group. This was accompanied by significantly higher mean arterial pressure (MAP), body mass index (BMI), waist circumference (WC) and plasma endothelial nitric oxide (eNOS) levels in PD control. Additionally, there were increased heart malondialdehyde levels, reduced heart superoxide dismutase and glutathione peroxidase activity as well as increased plasma interleukin-6, tumour necrosis factor alpha and c-reactive protein levels present in the PD control group. Notably, both GTIN-treated groups showed significantly reduced plasma lipid levels and increased HDL, as well as decreases in MAP, BMI, WC and eNOS levels in comparison to PD control. Additionally, GTIN significantly decreased heart lipid peroxidation, enhanced antioxidant activity and decreased plasma inflammation markers. These findings may suggest that GTIN administration in both the presence and absence of dietary intervention may offer therapeutic potential in ameliorating cardiovascular disturbances associated with the PD state. However, future studies are needed to determine the physiological mechanisms by which GTIN improves cardiovascular function in the PD state.

Clinical heterogeneity of sleep quality, emotional and behavioral characteristics, and eating habits in adolescents with obesity: A cluster analysis

This study aims to examine the role of sleep quality, emotional and behavioral characteristics, and eating behavior in adolescents with obesity by means of cluster analysis. One hundred ninety-four adolescents (78 girls, 116 boys) aged 12-17 (mean 14.3 ± 2.7) with obesity (ICD-10 code E 66.0) entered the study. The Adolescent Sleep Wake Scale was used to evaluate sleep quality. The Achenbach Youth Self-Report for Ages 11-18 questionnaire was used to evaluate emotional and behavioral disturbances. The Dutch Eating Behavior Questionnaire was used to assess maladaptive eating. k-Means cluster analysis was used to clarify heterogeneity. Four clusters were identified: the first included anxious, depressed, socially withdrawn adolescents with thought problems and somatic complaints, non-aggressive, obedient, and having mean values on the sleep quality scale, inclined to restrict their food consumption. The second consisted of rule-breaking youngsters with poor sleep quality, reluctant to restrict their food consumption. The third comprised subjects with the highest values on the sleep quality and lowest values on emotional and behavioral problems, aimed at restricting food consumption. The fourth comprised adolescents with obvious signs of emotional disorders, poorest sleep quality, disinhibited behavior, and emotional and external eating. No statistically significant difference was found between the clusters in sex distribution. Patient allocation to the second or fourth cluster was associated with significantly higher body mass index values, as opposed to the reference third cluster.    Conclusion: There is significant variation in teenagers with obesity who have divergent psychological profiles, which should be taken into account. What is Known: • Patients with obesity present with different clinical characteristics. What is New: • Adolescents with obesity may be partitioned into clusters described in terms of emotional, behavioral patterns, including sleep characteristics, and maladaptive eating habits.

Identification of State Markers in Anorexia Nervosa: Replication and Extension of Inflammation Associated Biomarkers Using Multiplex Profiling in Anorexia Nervosa and Atypical Anorexia Nervosa

Proteomics provides an opportunity for detection and monitoring of anorexia nervosa (AN) and its related variant, atypical-AN (atyp-AN). However, research to date has been limited by the small number of proteins explored, exclusive focus on adults with AN, and lack of replication across studies. This study performed Olink Proseek Multiplex profiling of 92 proteins involved in inflammation among females with AN and atyp-AN (N = 64), all < 90% of expected body weight, and age-matched healthy controls (HC; N=44). After correction for multiple testing, nine proteins differed significantly in the AN/atyp-AN group relative to HC group ( lower levels: CXCL1, HGF, IL-18R1, TNFSF14, TRANCE; higher levels: CCL23, Flt3L, LIF-R, MMP-1). The expression levels of three proteins ( lower IL-18R1, TRANCE; higher LIF-R) were uniquely disrupted in females with AN. No unique expression levels emerged for atyp-AN. Across the whole sample, twenty-one proteins correlated positively with BMI (ADA, AXIN1, CD5, CD244, CD40, CD6, CXCL1, FGF-21, HGF, IL-10RB, IL-12B, IL18, IL-18R1, IL6, LAP TGF-beta-1, SIRT2, STAMBP, TNFRSF9, TNFSF14, TRAIL, TRANCE) and six (CCL11, CCL23, FGF-19, IL8, LIF-R, OPG) were negatively correlated with BMI. Overall, our results replicate the prior study demonstrating a dysregulated inflammatory status in AN, and extend these results to atyp-AN (AN/atyp-AN all < 90% of expected body weight). Of the 27 proteins correlated with BMI, 18 were replicated from a prior study using similar methods, highlighting the promise of inflammatory protein expression levels as biomarkers of disease monitoring. Additional studies of individuals across the entire weight spectrum are needed to understand the role of inflammation in atyp-AN.

[Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a network analysis-based model]

OBJECTIVE

To attempt to identify persistent associations between sleep quality, symptoms of emotional and behavioral disturbances, and characteristics of eating behavior in obese adolescents based on a network analysis.

MATERIAL AND METHODS

The study included 194 adolescents, aged 12-17 years (76 girls, 118 boys), with a confirmed diagnosis of obesity due to excess calories (ICD-10 code E66.0). Sleep quality was studied on the basis of the Adolescent Sleep Wake Scale (ASWS), emotional and behavioral disturbances were assessed with the Achenbach Youth Self-Report for Ages 11-18 (YSR), eating behavior - with the Dutch Eating Behavior Questionnaire (DEBQ). Network analysis was used to identify the most significant and stable associations between the studied indicators.

RESULTS

The association of poor sleep quality with manifestations of disinhibited behavior in the form of violations of the rules of behavior, aggressiveness, and impaired attention was revealed. Positive correlations between the manifestations of disinhibited behavior (primarily, rule-breaking behavior) and emotional eating behavior, which, in turn, had a positive relationship with external and a negative relationship with restrictive eating behavior, were noted. The disinhibited adolescent behavior is linked with uncontrolled food intake, which can contribute to the development of obesity.

CONCLUSION

Impaired sleep quality, symptoms of emotional and behavioral disorders, and eating disorders in obese adolescents present a stable and specific clinical pattern that should be taken into account when justifying therapy.

Severe Obesity in Children and Adolescents: Metabolic Effects, Assessment, and Treatment

Childhood obesity has been increasing steadily in recent decades, and severe childhood obesity has emerged as a major public health problem both nationally and internationally. A current concern is that lockdown due to the coronavirus disease 2019 (COVID-19) pandemic could exacerbate the spread of childhood obesity and increase the gap in obesity risk. Recent research results indicate the aggravation of obesity after school closures. The consequences of severe childhood obesity are more devastating than those of mild to moderate obesity. Children with severe obesity are at greater risk than others for hypertension, type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease, atherosclerosis, and adult obesity. Accurately assessing and diagnosing a child with severe obesity is the key to implementing successful therapy. A detailed and accurate patient history and physical examination are important to discriminate monogenic obesity and metabolic syndrome diagnoses from severe obesity without an underlying cause. Psychosocial factors, including eating behaviors, should be assessed to facilitate better weight management outcomes. Treatment options for severe pediatric obesity include lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery. However, lifestyle modification should be the priority. Although progress has been made, safe and effective treatment for severe pediatric obesity is still challenging. More efforts and innovations are needed to find a solution for the huge medical and emotional burden that these children and their families carry. Public health organizations also need to make efforts to encourage and normalize healthy eating habits and exercise to prevent severe obesity in childhood.