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Elguezabal Rodelo RG, Porchia LM, Torres‐Rasgado E, López-Bayghen E, Gonzalez-Mejia ME. Visceral and subcutaneous abdominal fat is associated with non-alcoholic fatty liver disease while augmenting Metabolic Syndrome's effect on non-alcoholic fatty liver disease: A cross-sectional study of NHANES 2017-2018. PLoS One 2024; 19:e0298662. [PMID: 38394065 PMCID: PMC10889905 DOI: 10.1371/journal.pone.0298662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The aim was to evaluate the effect different types of abdominal fat have on NAFLD development and the effects of abdominal fat has on the association between Metabolic Syndrome (MetS) and NALFD. METHODS Data was collected from the cross-sectional NHANES dataset (2017-2018 cycle). Using the controlled attenuation parameter (USG CAP, dB/m), which measures the level of steatosis, the cohort was stratified into two groups: NAFLD(+) (≥274 dB/m) and NAFLD(-). Using complex samples analyses, associations between liver steatosis or NAFLD and types of abdominal fat area [Total abdominal (TAFA), subcutaneous (SAT), and visceral (VAT)] were determined. Pearson's correlation coefficient (r) was calculated to evaluate the associations between adipose tissues and NAFLD. Logistic regression was used to determine the risk [odds ratio (OR) and 95% confidence interval (95%CI)]. Participants were also classified by MetS, using the Harmonizing Definition criteria. RESULTS Using 1,980 participants (96,282,896 weighted), there was a significant (p<0.001) correlation between USG CAP and TAFA (r = 0.569), VAT (r = 0.645), and SAT (r = 0.479). Additionally, the risk of developing NAFLD was observed for total abdominal obesity (OR = 19.9, 95%CI: 5.1-77.8, p<0.001), visceral obesity (OR = 9.1, 95%CI: 6.2-13.5, p<0.001) and subcutaneous obesity (OR = 4.8, 95%CI: 3.2-6.9, p<0.001). Using 866 participants (44,399,696 weighted), for visceral obesity, participants with MetS and visceral obesity (OR = 18.1, 95%CI: 8.0-41.3, p<0.001) were shown to have a greater risk than participants with MetS only (OR = 6.3, 95%CI: 2.6-15.2, p<0.001). For subcutaneous obesity, again, participants with MetS and subcutaneous obesity (OR = 18.3, 95%CI: 8.0-41.9, p<0.001) were shown to have a greater risk than the MetS-only group (OR = 10.3, 95%CI: 4.8-22.4, p<0.001). CONCLUSION TAFA, VAT, and SAT were positively associated with USG CAP values and increased the risk of developing NAFLD. Also, the type of abdominal fat depots did affect the association between MetS and NAFLD.
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Affiliation(s)
| | - Leonardo M. Porchia
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla, México
| | | | - Esther López-Bayghen
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
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Vallis M. Helping providers address psychological aspects of obesity in routine care: Development of the obesity adjustment dialogue tool (OADT). OBESITY PILLARS (ONLINE) 2023; 8:100088. [PMID: 38125657 PMCID: PMC10728697 DOI: 10.1016/j.obpill.2023.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 12/23/2023]
Abstract
Background This study developed and validated a dialogue tool (Obesity Adjustment Dialogue Tool) to efficiently assess QoL and drive to eat for use in routine clinical care. Methods A 13-question interview was created, assessing the impact of living with obesity on quality of life and drive to eat. In a counter-balanced order, PwO were interviewed and completed the Obesity Adjustment Survey (OAS), the Impact of Obesity on Quality of Life-Lite scale (IWQoL), the Three Factor Eating Questionnaire (TREQ), and the Control of Eating Questionnaire (COEQ). Questionnaire results were used to validate the interview using correlational and concordance measures. Results 101 PwO consented and 98 completed all measures (mean BMI = 37.8; 30.7% Class III obesity). Correlations between the QoL dialogue tool and validated instruments (OAS, IWQOL) were moderate to high. Correlations between cravings questions and validated measures (TFEQ, COEQ) were high except for attempts to control eating. Correspondence based on categorizing both the dialogue tool and scales into high/low impact was high except for attempts to control eating (which was dropped from the final tool). Conclusion The Obesity Adjustment Dialogue Tool is a brief clinician-led structured interview which closely matches information derived from validated scales. This tool offers an efficient approach to incorporating QoL factors into obesity management.
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Affiliation(s)
- Michael Vallis
- Family Medicine, Dalhousie University, 133 Milsom St, Halifax, Nova Scotia, B3N 3M3, Canada
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3
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Zavros A, Andreou E, Aphamis G, Bogdanis GC, Sakkas GK, Roupa Z, Giannaki CD. The Effects of Zinc and Selenium Co-Supplementation on Resting Metabolic Rate, Thyroid Function, Physical Fitness, and Functional Capacity in Overweight and Obese People under a Hypocaloric Diet: A Randomized, Double-Blind, and Placebo-Controlled Trial. Nutrients 2023; 15:3133. [PMID: 37513551 PMCID: PMC10386647 DOI: 10.3390/nu15143133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Evidence of the effectiveness of zinc (Zn) and selenium (Se) on resting metabolic rate (RMR) and physical function parameters in people with overweight and obesity is scarce, while the effects of zinc and selenium on thyroid function and body composition are still a topic of debate and controversy. The aim of this randomized, double-blind, and placebo-controlled trial was to examine the effects of a hypocaloric diet and Se-Zn co-supplementation on RMR, thyroid function, body composition, physical fitness, and functional capacity in overweight or obese individuals. Twenty-eight overweight-obese participants (mean BMI: 29.4 ± 4.7) were randomly allocated (1:1) to the supplementation group (n = 14, 31.1 ± 5.5 yrs, 9 females) and the placebo group (n = 14, 32.1 ± 4.8 yrs, 6 females). The participants received Zn (25 mg of zinc gluconate/day) and Se (200 mcg of L-selenomethionine/day) or placebo tablets containing starch for eight weeks. The participants of both groups followed a hypocaloric diet during the intervention. RMR, thyroid function, body composition, cardiorespiratory fitness (VO2max), and functional capacity (sit-to-stand tests, timed up-and-go test, and handgrip strength) were assessed before and after the intervention. A significant interaction was found between supplementation and time on RMR (p = 0.045), with the intervention group's RMR increasing from 1923 ± 440 to 2364 ± 410 kcal/day. On the other hand, no interaction between supplementation and time on the thyroid function was found (p > 0.05). Regarding the effects of Zn/Se co-administration on Se levels, a significant interaction between supplementation and time on Se levels was detected (p = 0.004). Specifically, the intervention group's Se serum levels were increased from 83.04 ± 13.59 to 119.40 ± 23.93 μg/L. However, Zn serum levels did not change over time (90.61 ± 23.23 to 89.58 ± 10.61 umol/L). Even though all body composition outcomes improved in the intervention group more than placebo at the second measurement, no supplement × time interaction was detected on body composition (p > 0.05). Cardiorespiratory fitness did not change over the intervention. Yet, a main effect of time was found for some functional capacity tests, with both groups improving similarly over the eight-week intervention period (p < 0.05). In contrast, a supplement x group interaction was found in the performance of the timed up-and-go test (TUG) (p = 0.010), with the supplementation group improving more. In conclusion, an eight-week intervention with Zn/Se co-supplementation combined with a hypocaloric diet increased the RMR, TUG performance, and Se levels in overweight and obese people. However, thyroid function, Zn levels, body composition, and the remaining outcomes of exercise performance remained unchanged.
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Affiliation(s)
- Antonis Zavros
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Eleni Andreou
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - George Aphamis
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Gregory C Bogdanis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Giorgos K Sakkas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Zoe Roupa
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - Christoforos D Giannaki
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
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Tremblay EJ, Tchernof A, Pelletier M, Chabot N, Joanisse DR, Mauriège P. Contribution of markers of adiposopathy and adipose cell size in predicting insulin resistance in women of varying age and adiposity. Adipocyte 2022; 11:175-189. [PMID: 35436409 PMCID: PMC9037496 DOI: 10.1080/21623945.2022.2059902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Adipose tissue (AT) dysfunctions, such as adipocyte hypertrophy, macrophage infiltration and secretory adiposopathy (low plasma adiponectin/leptin, A/L, ratio), associate with metabolic disorders. However, no study has compared the relative contribution of these markers to cardiometabolic risk in women of varying age and adiposity. Body composition, regional AT distribution, lipid-lipoprotein profile, glucose homeostasis and plasma A and L levels were determined in 67 women (age: 40-62 years; BMI: 17-41 kg/m2). Expression of macrophage infiltration marker CD68 and adipocyte size were measured from subcutaneous abdominal (SCABD) and omental (OME) fat. AT dysfunction markers correlated with most lipid-lipoprotein levels. The A/L ratio was negatively associated with fasting insulinemia and HOMA-IR, while SCABD or OME adipocyte size and SCABD CD68 expression were positively related to these variables. Combination of tertiles of largest adipocyte size and lowest A/L ratio showed the highest HOMA-IR. Multiple regression analyses including these markers and TAG levels revealed that the A/L ratio was the only predictor of fasting insulinemia and HOMA-IR. The contribution of the A/L ratio was superseded by adipose cell size in the model where the latter replaced TAGs. Finally, leptinemia was a better predictor of IR than adipocyte size and the A/L ratio in our participants sample.
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Affiliation(s)
- Eve-Julie Tremblay
- Département de kinésiologie, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche de l’institut Universitaire de cardiologie et pneumologie de Québec (CRIUCPQ), Université Laval, Québec, Canada
| | - André Tchernof
- Centre de recherche de l’institut Universitaire de cardiologie et pneumologie de Québec (CRIUCPQ), Université Laval, Québec, Canada
- École de Nutrition, Faculté des sciences de l’agriculture et de l’alimentation, Université Laval, Québec, Canada
| | - Mélissa Pelletier
- Centre de recherche de l’institut Universitaire de cardiologie et pneumologie de Québec (CRIUCPQ), Université Laval, Québec, Canada
| | - Nicolas Chabot
- Département de kinésiologie, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche de l’institut Universitaire de cardiologie et pneumologie de Québec (CRIUCPQ), Université Laval, Québec, Canada
| | - Denis R. Joanisse
- Département de kinésiologie, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche de l’institut Universitaire de cardiologie et pneumologie de Québec (CRIUCPQ), Université Laval, Québec, Canada
| | - Pascale Mauriège
- Département de kinésiologie, Faculté de médecine, Université Laval, Québec, Canada
- Centre de recherche de l’institut Universitaire de cardiologie et pneumologie de Québec (CRIUCPQ), Université Laval, Québec, Canada
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Zhu Y, Loggia ML, Edwards RR, Flowers KM, Muñoz-Vergara DW, Partridge AH, Schreiber KL. Increased Clinical Pain Locations and Pain Sensitivity in Women After Breast Cancer Surgery: Influence of Aromatase Inhibitor Therapy. Clin J Pain 2022; 38:721-729. [PMID: 36136765 PMCID: PMC9649865 DOI: 10.1097/ajp.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/13/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Aromatase inhibitors (AIs), which potently inhibit estrogen biosynthesis, are a standard treatment for hormone sensitive early-stage breast cancer. AIs have been associated with substantial joint pain and muscle stiffness (aromatase inhibitor-associated musculoskeletal syndrome). However, the link between AIs and number of clinical pain locations and pain sensitivity are less well understood. The aim of this study was to compare longitudinal changes in clinical pain and quantitative pain sensitivity between women who did or did not receive AI therapy. METHODS Women with early-stage breast cancer were prospectively enrolled and assessed for clinical pain in surgical and nonsurgical body areas using the Brief Pain Inventory and Breast Cancer Pain Questionnaire, and for pain sensitivity using quantitative sensory testing preoperatively and at 1 year postoperatively. Pain outcomes between participants who did and did not begin adjuvant AI therapy were compared using Wilcoxon Signed-Ranks and generalized estimating equation linear regression analyses. RESULTS Clinical pain and pain sensitivity were comparable between AI (n=49) and no-AI (n=106) groups preoperatively. After adjusting for body mass index, AI therapy was associated with a greater increase in the number of painful nonsurgical body sites (significant time by treatment interaction, P =0.024). Pain location was most frequent in knees (28%), lower back (26%), and ankles/feet (17%). Quantitative sensory testing revealed a significant decrease in pain sensitivity (increased pressure pain threshold) in the no-AI group over time, but not in the AI group. CONCLUSIONS AI therapy was associated with increased diffuse joint-related pain and greater post-treatment pain sensitivity, potentially implicating central sensitization as a contributing pain mechanism of aromatase inhibitor-associated musculoskeletal syndrome worthy of future investigation.
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Affiliation(s)
- Yehui Zhu
- Department of Radiology, Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Marco L. Loggia
- Department of Radiology, Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert R. Edwards
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kelsey M. Flowers
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dennis W. Muñoz-Vergara
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ann H. Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute and Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin L. Schreiber
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Blüher M, Ceriello A, Davies M, Rodbard H, Sattar N, Schnell O, Tonchevska E, Giorgino F. Managing weight and glycaemic targets in people with type 2 diabetes—How far have we come? Endocrinol Diabetes Metab 2022; 5:e00330. [PMID: 35298097 PMCID: PMC9094453 DOI: 10.1002/edm2.330] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction As the vast majority of people with type 2 diabetes (T2D) are also overweight or obese, healthcare professionals (HCP) are faced with the task of addressing both weight management and glucose control. In this narrative review, we aim to identify the challenges of reaching and maintaining body weight targets in people with T2D and highlight current and future treatment interventions. Methods A search of the PubMed database was conducted using the search terms “diabetes” and “weight loss.” Results According to emerging evidence, treating obesity may be antecedent to the development and progression of T2D. While clinical benefits typically set in upon achieving a weight loss of 3–5%, these benefits are progressive leading to further health improvements, and weight loss of >15% can have a disease‐modifying effect in people with T2D, an outcome that up to recently could not be achieved with any blood glucose‐lowering pharmacotherapy. However, advanced treatment options with weight‐loss effects currently in development including the dual GIP/GLP‐1 receptor agonists may enable simultaneous achievement of individual glycemic and weight goals. Conclusion Despite considerable therapeutic progress, there is still a large unmet medical need in patients with T2D who miss their individualized glycemic and weight‐loss targets. Nonetheless, it is to be expected that development of future therapies and their use will favourably change the scenario of weight and glucose control in T2D.
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Affiliation(s)
- Matthias Blüher
- Medical Department III – Endocrinology, Nephrology, Rheumatology University of Leipzig Medical Center Leipzig Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI‐MAG) of the Helmholtz Zentrum München at the University of Leipzig Leipzig Germany
| | - Antonio Ceriello
- Department of Cardiovascular and Metabolic Diseases IRCCS MultiMedica Milan Italy
| | - Melanie Davies
- Diabetes Research Centre University of Leicester Leicester UK
- NIHR Leicester Biomedical Research Centre Leicester UK
| | - Helena Rodbard
- Endocrine and Metabolic Consultants Rockville Maryland USA
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Oliver Schnell
- Sciarc GmbH Baierbrunn Germany
- Forschergruppe Diabetes e. V. Munich Germany
| | | | - Francesco Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases University of Bari Aldo Moro Bari Italy
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Cuda SE, Censani M. Assessment, differential diagnosis, and initial clinical evaluation of the pediatric patient with obesity: An Obesity Medical Association (OMA) Clinical Practice Statement 2022. OBESITY PILLARS (ONLINE) 2022; 1:100010. [PMID: 37990703 PMCID: PMC10662031 DOI: 10.1016/j.obpill.2022.100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 12/26/2021] [Accepted: 01/02/2022] [Indexed: 11/23/2023]
Abstract
Background The Obesity Medical Association (OMA) Clinical Practice Statement (CPS) on the assessment, differential diagnosis, and initial clinical evaluation of pediatric patients with obesity is intended to provide clinicians with an overview of clinical practices applicable to children and adolescents with body mass indexes greater than or equal to the 95th percentile for their ages, particularly those with adverse consequences resulting from increased body mass. The information in this CPS is based on scientific evidence, supported by the medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS is based upon referenced evidence and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement on assessment, differential diagnosis, and initial clinical evaluation of pediatric patients with obesity provides clinical information regarding classification of children and adolescents with overweight or obesity, differential diagnoses to consider, and a roadmap for the initial clinical evaluation. Conclusions This OMA Clinical Practice Statement on assessment, differential diagnosis, and initial clinical evaluation of pediatric patients with obesity is an overview of current recommendations. Assessment of pediatric patients with obesity is the first step in determining treatments leading to the improvement of the health of children and adolescents with obesity, especially those with metabolic, physiological, and psychological complications.
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Affiliation(s)
- Suzanne E. Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
| | - Marisa Censani
- New York Presbyterian Hospital, Weill Cornell Medicine, Department of Pediatrics, Division of Pediatric Endocrinology; New York, NY, USA
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Fitch AK, Bays HE. Obesity definition, diagnosis, bias, standard operating procedures (SOPs), and telehealth: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100004. [PMID: 37990702 PMCID: PMC10661988 DOI: 10.1016/j.obpill.2021.100004] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2023]
Abstract
Background The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) regarding definition, diagnosis, bias, standard operating procedures (SOPs) and telehealth is intended to provide clinicians an overview of obesity medicine and provide basic organizational tools towards establishing, directing, managing, and maintaining an obesity medical practice. Methods This CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by Obesity Medicine Association leadership. Results OMA has defined obesity as: "A chronic, progressive, relapsing, and treatable multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences." While body mass index may be sufficiently diagnostic for populations and many patients, accurate diagnosis of adiposity in an individual may require anthropometric assessments beyond body weight alone (e.g., waist circumference, percent body fat, and android/visceral fat). Obesity complications can be categorized as "sick fat disease" (adiposopathy) and/or "fat mass disease." Obesity complications predominantly of fat mass origins include sleep apnea and orthopedic conditions. Obesity complications due to adiposopathic endocrinopathies and/or immunopathies include cardiovascular disease, cancer, elevated blood sugar, elevated blood pressure, dyslipidemia, fatty liver, and alterations in sex hormones in both males (i.e., hypogonadism) and females (i.e., polycystic ovary syndrome). Obesity treatment begins with proactive steps to avoid weight bias, including patient-appropriate language, office equipment, and supplies. To help manage obesity and its complications, this CPS provides a practical template for an obesity medicine practice, creation of standard operating procedures, and incorporation of the OMA "ADAPT" method in telehealth (Assessment, Diagnosis, Advice, Prognosis, and Treatment). Conclusions The OMA CPS regarding "Obesity Definition, Diagnosis, Bias, Standard Operating Procedures (SOPs), and Telehealth" is one in a series of OMA CPSs designed to assist clinicians care for patients with the disease of obesity.
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Affiliation(s)
- Angela K. Fitch
- Massachusetts General Hospital Weight Center, Harvard Medical School, 50 Staniford Street Suite 430, Boston, MA, 02114, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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Guerra JVS, Dias MMG, Brilhante AJVC, Terra MF, García-Arévalo M, Figueira ACM. Multifactorial Basis and Therapeutic Strategies in Metabolism-Related Diseases. Nutrients 2021; 13:nu13082830. [PMID: 34444990 PMCID: PMC8398524 DOI: 10.3390/nu13082830] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022] Open
Abstract
Throughout the 20th and 21st centuries, the incidence of non-communicable diseases (NCDs), also known as chronic diseases, has been increasing worldwide. Changes in dietary and physical activity patterns, along with genetic conditions, are the main factors that modulate the metabolism of individuals, leading to the development of NCDs. Obesity, diabetes, metabolic associated fatty liver disease (MAFLD), and cardiovascular diseases (CVDs) are classified in this group of chronic diseases. Therefore, understanding the underlying molecular mechanisms of these diseases leads us to develop more accurate and effective treatments to reduce or mitigate their prevalence in the population. Given the global relevance of NCDs and ongoing research progress, this article reviews the current understanding about NCDs and their related risk factors, with a focus on obesity, diabetes, MAFLD, and CVDs, summarizing the knowledge about their pathophysiology and highlighting the currently available and emerging therapeutic strategies, especially pharmacological interventions. All of these diseases play an important role in the contamination by the SARS-CoV-2 virus, as well as in the progression and severity of the symptoms of the coronavirus disease 2019 (COVID-19). Therefore, we briefly explore the relationship between NCDs and COVID-19.
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Affiliation(s)
- João V. S. Guerra
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Pharmaceutical Sciences, Faculty Pharmaceutical Sciences, University of Campinas, Campinas 13083-970, Brazil
| | - Marieli M. G. Dias
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
| | - Anna J. V. C. Brilhante
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biorenewables National Laboratory (LNBR), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil
| | - Maiara F. Terra
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Graduate Program in Functional and Molecular Biology, Institute of Biology, State University of Campinas (Unicamp), Campinas 13083-970, Brazil;
| | - Marta García-Arévalo
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Correspondence: or (M.G.-A.); (A.C.M.F.)
| | - Ana Carolina M. Figueira
- Brazilian Center for Research in Energy and Materials (CNPEM), Brazilian Biosciences National Laboratory (LNBio), Polo II de Alta Tecnologia—R. Giuseppe Máximo Scolfaro, Campinas 13083-100, Brazil; (J.V.S.G.); (M.M.G.D.); (M.F.T.)
- Correspondence: or (M.G.-A.); (A.C.M.F.)
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Alviz L, Tebar-García D, Lopez-Rosa R, Galan-Moya EM, Moratalla-López N, Alonso GL, Nava E, Llorens S. Pathogenic Microenvironment from Diabetic-Obese Visceral and Subcutaneous Adipocytes Activating Differentiation of Human Healthy Preadipocytes Increases Intracellular Fat, Effect of the Apocarotenoid Crocetin. Nutrients 2021; 13:nu13031032. [PMID: 33806806 PMCID: PMC8004803 DOI: 10.3390/nu13031032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/12/2022] Open
Abstract
In diabetes mellitus type 2 (DM2), developed obesity is referred to as diabesity. Implementation of a healthy diet, such as the Mediterranean, prevents diabesity. Saffron is frequently used in this diet because of its bioactive components, such as crocetin (CCT), exhibit healthful properties. It is well known that obesity, defined as an excessive accumulation of fat, leads to cardiometabolic pathology through adiposopathy or hypertrophic growth of adipose tissue (AT).This is related to an impaired adipogenic process or death of adipocytes by obesogenic signals. We aimed to evaluate the effect of the pathogenic microenvironment and CCT, activating differentiation of healthy preadipocytes (PA). For this, we used human cryopreserved PA from visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) depots obtained from healthy and obese-DM2 donors. We studied the effect of a metabolically detrimental (diabesogenic) environment, generated by obese-DM2 adipocytes from VAT (VdDM) or SAT (SdDM), on the viability and accumulation of intracellular fat of adipocytes differentiated from healthy PA, in the presence or absence of CCT (1 or 10 μM). Intracellular fat was quantified by Oil Red O staining. Cytotoxicity was measured using the MTT assay. Our results showed that diabesogenic conditions induce cytotoxicity and provide a proadipogenic environment only for visceral PA. CCT at 10 μM acted as an antiadipogenic and cytoprotective compound.
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Affiliation(s)
- Lesgui Alviz
- Seguro Social de Salud del Perú (EsSalud) Andahuaylas, Apurímac 03701, Peru;
| | - David Tebar-García
- Translational Oncology Laboratory, Centro Regional de Investigaciones Biomédicas (CRIB), Universidad de Castilla-La Mancha, 02008 Albacete, Spain; (D.T.-G.); (R.L.-R.); (E.M.G.-M.)
| | - Raquel Lopez-Rosa
- Translational Oncology Laboratory, Centro Regional de Investigaciones Biomédicas (CRIB), Universidad de Castilla-La Mancha, 02008 Albacete, Spain; (D.T.-G.); (R.L.-R.); (E.M.G.-M.)
| | - Eva M. Galan-Moya
- Translational Oncology Laboratory, Centro Regional de Investigaciones Biomédicas (CRIB), Universidad de Castilla-La Mancha, 02008 Albacete, Spain; (D.T.-G.); (R.L.-R.); (E.M.G.-M.)
| | - Natalia Moratalla-López
- Cátedra de Química Agrícola, ETSI Agrónomos y de Montes, Universidad de Castilla-La Mancha, Campus Universitario, 02071 Albacete, Spain; (N.M.-L.); (G.L.A.)
| | - Gonzalo L. Alonso
- Cátedra de Química Agrícola, ETSI Agrónomos y de Montes, Universidad de Castilla-La Mancha, Campus Universitario, 02071 Albacete, Spain; (N.M.-L.); (G.L.A.)
| | - Eduardo Nava
- Department of Medical Sciences, Faculty of Medicine of Albacete, Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, 02008 Albacete, Spain;
| | - Sílvia Llorens
- Department of Medical Sciences, Faculty of Medicine of Albacete, Centro Regional de Investigaciones Biomédicas (CRIB), University of Castilla-La Mancha, 02008 Albacete, Spain;
- Correspondence:
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11
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Bini S, D’Erasmo L, Di Costanzo A, Minicocci I, Pecce V, Arca M. The Interplay between Angiopoietin-Like Proteins and Adipose Tissue: Another Piece of the Relationship between Adiposopathy and Cardiometabolic Diseases? Int J Mol Sci 2021; 22:ijms22020742. [PMID: 33451033 PMCID: PMC7828552 DOI: 10.3390/ijms22020742] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 12/15/2022] Open
Abstract
Angiopoietin-like proteins, namely ANGPTL3-4-8, are known as regulators of lipid metabolism. However, recent evidence points towards their involvement in the regulation of adipose tissue function. Alteration of adipose tissue functions (also called adiposopathy) is considered the main inducer of metabolic syndrome (MS) and its related complications. In this review, we intended to analyze available evidence derived from experimental and human investigations highlighting the contribution of ANGPTLs in the regulation of adipocyte metabolism, as well as their potential role in common cardiometabolic alterations associated with adiposopathy. We finally propose a model of ANGPTLs-based adipose tissue dysfunction, possibly linking abnormalities in the angiopoietins to the induction of adiposopathy and its related disorders.
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12
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Abstract
Obesity is a chronic disease caused by dysregulated energy homeostasis pathways that encourage the accumulation of adiposity, which in turn results in the development or exacerbation of weight-related comorbidities. Treatment of obesity relies on a foundation of lifestyle modification; weight loss pharmacotherapy, bariatric surgery and devices are additional tools to help patients achieve their health goals. Appropriate management of patients with obesity provides multiple metabolic benefits beyond weight loss.
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Affiliation(s)
- Beverly G Tchang
- Department of Internal Medicine, Division of Endocrinology, Weill Cornell Medical College, 1165 York Avenue, New York, NY 10065, USA
| | - Katherine H Saunders
- Department of Internal Medicine, Division of Endocrinology, Weill Cornell Medical College, 1165 York Avenue, New York, NY 10065, USA
| | - Leon I Igel
- Department of Internal Medicine, Division of Endocrinology, Weill Cornell Medical College, 1165 York Avenue, New York, NY 10065, USA.
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13
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Role of adiposopathy and physical activity in cardio-metabolic disorder diseases. Clin Chim Acta 2020; 511:243-247. [PMID: 33148528 DOI: 10.1016/j.cca.2020.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/27/2023]
Abstract
Positive calorie balance disrupts the function of visceral adipose tissue, including the cardiac adipose tissue and the perivascular adipose tissue. The inflammatory and hormonal factors, which are released from adipose tissue, play a central role in inter-organ cross talk, affecting the development of obesity. Excess fat in visceral adipocytes impairs endocrine as well as immune response, leading to multiple aberrant status and posing serious risks to the future health of humans. As confirmed in previous studies, up-regulated pro-inflammatory and down-regulated anti-inflammatory cytokines disturb the communication among muscle, liver, and vasculature. In other words, adiposopathy promote cardio-metabolic risk factors, such as atherosclerosis, hypertension, insulin resistance, dyslipidemia, and pro-thrombotic state, which in turn directly and indirectly promote cardio-metabolic disorder diseases. Increasing evidence from human and animal studies has shown that physical activity restores the size of adipocytes and helps in re-browning of white adipose tissue (WAT). This review summarizes the current evidence on the roles of adiposopathy on cardio-metabolic disorder diseases and the importance of physical activity in restoring the function of adipocytes.
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14
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Mauriège P, Karelis AD, Taleb N, Clément AA, Joanisse DR. Comparing an adiposopathy approach with four popular classifications schemes to categorize the metabolic profile of postmenopausal women. J Physiol Biochem 2020; 76:609-622. [PMID: 32970306 DOI: 10.1007/s13105-020-00766-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 09/07/2020] [Indexed: 01/04/2023]
Abstract
Numerous classifications are used to discern metabolically healthy obese (MHO) from metabolically abnormal obese (MAO) individuals. The goal of this study was to compare a single phenotype approach, adiposopathy (i.e., the plasma adiponectin/leptin ratio), with four commonly used classifications (International Diabetes Federation (IDF), Karelis, Lynch, Wildman), all based on obesity with other risk factors), for their ability to discern phenotypic differences between MAO and MHO postmenopausal women. Anthropometry, body composition, blood pressure, cardiorespiratory fitness (CRF), lipid-lipoprotein, hepatic, inflammatory, and adipokine profiles, as well as glucose-insulin homeostasis, were assessed in 79 obese sedentary postmenopausal women (60 ± 5 years; body mass index, BMI, 34.0 ± 3.7 kg/m2). Abdominal subcutaneous adipose tissue (SCAT) expression of selected genes involved in fatty acid metabolism and inflammation was used as markers of tissue state (n = 48). Beyond their intrinsic criteria, adiposopathy was almost as effective as the Karelis definition in discerning differences in MHO for adiposity (reduced body weight, BMI, waist circumference, and fat mass), lipid-lipoprotein (lower triacylglycerol and higher HDL-cholesterol levels, reduced atherogenic ratios) and adipokine (higher adiponectin and lower leptin levels) profiles, and glucose-insulin homeostasis (lower insulin resistance) as well as for some SCAT gene expression related to lipolysis and lipogenesis, but was the only one able to distinguish these subjects for greater CRF. The other classifications revealed fewer differences between MAO and MHO women. These data suggest that considering a marker of AT dysfunction such as adiposopathy either alone or in addition to other criteria could be potentially interesting in discerning the MHO phenotype.
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Affiliation(s)
- Pascale Mauriège
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada. .,Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, Canada.
| | - Antony D Karelis
- Département des Sciences de l'activité physique, Université du Québec à Montréal, Montréal, Canada.,Institut de Recherches Cliniques de Montréal, Université de Montréal, Montréal, Canada
| | - Nadine Taleb
- Institut de Recherches Cliniques de Montréal, Université de Montréal, Montréal, Canada
| | - Andrée-Anne Clément
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.,Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, Canada
| | - Denis R Joanisse
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.,Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, Canada
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15
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De Lorenzo A, Romano L, Di Renzo L, Di Lorenzo N, Cenname G, Gualtieri P. Obesity: A preventable, treatable, but relapsing disease. Nutrition 2020; 71:110615. [DOI: 10.1016/j.nut.2019.110615] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/19/2019] [Accepted: 10/05/2019] [Indexed: 12/26/2022]
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16
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Saxena A, Tiwari P, Wahi N, Kumar A, Mathur SK. The common pathophysiologic threads between Asian Indian diabetic's 'Thin Fat Phenotype' and partial lipodystrophy: the peripheral adipose tissue transcriptomic evidences. Adipocyte 2020; 9:253-263. [PMID: 32491965 PMCID: PMC7469556 DOI: 10.1080/21623945.2020.1776082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
T2D is a complex disease with poorly understood mechanisms. In Asian Indians, it is associated with “thin fat” phenotype which resembles with partial lipodystrophy. We hypothesized that disturbed expression of lipodystrophy genes might play a role in T2D pathogenesis. Therefore, we attempted to establish a link between these two diseases by studying the overlap between the network of lipodystrophy genes and the differentially expressed genes (DEGs) in the peripheral subcutaneous adipose tissue of Asian Indians diabetics. We found that 16, out of 138 lipodystrophy genes were differentially regulated in diabetics and around 18% overlap between their network and the DEGs; the expression level of lipodystrophy genes showed an association with disease-related intermediate phenotypic traits among diabetics but not in the control group. We also attempted to individualize the diabetic patients based on ±2 fold altered expression of lipodystrophy genes as compared to their average expression in the control group. In conclusion, significant overlap exists between some of the lipodystrophy genes and their network with DEGs in the peripheral adipose tissue in diabetics. They possibly play a role in the pathogenesis of diabetes and individualization of diabetics is possible based on their altered expression in their peripheral adipose tissue.
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Affiliation(s)
- Aditya Saxena
- Department of Biotechnology, Institute of Applied Sciences and Humanities, GLA University, Mathura, India
| | - Pradeep Tiwari
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
- Department of Biotechnology and Bioinformatics, Birla Institute of Scientific Research (BISR), Jaipur, India
- Department of Chemistry, School of Basic Sciences, Manipal University Jaipur, Jaipur, India
| | - Nitin Wahi
- Department of Bioinfoirmatics, Pathfinder Research and Training Foundation, Gr. Noida, India
| | - Anshul Kumar
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
| | - Sandeep Kumar Mathur
- Department of Endocrinology, Sawai Man Singh Medical College and Hospital, Jaipur, India
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Gilbertson NM, Eichner NZM, Heiston EM, Gaitán JM, Francois ME, Mehaffey JH, Hassinger TE, Hallowell PT, Weltman A, Malin SK. A low-calorie diet with or without interval exercise training improves adiposopathy in obese women. Appl Physiol Nutr Metab 2019; 44:1057-1064. [PMID: 30785773 DOI: 10.1139/apnm-2018-0717] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The objective of this study was to test if a low-calorie diet plus interval exercise (LCD+INT) improves adiposopathy, an endocrine dysfunction, when compared with an energy-deficit-matched LCD in obese women. Subjects (age: 48.2 ± 2.4 years, body mass index: 37.8 ± 1.3 kg/m2) were randomized to a 13-day LCD (n = 12; mixed meals of ∼1200 kcal/day) or LCD+INT (n = 12; 12 sessions of 60 min/day alternating 3 min at 50% and 90% peak heart rate). Exercise was estimated to expend 350 kcal per oxygen uptake-heart rate regression analysis and individuals were refed calories expended to match energy availability between groups. Absolute (post - pre caloric intake) and relative (total daily and exercise energy expenditure relative to calorie intake) energy deficits were calculated. Fitness (peak oxygen uptake) and body composition (BodPod; Cosmed USA Inc.) were measured and a 120-min, 75g oral glucose tolerance test was performed at pre- and post-intervention to assess adiposopathy (i.e., ratio of high molecular weight-adiponectin to leptin) and estimate insulin sensitivity. LCD and LCD+INT had similar absolute (P = 0.55) and relative (P = 0.76) energy deficits. LCD and LCD+INT had similar reductions in fat mass (both P < 0.001), despite LCD inducing greater weight loss (P = 0.02) than LCD+INT. Both treatments improved adiposopathy (P = 0.003) and peripheral insulin sensitivity (P = 0.02). Absolute energy deficit correlated to improved adiposopathy (r = -0.41, P = 0.05), and absolute and relative energy deficits were associated with increased insulin sensitivity (r = -0.47, P = 0.02; and r = -0.40, P = 0.05, respectively), independent of body composition changes and increased peak oxygen uptake. Taken together, LCD, with or without INT, improves adiposopathy in relation to insulin sensitivity in obese women, suggesting that a short-term energy deficit is key for reducing risk of type 2 diabetes.
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Affiliation(s)
- Nicole M Gilbertson
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
| | - Natalie Z M Eichner
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
| | - Emily M Heiston
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
| | - Julian M Gaitán
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
| | - Monique E Francois
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
| | - J Hunter Mehaffey
- Department of Surgery, University of Virginia, Charlottesville, VA 22902, USA
| | - Taryn E Hassinger
- Department of Surgery, University of Virginia, Charlottesville, VA 22902, USA
| | - Peter T Hallowell
- Department of Surgery, University of Virginia, Charlottesville, VA 22902, USA
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
- Division of Endocrinology & Metabolism, Department of Medicine, University of Virginia, Charlottesville, VA 22902, USA
| | - Steven K Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22902, USA
- Division of Endocrinology & Metabolism, Department of Medicine, University of Virginia, Charlottesville, VA 22902, USA
- Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA 22902, USA
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18
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Mohan S, R PRM, Brown L, Ayyappan P, G RK. Endoplasmic reticulum stress: A master regulator of metabolic syndrome. Eur J Pharmacol 2019; 860:172553. [PMID: 31325433 DOI: 10.1016/j.ejphar.2019.172553] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/04/2019] [Accepted: 07/16/2019] [Indexed: 12/20/2022]
Abstract
Endoplasmic reticulum (ER) stress, a change in the ER homeostasis, leads to initiation of the unfolded protein response (UPR). The primary functions of the UPR are to restore the ER's physiological activity and coordinate the apoptotic and adaptive responses. Pathophysiological conditions that augment ER stress include hypoxia, misfolded and/or mutated protein accumulation, and high glucose. Prolonged ER stress is a critical factor in the pathogenesis of metabolic syndrome including type 2 diabetes mellitus, cardiovascular diseases, atherosclerosis, obesity, and fatty liver disease. UPR is a complex homeostatic pathway between newly synthesized proteins and their maturation, although the regulatory mechanisms contributing to the UPR and the possible therapeutic strategies are yet to be clarified. Therefore, a comprehensive understanding of the underlying molecular mechanisms is necessary to develop therapeutic interventions targeting ER stress response. In this review, we discuss the role of ER stress and UPR signaling in the pathogenesis of metabolic syndrome, highlighting the main functions of UPR components. We have emphasized the use of novel small molecular chemical chaperones, considered as modulators of ER stress. The initial studies with these chemical chaperones are promising, but detailed studies are required to define their efficacy and adverse effects during therapeutic use in humans.
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Affiliation(s)
- Sreelekshmi Mohan
- Biochemistry and Molecular Mechanism Laboratory, Agroprocessing and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology, Industrial Estate, Thiruvananthapuram, 695019, Kerala, India; Academy of Scientific & Innovative Research (AcSIR), New Delhi, India
| | - Preetha Rani M R
- Biochemistry and Molecular Mechanism Laboratory, Agroprocessing and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology, Industrial Estate, Thiruvananthapuram, 695019, Kerala, India; Academy of Scientific & Innovative Research (AcSIR), New Delhi, India
| | - Lindsay Brown
- School of Health and Wellbeing/Functional Foods Research Group, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Prathapan Ayyappan
- Department of Surgery-Transplant, University of Nebraska Medical Center, Omaha, NE, USA
| | - Raghu K G
- Biochemistry and Molecular Mechanism Laboratory, Agroprocessing and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology, Industrial Estate, Thiruvananthapuram, 695019, Kerala, India; Academy of Scientific & Innovative Research (AcSIR), New Delhi, India.
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A Systematic Review on the Association between Lipid Accumulation Product Index and Type 2 Diabetes Mellitus. J ASEAN Fed Endocr Soc 2019; 34:16-20. [PMID: 33442132 PMCID: PMC7784243 DOI: 10.15605/jafes.034.01.04] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/02/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction Excess fat accumulation contributes to the development of type 2 diabetes mellitus (T2DM). Lipid accumulation product (LAP) is an index computed from waist circumference and triglycerides, which represents increased lipotoxicity. We aim to study the relationship of LAP index and T2DM and its utility as a predictor for T2DM development. Methodology A literature search in PubMed and Cochrane database was performed to retrieve and review studies reporting the association between LAP and T2DM. Results Two cross-sectional studies from Japan and the United States, and one cohort study from Iran were obtained. A high LAP was associated with a higher risk of T2DM [odds ratio (OR) 19.1, 95% confidence interval (CI) (6.6-55.5) for women; and OR 7.4, 95% CI (5.1-10.8) for men]. Conclusion LAP was strongly associated with T2DM. Its utility in predicting the development of T2DM needs to be confirmed.
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20
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Selthofer-Relatić K, Kibel A, Delić-Brkljačić D, Bošnjak I. Cardiac Obesity and Cardiac Cachexia: Is There a Pathophysiological Link? J Obes 2019; 2019:9854085. [PMID: 31565432 PMCID: PMC6745151 DOI: 10.1155/2019/9854085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 07/18/2019] [Indexed: 12/16/2022] Open
Abstract
Obesity is a risk factor for cardiometabolic and vascular diseases like arterial hypertension, diabetes mellitus type 2, dyslipidaemia, and atherosclerosis. A special role in obesity-related syndromes is played by cardiac visceral obesity, which includes epicardial adipose tissue and intramyocardial fat, leading to cardiac steatosis; hypertensive heart disease; atherosclerosis of epicardial coronary artery disease; and ischemic cardiomyopathy, cardiac microcirculatory dysfunction, diabetic cardiomyopathy, and atrial fibrillation. Cardiac expression of these changes in any given patient is unique and multimodal, varying in clinical settings and level of expressed changes, with heart failure development depending on pathophysiological mechanisms with preserved, midrange, or reduced ejection fraction. Progressive heart failure with misbalanced metabolic and catabolic processes will change muscle, bone, and fat mass and function, with possible changes in the cardiac fat state from excessive accumulation to reduction and cardiac cachexia with a worse prognosis. The question we address is whether cardiac obesity or cardiac cachexia is to be more feared.
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Affiliation(s)
- K. Selthofer-Relatić
- Department for Cardiovascular Disease, University Hospital Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
- Department for Internal Medicine, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
| | - A. Kibel
- Department for Cardiovascular Disease, University Hospital Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
- Department for Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
| | - D. Delić-Brkljačić
- Department for Internal Medicine, School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
- Clinic for Cardiology, University Hospital “Sestre Milosrdnice”, Vinogradska Cesta 29, 10000 Zagreb, Croatia
| | - I. Bošnjak
- Department for Cardiovascular Disease, University Hospital Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
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Kutoh E, Wada A, Hayashi J. REGULATION OF FREE FATTY ACID BY SITAGLIPTIN MONOTHERAPY IN DRUG-NAÏVE SUBJECTS WITH TYPE 2 DIABETES. Endocr Pract 2018; 24:1063-1072. [PMID: 30289315 DOI: 10.4158/ep-2018-0287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of sitagliptin on the regulation of free fatty acid (FFA) and other metabolic parameters in drug-naïve subjects with type 2 diabetes mellitus (T2DM). METHODS This was a prospective, nonrandomized, observational study. Drug-naïve subjects with T2DM received 25 to 50 mg/day sitagliptin monotherapy (n = 64). At 3 months, FFA and other metabolic parameters were compared with those at baseline. FFA was measured by colorimetry with enzymatic reactions. As a comparator, 12.5 to 25 mg/day alogliptin monotherapy was given to drug-naïve subjects with T2DM (n = 55). RESULTS Significant reductions in FFA (-13.2%, P<0.01) levels were observed with sitagliptin but not alogliptin. Both drugs showed similar glycemic efficacies. Significant correlations were observed between the changes (Δ) of FFA and Δglycated hemoglobin A1c (HbA1c), Dtotal cholesterol (TC), Δnon-high-density lipoprotein cholesterol (HDL-C), or Δlow-density lipoprotein cholesterol (LDL-C), and significant negative correlations were seen between ΔFFA and Δhomeostasis model assessment-B (HOMA-B), ΔC-peptide immunoreactivity (CPR)-index or Δbody mass index (BMI) in the sitagliptin group. The subjects in the sitagliptin group were further divided into 2 subgroups (n = 32 each) according to the changes of FFA (group B [above the median] ΔFFA = 23.1 %, P<.0005; group A [below the median] ΔFFA = -37.3 %, P<.00001). At baseline, FFA levels were significantly higher in group A versus group B ( P<.001). Higher degrees of reductions of FBG (-14.6% vs. -9.3%, P<0.05) or HbA1c (-20.6% vs. -16.9%, P<.05), and increases of HOMA-B (52.7% vs. 38.3%, P<.03) or CPR-index (37.5% vs. 18.8%, P<.02) were observed in group A versus group B. Significant reductions of TC (-5.8%, P<.002), non-HDL-C (-7.8%, P<.001) or LDL-C (-6.3%, P<.02), and significant increases of C-peptide (11.3%, P<.05) were seen only in group A. CONCLUSION Sitagliptin could downregulate high FFA levels. Subjects with reductions of FFA levels had better glycemic efficacies and higher degrees of enhancement of beta-cell function than others. Reductions of atherogenic cholesterols were seen in these populations. ABBREVIATIONS CPR = C-peptide immunoreactivity; DPP-4 = dipeptidyl peptidase 4; FBG = fasting blood glucose; FFA = free fatty acid; HbA1c = glycated hemoglobin A1c; HDL-C = high-density lipoprotein cholesterol; HOMA-R = homeostasis model assessment-R; HOMA-B = homeostasis model assessment-B; non-HDL-C = non-HDL-cholesterol; LDL-C = low-density lipoprotein cholesterol; TC = total cholesterol; T2DM = type 2 diabetes; TG = triglyceride; UA = uric acid.
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The relationship between adiposopathy and glucose-insulin homeostasis is not affected by moderate-intensity aerobic training in healthy women with obesity. J Physiol Biochem 2018; 74:591-601. [PMID: 29696568 DOI: 10.1007/s13105-018-0630-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/16/2018] [Indexed: 12/20/2022]
Abstract
The contribution of adiposopathy to glucose-insulin homeostasis remains unclear. This longitudinal study examined the potential relationship between the adiponectin/leptin ratio (A/L, a marker of adiposopathy) and insulin resistance (IR: homeostasis model assessment (HOMA)), insulin sensitivity (IS: Matsuda), and insulin response to an oral glucose tolerance test before and after a 16-week walking program, in 29 physically inactive pre- and postmenopausal women with obesity (BMI, 29-35 kg/m2; age, 47-54 years). Anthropometry, body composition, VO2max, and fasting lipid-lipoprotein and inflammatory profiles were assessed. A/L was unchanged after training (p = 0.15), despite decreased leptin levels (p < 0.05). While the Matsuda index tended to increase (p = 0.07), HOMA decreased (p < 0.05) and fasting insulin was reduced (p < 0.01) but insulin area under the curve (AUC) remained unchanged (p = 0.18) after training. Body fatness and VO2max were improved (p < 0.05) while triacylglycerols increased and HDL-CHOL levels decreased after training (p < 0.05). At baseline, A/L was positively associated with VO2max, HDL-CHOL levels, and Matsuda (0.37 < ρ < 0.56; p < 0.05) but negatively with body fatness, HOMA, insulin AUC, IL-6, and hs-CRP levels (- 0.41 < ρ < - 0.66; p < 0.05). After training, associations with fitness, HOMA, and inflammation were lost. Multiple regression analysis revealed A/L as an independent predictor of IR and IS, before training (partial R2 = 0.10 and 0.22), although A/L did not predict the insulin AUC pre- or post-intervention. A significant correlation was found between training-induced changes to A/L and IS (r = 0.38; p < 0.05) but not with IR or insulin AUC. Although changes in the A/L ratio could not explain improvements to glucose-insulin homeostasis indices following training, a relationship with insulin sensitivity was revealed in healthy women with obesity.
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Rocha-Rodrigues S, Gonçalves IO, Beleza J, Ascensão A, Magalhães J. Physical exercise mitigates high-fat diet-induced adiposopathy and related endocrine alterations in an animal model of obesity. J Physiol Biochem 2018; 74:235-246. [PMID: 29478123 DOI: 10.1007/s13105-018-0609-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 02/01/2018] [Indexed: 01/21/2023]
Abstract
The dysregulation of adipokine secretion owing to adiposopathy can contribute to the pathogenesis of obesity-related disorders. Being that exercise is an advised strategy against obesity-induced adiposopathy, we aimed to analyze the role of physical exercise as a preventive and therapeutic strategy against high-fat diet (HFD)-induced adipokine and ghrelin alterations. Rats were pair-fed the Lieber De Carli standard diet (S, 35 Kcal% fat) or HFD (71 Kcal% fat) over 17 weeks. Animals were assigned into four groups as follows: standard diet sedentary (SS), standard diet voluntary physical activity (SVPA), high-fat diet sedentary (HS), and high-fat diet voluntary physical activity (HVPA). After 9 weeks of dietary treatment, half of the SS and HS animals were submitted to an 8-week endurance training program, standard diet endurance training (SET), and high-fat-diet endurance training (HET) groups, maintaining the respective diets. Although there were no changes in body weight, HFD increased visceral adiposity, percentage of large adipocytes, hypoxia inducible factor (HIF)-1α, and leptin contents in epididymal adipose tissue (eWAT) and decreased plasma content of adiponectin (AdipQ). Both VPA and ET decreased visceral adiposity and percentage of large adipocytes in HFD-fed animals, but ET also increased the percentage of small- to medium-sized adipocytes. VPA increased plasma growth hormone secretagogue receptor (GHS-R) and decreased leptin protein in HVPA group. ET decreased plasma insulin and leptin levels and eWAT HIF-1α and leptin expression in HET group. Moreover, ET improved insulin sensitivity, plasma high molecular weight, and AdipQ and ghrelin levels and increased eWAT and GHS-R expression. Our data suggest that exercise, particularly ET, reverted adiposopathy and related endocrine alterations induced by an isocaloric HFD pair-fed diet.
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Affiliation(s)
- Sílvia Rocha-Rodrigues
- CIAFEL-Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal.
| | - Inês O Gonçalves
- CIAFEL-Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
| | - Jorge Beleza
- CIAFEL-Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
| | - António Ascensão
- CIAFEL-Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
| | - José Magalhães
- CIAFEL-Research Centre in Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450, Porto, Portugal
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Cuda SE, Censani M. Pediatric Obesity Algorithm: A Practical Approach to Obesity Diagnosis and Management. Front Pediatr 2018; 6:431. [PMID: 30729102 PMCID: PMC6351475 DOI: 10.3389/fped.2018.00431] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 12/24/2018] [Indexed: 02/02/2023] Open
Abstract
Childhood obesity is a growing global health problem. Despite the highest rates of childhood obesity in the United States and other developed countries over the last 30 years, there is still no clear treatment strategy. Practitioners often do not know where to turn to find guidance on managing the nearly one third of their population who present for medical care either with obesity that coexists with other medical problems or because of obesity. The Pediatric Obesity Algorithm is an evidence based roadmap for the diagnosis and management of children with obesity. In this article, we summarize topics from the Pediatric Obesity Algorithm pertaining to pediatric obesity diagnosis, evaluation, and management including assessment, differential diagnosis, review of systems, diagnostic work up, physical exam, age specific management, comorbidities, use of medications and surgery, and medication associated weight gain. Identifying and treating children with obesity as early as possible is important, as is identifying comorbid conditions. Earlier and more comprehensive management through resources such as the Pediatric Obesity Algorithm serve to help guide health care practitioners with a practical and evidence based approach to the diagnosis and management of children with obesity, and provide families with the tools needed for a healthy future.
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Affiliation(s)
- Suzanne E Cuda
- Department of Pediatrics, Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, TX, United States
| | - Marisa Censani
- Division of Pediatric Endocrinology, Department of Pediatrics, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, United States
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Rocha-Rodrigues S, Gonçalves IO, Beleza J, Ascensão A, Magalhães J. Effects of endurance training on autophagy and apoptotic signaling in visceral adipose tissue of prolonged high fat diet-fed rats. Eur J Nutr 2017; 57:2237-2247. [PMID: 28699087 DOI: 10.1007/s00394-017-1500-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 06/30/2017] [Indexed: 01/29/2023]
Abstract
PURPOSE Autophagy and apoptosis play critical roles in both development and tissue homeostasis in response to (patho)physiological stimuli, such as high-fat diet (HFD) and endurance training (ET). Therefore, we aimed to investigate how ET modulates autophagy and apoptotic-related signaling in visceral adipose tissue of long-standing HFD-fed rats. METHODS The study was conducted over a 17-week period on Sprague-Dawley rats, which were divided into four groups (n = 8/group): standard diet sedentary (STD+SED), high-fat diet sedentary (HFD+SED), standard diet ET (STD+ET) and high-fat diet ET (HFD+ET). After 9 weeks of dietary regimens, ET groups were trained for 8 weeks on treadmill (5 days/week at 25 m/min for 60 min/day), while maintaining dietary regimens. Autophagy and apoptotic-signaling markers in epididymal white adipose tissue (eWAT) were determined using RT-qPCR, Western blot and spectrometry techniques. RESULTS ET reduced body weight, visceral fat mass and HOMA-IR in standard and HF diet-fed animals. Moreover, ET reverted the HFD-induced increases in the percentage of larger adipocytes and also reduced the percentage of smaller adipocytes. The HFD decreased pre-adipocyte factor 1 (DLK1/PREF1) and increased the pro-apoptotic markers (Bax protein and caspase 3-like activity), while having no impact on autophagy markers. However, ET increased DLK1/PREF1 and Bcl-2 in both diet types, while decreasing Bax and caspases 9, 8 and 3-like activities in HFD feeding rats. Additionally, Beclin-1 and p62 protein significantly increased in ET groups of both diet types. CONCLUSIONS Data demonstrate that 8 weeks of ET was effective in attenuating apoptotic-related signaling in long-standing HFD-fed rats. Moreover, HFD and ET had no impact on VAT autophagy markers.
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Affiliation(s)
- Sílvia Rocha-Rodrigues
- Faculty of Sport, CIAFEL - Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal. .,Faculty of Sport Sciences, LaMetEx - Laboratory of Metabolism and Exercise, University of Porto, Porto, Portugal.
| | - Inês O Gonçalves
- Faculty of Sport, CIAFEL - Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Faculty of Sport Sciences, LaMetEx - Laboratory of Metabolism and Exercise, University of Porto, Porto, Portugal
| | - Jorge Beleza
- Faculty of Sport, CIAFEL - Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Faculty of Sport Sciences, LaMetEx - Laboratory of Metabolism and Exercise, University of Porto, Porto, Portugal
| | - António Ascensão
- Faculty of Sport, CIAFEL - Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Faculty of Sport Sciences, LaMetEx - Laboratory of Metabolism and Exercise, University of Porto, Porto, Portugal
| | - José Magalhães
- Faculty of Sport, CIAFEL - Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.,Faculty of Sport Sciences, LaMetEx - Laboratory of Metabolism and Exercise, University of Porto, Porto, Portugal
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González-Campoy JM. Bariatric Endocrinology, Adiposopathy, and Disorders of Regional Fat Distribution. AACE Clin Case Rep 2017. [DOI: 10.4158/accr-2017-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lee JJ, Pedley A, Hoffmann U, Massaro JM, Keaney JF, Vasan RS, Fox CS. Cross-Sectional Associations of Computed Tomography (CT)-Derived Adipose Tissue Density and Adipokines: The Framingham Heart Study. J Am Heart Assoc 2016; 5:e002545. [PMID: 26927600 PMCID: PMC4943240 DOI: 10.1161/jaha.115.002545] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Excess accumulation of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) is associated with adverse levels of adipokines and cardiovascular disease risk. Whether fat quality is associated with adipokines has not been firmly established. This study examined the association between abdominal SAT and VAT density, an indirect measure of fat quality, with a panel of metabolic regulatory biomarkers secreted by adipose tissue or the liver independently of absolute fat volumes. Methods and Results We evaluated 1829 Framingham Heart Study participants (44.9% women). Abdominal SAT and VAT density was estimated indirectly by adipose tissue attenuation using computed tomography. Adipokines included adiponectin, leptin receptor, leptin, fatty acid‐binding protein 4 (FABP‐4), retinol‐binding protein 4 (RBP‐4), and fetuin‐A. Fat density was associated with all the biomarkers evaluated, except fetuin‐A. Lower fat density (ie, more‐negative fat attenuation) was associated with lower adiponectin and leptin receptor, but higher leptin and FABP‐4 levels (all P<0.0001). SAT density was inversely associated with RPB‐4 in both sexes, whereas the association between VAT density and RPB‐4 was only observed in men (P<0.0001). In women, after additional adjustment for respective fat volume, SAT density retained the significant associations with adiponectin, leptin, FABP‐4, and RBP‐4; and VAT density with adiponectin only (all P<0.0001). In men, significant associations were maintained upon additional adjustment for respective fat volume (P<0.005). Conclusions Lower abdominal fat density was associated with a profile of biomarkers suggestive of greater cardiometabolic risk. These observations support that fat density may be a valid biomarker of cardiometabolic risk.
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Affiliation(s)
- Jane J Lee
- National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA
| | - Alison Pedley
- National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA
| | - Udo Hoffmann
- Department of Radiology, Massachusetts General Hospital, Boston, MA
| | | | - John F Keaney
- Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Ramachandran S Vasan
- National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA Evans Department of Medicine, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA Sections of Cardiology and Preventive Medicine, Boston University School of Medicine, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Caroline S Fox
- National Heart, Lung, and Blood Institute's Division of Intramural Research, The Framingham Heart Study, and the Population Studies Branch, Framingham, MA Division of Endocrinology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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De Lorenzo A, Soldati L, Sarlo F, Calvani M, Di Lorenzo N, Di Renzo L. New obesity classification criteria as a tool for bariatric surgery indication. World J Gastroenterol 2016; 22:681-703. [PMID: 26811617 PMCID: PMC4716069 DOI: 10.3748/wjg.v22.i2.681] [Citation(s) in RCA: 149] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/05/2015] [Accepted: 12/01/2015] [Indexed: 02/06/2023] Open
Abstract
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.
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Bays HE, Jones PH, Jacobson TA, Cohen DE, Orringer CE, Kothari S, Azagury DE, Morton J, Nguyen NT, Westman EC, Horn DB, Scinta W, Primack C. Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: FULL REPORT. J Clin Lipidol 2016; 10:33-57. [DOI: 10.1016/j.jacl.2015.12.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 02/06/2023]
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Abstract
BACKGROUND To examine the contribution of generational epigenetic dysregulation to the inception of obesity and its adiposopathic consequences. METHODS Sources for this review included searches of PubMed, Google Scholar, and international government/major association websites using terms including adiposity, adiposopathy, epigenetics, genetics, and obesity. RESULTS Excessive energy storage in adipose tissue often results in fat cell and fat organ dysfunction, which may cause metabolic and fat mass disorders. The adverse clinical manifestations of obesity are not solely due to the amount of body fat (adiposity), but are also dependent on anatomical and functional perturbations (adiposopathy or 'sick fat'). This review describes extragenetic factors and genetic conditions that promote obesity. It also serves as an introduction to epigenetic dysregulation (i.e., abnormalities in gene expression that occur without alteration in the genetic code itself), which may contribute to obesity and adiposopathic metabolic health outcomes in offspring. Within the epigenetic paradigm, obesity is a transgenerational disease, with weight lost or gained by either parent potentially impacting generational risk for obesity and its complications. CONCLUSIONS Epigenetics may be an important contributor to the emergence of obesity and its complications as global epidemics. Although transgenerational epigenetic influences present challenges, they may also present interventional opportunities, via justifying weight management for individuals before, during, and after pregnancy and for future generations.
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Affiliation(s)
- Harold Bays
- a a Louisville Metabolic and Atherosclerosis Research Center (L-MARC) , Louisville , KY , USA
| | - Wendy Scinta
- b b Medical Weight Loss of NY , Fayetteville , NY , USA
- c c State University of New York , Upstate Department of Family Medicine , Syracuse , NY , USA
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Teixeira TFS, Alves RDM, Moreira APB, Peluzio MDCG. Main characteristics of metabolically obese normal weight and metabolically healthy obese phenotypes. Nutr Rev 2015; 73:175-90. [PMID: 26024540 DOI: 10.1093/nutrit/nuu007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In this review, the influence of fat depots on insulin resistance and the main characteristics of metabolically obese normal-weight and metabolically healthy obese phenotypes are discussed. Medline/PubMed and Science Direct were searched for articles related to the terms metabolically healthy obesity, metabolically obese normal weight, adipose tissue, and insulin resistance. Normal weight and obesity might be heterogeneous in regard to their effects. Fat distribution and lower insulin sensitivity are the main factors defining phenotypes within the same body mass index. Although these terms are interesting, controversies about them remain. Future studies exploring these phenotypes will help elucidate the roles of adiposity and/or insulin resistance in the development of metabolic alterations.
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Affiliation(s)
- Tatiana F S Teixeira
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil.
| | - Raquel D M Alves
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Ana Paula B Moreira
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Maria do Carmo G Peluzio
- TFS Teixeira, RDM Alves, APB Moreira, and MdCG Peluzio are with the Nutrition and Health Department, Federal University of Viçosa, Viçosa, MG, Brazil
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Noyes AM, Dua K, Devadoss R, Chhabra L. Cardiac adipose tissue and its relationship to diabetes mellitus and cardiovascular disease. World J Diabetes 2014; 5:868-876. [PMID: 25512789 PMCID: PMC4265873 DOI: 10.4239/wjd.v5.i6.868] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 09/23/2014] [Accepted: 10/16/2014] [Indexed: 02/05/2023] Open
Abstract
Type-2 diabetes mellitus (T2DM) plays a central role in the development of cardiovascular disease (CVD). However, its relationship to epicardial adipose tissue (EAT) and pericardial adipose tissue (PAT) in particular is important in the pathophysiology of coronary artery disease. Owing to its close proximity to the heart and coronary vasculature, EAT exerts a direct metabolic impact by secreting proinflammatory adipokines and free fatty acids, which promote CVD locally. In this review, we have discussed the relationship between T2DM and cardiac fat deposits, particularly EAT and PAT, which together exert a big impact on the cardiovascular health.
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Kelly KR, Navaneethan SD, Solomon TPJ, Haus JM, Cook M, Barkoukis H, Kirwan JP. Lifestyle-induced decrease in fat mass improves adiponectin secretion in obese adults. Med Sci Sports Exerc 2014; 46:920-6. [PMID: 24614337 DOI: 10.1249/mss.0000000000000200] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Several studies have identified relationships between weight loss and adipokine levels; however, none have looked at the combined effect of aerobic exercise training with the consumption of a low- or a high-glycemic diet. We examined the effects of 12 wk of aerobic exercise combined with either a low-glycemic index diet (∼40 U) plus exercise (LoGIX) or a high-glycemic index diet (∼80 U) diet plus exercise (HiGIX) on plasma leptin and adiponectin (total and high molecular weight [HMW]) in 27 older obese adults (age = 65 ± 0.5 yr, body mass index = 34.5 ± 0.7 kg·m). METHODS Insulin sensitivity was calculated from an oral glucose tolerance test. Fasting HMW adiponectin and leptin were quantified from plasma samples obtained before the insulin sensitivity index obtained from the oral glucose tolerance test. Glucose and insulin measures were obtained before and every 30 min during the test. Dual-energy x-ray absorptiometry and computerized tomography were used to determine body composition and to quantify subcutaneous and visceral abdominal adiposity, respectively. RESULTS Fasting leptin was significantly decreased in both groups (LoGIX: preintervention = 33.8 ± 4.7, postintervention = 19.2 ± 4.5; HiGIX: preintervention = 27.9 ± 4.2, postintervention = 11.9 ± 2.2 ng·mL; P = 0.004), and HMW adiponectin was significantly increased (LoGIX: preintervention = 1606.9 ± 34.6, postintervention = 3502.3 ± 57; HiGIX: preintervention = 3704.8 ± 38.1, postintervention = 4284.3 ± 52.8 pg·mL; P = 0.003) after the 12-wk intervention. Total body fat was reduced after both interventions. Visceral fat mass was inversely correlated with HMW adiponectin, whereas subcutaneous fat correlated with leptin. CONCLUSIONS The data suggest that exercise training, independent of dietary glycemic index, favorably alters HMW adiponectin and leptin secretion and that a reduction in visceral fat mass is a key factor regulating HMW adiponectin in older obese persons.
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Affiliation(s)
- Karen R Kelly
- 1Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH; 2Department of Nutrition, Case Western Reserve University, School of Medicine, Cleveland, OH; 3Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH; 4Department of Physiology, Case Western Reserve University, School of Medicine, Cleveland, OH; and 5Metabolic Translational Research Center, Cleveland Clinic, Cleveland, OH
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Trepanowski JF, Varady KA. Veganism Is a Viable Alternative to Conventional Diet Therapy for Improving Blood Lipids and Glycemic Control. Crit Rev Food Sci Nutr 2014; 55:2004-13. [DOI: 10.1080/10408398.2012.736093] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Riondino S, Roselli M, Palmirotta R, Della-Morte D, Ferroni P, Guadagni F. Obesity and colorectal cancer: Role of adipokines in tumor initiation and progression. World J Gastroenterol 2014; 20:5177-5190. [PMID: 24833848 PMCID: PMC4017033 DOI: 10.3748/wjg.v20.i18.5177] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/20/2014] [Accepted: 03/06/2014] [Indexed: 02/06/2023] Open
Abstract
Obesity-associated diseases account for a large portion of public health challenges. Among obesity-related disorders, a direct and independent relationship has been ascertained for colorectal cancer (CRC). The evidence that adipocyte hypertrophy and excessive adipose tissue accumulation (mainly visceral) can promote pathogenic adipocyte and adipose tissue-related diseases, has led to formulate the concept of “adiposopathy”, defined as adipocyte and adipose tissue dysfunction that contributes to metabolic syndrome. Adipose tissue can, indeed, be regarded as an important and highly active player of the innate immune response, in which cytokine/adipokine secretion is responsible for a paracrine loop between adipocytes and macrophages, thus contributing to the systemic chronic low-grade inflammation associated with visceral obesity, which represents a favorable niche for tumor development. The adipocyte itself participates as a central mediator of this inflammatory response in obese individuals by secreting hormones, growth factors and proinflammatory cytokines, which are of particular relevance for the pathogenesis of CRC. Among adipocyte-secreted hormones, the most relevant to colorectal tumorigenesis are adiponectin, leptin, resistin and ghrelin. All these molecules have been involved in cell growth and proliferation, as well as tumor angiogenesis and it has been demonstrated that their expression changes from normal colonic mucosa to adenoma and adenocarcinoma, suggesting their involvement in multistep colorectal carcinogenesis. These findings have led to the hypothesis that an unfavorable adipokine profile, with a reduction of those with an anti-inflammatory and anti-cancerous activity, might serve as a prognostic factor in CRC patients and that adipokines or their analogues/antagonists might become useful agents in the management or chemoprevention of CRC.
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Gonzalez-Campoy JM, Richardson B, Richardson C, Gonzalez-Cameron D, Ebrahim A, Strobel P, Martinez T, Blaha B, Ransom M, Quinonez-Weislow J, Pierson A, Gonzalez Ahumada M. Bariatric endocrinology: principles of medical practice. Int J Endocrinol 2014; 2014:917813. [PMID: 24899894 PMCID: PMC4036612 DOI: 10.1155/2014/917813] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 03/19/2014] [Accepted: 04/11/2014] [Indexed: 12/11/2022] Open
Abstract
Obesity, is a chronic, biological, preventable, and treatable disease. The accumulation of fat mass causes physical changes (adiposity), metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy), and psychological changes. Bariatric endocrinology was conceived from the need to address the neuro-endocrinological derangements that are associated with adiposopathy, and from the need to broaden the scope of the management of its complications. In addition to the well-established metabolic complications of overweight and obesity, adiposopathy leads to hyperinsulinemia, hyperleptinemia, hypoadiponectinemia, dysregulation of gut peptides including GLP-1 and ghrelin, the development of an inflammatory milieu, and the strong risk of vascular disease. Therapy for adiposopathy hinges on effectively lowering the ratio of orexigenic to anorexigenic signals reaching the the hypothalamus and other relevant brain regions, favoring a lower caloric intake. Adiposopathy, overweight and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications, and to normalize adipose tissue function for the adiposopathic complications. This paper defines the principles of medical practice in bariatric endocrinology-the treatment of overweight and obesity as means to treat adiposopathy and its accompanying metabolic and hormonal derangements.
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Affiliation(s)
- J. Michael Gonzalez-Campoy
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Bruce Richardson
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Conor Richardson
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - David Gonzalez-Cameron
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Ayesha Ebrahim
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Pamela Strobel
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Tiphani Martinez
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Beth Blaha
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Maria Ransom
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Jessica Quinonez-Weislow
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Andrea Pierson
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
| | - Miguel Gonzalez Ahumada
- Minnesota Center for Obesity, Metabolism and Endocrinology (MNCOME), 1185 Town Centre Drive, Suite 220, Eagan, MN 55123, USA
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Abstract
Among lean populations, cardiovascular disease (CVD) is rare. Among those with increased adiposity, CVD is the commonest cause of worldwide death. The "obesity paradox" describes seemingly contrary relationships between body fat and health/ill-health. Multiple obesity paradoxes exist, and include the anatomic obesity paradox, physiologic obesity paradox, demographic obesity paradox, therapeutic obesity paradox, cardiovascular event/procedure obesity paradox, and obesity treatment paradox. Adiposopathy ("sick fat") is defined as adipocyte/adipose tissue dysfunction caused by positive caloric balance and sedentary lifestyle in genetically and environmentally susceptible individuals. Adiposopathy contributes to the commonest metabolic disorders encountered in clinical practice (high glucose levels, high blood pressure, dyslipidemia, etc.), all major CVD risk factors. Ockham's razor is a principle of parsimony which postulates that among competing theories, the hypothesis with the fewest assumptions is the one best selected. Ockham's razor supports adiposopathy as the primary cause of most cases of adiposity-related metabolic diseases, which in turn helps resolve the obesity paradox.
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Affiliation(s)
- Harold Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA,
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Bays HE. Lorcaserin: drug profile and illustrative model of the regulatory challenges of weight-loss drug development. Expert Rev Cardiovasc Ther 2014; 9:265-77. [DOI: 10.1586/erc.10.22] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bays H. Phentermine, topiramate and their combination for the treatment of adiposopathy (‘sick fat’) and metabolic disease. Expert Rev Cardiovasc Ther 2014; 8:1777-801. [DOI: 10.1586/erc.10.125] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Bays HE. Lorcaserin and adiposopathy: 5-HT2c agonism as a treatment for ‘sick fat’ and metabolic disease. Expert Rev Cardiovasc Ther 2014; 7:1429-45. [DOI: 10.1586/erc.09.123] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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41
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High pericardial and peri-aortic adipose tissue burden in pre-diabetic and diabetic subjects. BMC Cardiovasc Disord 2013; 13:98. [PMID: 24499326 PMCID: PMC3832227 DOI: 10.1186/1471-2261-13-98] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 10/28/2013] [Indexed: 12/13/2022] Open
Abstract
Background Central obesity in relation to insulin resistance is strongly linked to the development of type 2 diabetes. However, data regarding the association between pericardial and peri-aortic adiposity, a potential estimate of visceral adipose tissue burden, and pre-diabetes status remains unclear. The aim of this study was to examine whether the degree of pericardial and thoracic peri-aortic adipose tissue, when quantified by multi-detector computed tomography (MDCT), differs significantly in a normal, pre-diabetic, and overtly diabetic population. Methods We studied 562 consecutive subjects including 357 healthy, 155 pre-diabetic, and 50 diabetic patients selected from participants who underwent annual health surveys in Taiwan. Pre-diabetes status was defined by impaired fasting glucose or impaired glucose intolerance according to American Diabetes Association guidelines. Pericardial (PCF) and thoracic peri-aortic (TAT) adipose tissue burden was assessed using a non-contrast 16-slice multi-detector computed tomography (MDCT) dataset with off-line measurement (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Body fat composition, serum high-sensitivity C-reactive protein (hs-CRP) level and insulin resistance (HOMA-IR) were also assessed. Results Patients with diabetes and pre-diabetes had greater volume of PCF (89 ± 24.6, 85.3 ± 28.7 & 67.6 ± 26.7 ml, p < 0.001) as well as larger TAT (9.6 ± 3.1 ml vs 8.8 ± 4.2 & 6.6 ± 3.5 ml, respectively, p < 0.001) when compared to the normal group, although there were no significant differences in adiposity between the diabetic and pre-diabetic groups. For those without established diabetes in our study, increasing TAT burden, but not PCF, appear to correlate with insulin resistance (HOMA-IR) and hs-CRP in the multivariable models. Conclusions Pre-diabetic and diabetic subjects, compared to normoglycemia, were associated with significantly higher pericardial and peri-aortic adipose tissue burden. In addition, visceral fat accumulation adjacent to the thoracic aorta seemed to exert a significant impact on insulin resistance and systemic inflammation.
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Mendizábal Y, Llorens S, Nava E. Vasoactive effects of prostaglandins from the perivascular fat of mesenteric resistance arteries in WKY and SHROB rats. Life Sci 2013; 93:1023-32. [PMID: 24200844 DOI: 10.1016/j.lfs.2013.10.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/12/2013] [Accepted: 10/19/2013] [Indexed: 10/26/2022]
Abstract
AIMS We have studied the vasoactive role of prostaglandins derived from perivascular adipose tissue (PVAT) and their effects on endothelial function in healthy rats and rats with metabolic syndrome (SHROB). MAIN METHODS Mesenteric resistance arteries (MRA) from SHROB and control rats (WKY) were mounted on wire myographs: a) together with a sphere of naturally occurring perivascular adipose tissue (with-PVAT group), or b) dissecting all the adventitial tissue (without-PVAT group). KEY FINDINGS Endothelial function, tested by acetylcholine reactivity of SHROB arteries with PVAT, was significantly lower than that of WKY. With-PVAT arteries, especially the SHROB, showed lower responses than those without PVAT. NO synthase inhibition diminished the acetylcholine responses in every group except the with-PVAT SHROB group. Blockade of cyclooxygenase-2, PGI2-IP, TXA2-TP, or TXA2 synthase increased to different extents the arterial responses in the SHROB with-PVAT group. PVAT from both rat strains revealed cyclooxygenase-2 activity and immunoassay confirmed the release of PGE2, PGI2 and TXA2. SIGNIFICANCE Our major finding is that PVAT is a source of vasoactive prostaglandins in WKY and SHROB. We also report that the presence of visceral PVAT causes endothelial dysfunction of resistance arteries in the SHROB. The vascular responses to prostaglandins partly underlie the endothelial dysfunction of SHROB arteries.
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Affiliation(s)
- Yolanda Mendizábal
- Area of Physiology, Department of Medical Sciences, University of Castilla-La Mancha, School of Medicine and Regional Centre for Biomedical Research (CRIB), Albacete, Spain
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Vroegrijk IOCM, van Klinken JB, van Diepen JA, van den Berg SAA, Febbraio M, Steinbusch LKM, Glatz JFC, Havekes LM, Voshol PJ, Rensen PCN, van Dijk KW, van Harmelen V. CD36 is important for adipocyte recruitment and affects lipolysis. Obesity (Silver Spring) 2013; 21:2037-45. [PMID: 23512311 DOI: 10.1002/oby.20354] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 12/16/2012] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The scavenger receptor CD36 facilitates the cellular uptake of long-chain fatty acids. As CD36-deficiency attenuates the development of high fat diet (HFD)-induced obesity, the role of CD36-deficiency in preadipocyte recruitment and adipocyte function was set out to characterize. DESIGN AND METHODS Fat cell size and number were determined in gonadal, visceral, and subcutaneous adipose tissue of CD36(-/-) and WT mice after 6 weeks on HFD. Basal lipolysis and insulin-inhibited lipolysis were investigated in gonadal adipose tissue. RESULTS CD36(-/-) mice showed a reduction in adipocyte size in all fat pads. Gonadal adipose tissue also showed a lower total number of adipocytes because of a lower number of very small adipocytes (diameter <50 μm). This was accompanied by an increased pool of preadipocytes, which suggests that CD36-deficiency reduces the capacity of preadipocytes to become adipocytes. Regarding lipolysis, in adipose tissue from CD36(-/-) mice, cAMP levels were increased and both basal and 8-bromo-cAMP stimulated lipolysis were higher. However, insulin-mediated inhibition of lipolysis was more potent in CD36(-/-) mice. CONCLUSIONS These results indicate that during fat depot expansion, CD36-deficiency negatively affects preadipocyte recruitment and that in mature adipocytes, CD36-deficiency is associated with increased basal lipolysis and insulin responsiveness.
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Affiliation(s)
- Irene O C M Vroegrijk
- Department of General Internal Medicine, Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands
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Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, Gonzalez-Campoy JM, Jones SR, Kumar R, La Forge R, Samuel VT. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol 2013; 7:304-83. [PMID: 23890517 DOI: 10.1016/j.jacl.2013.04.001] [Citation(s) in RCA: 288] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/02/2013] [Accepted: 04/03/2013] [Indexed: 01/04/2023]
Abstract
The term "fat" may refer to lipids as well as the cells and tissue that store lipid (ie, adipocytes and adipose tissue). "Lipid" is derived from "lipos," which refers to animal fat or vegetable oil. Adiposity refers to body fat and is derived from "adipo," referring to fat. Adipocytes and adipose tissue store the greatest amount of body lipids, including triglycerides and free cholesterol. Adipocytes and adipose tissue are active from an endocrine and immune standpoint. Adipocyte hypertrophy and excessive adipose tissue accumulation can promote pathogenic adipocyte and adipose tissue effects (adiposopathy), resulting in abnormal levels of circulating lipids, with dyslipidemia being a major atherosclerotic coronary heart disease risk factor. It is therefore incumbent upon lipidologists to be among the most knowledgeable in the understanding of the relationship between excessive body fat and dyslipidemia. On September 16, 2012, the National Lipid Association held a Consensus Conference with the goal of better defining the effect of adiposity on lipoproteins, how the pathos of excessive body fat (adiposopathy) contributes to dyslipidemia, and how therapies such as appropriate nutrition, increased physical activity, weight-management drugs, and bariatric surgery might be expected to impact dyslipidemia. It is hoped that the information derived from these proceedings will promote a greater appreciation among clinicians of the impact of excess adiposity and its treatment on dyslipidemia and prompt more research on the effects of interventions for improving dyslipidemia and reducing cardiovascular disease risk in overweight and obese patients.
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Affiliation(s)
- Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY 40213, USA.
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Seaman DR. Body mass index and musculoskeletal pain: is there a connection? Chiropr Man Therap 2013; 21:15. [PMID: 23687943 PMCID: PMC3665675 DOI: 10.1186/2045-709x-21-15] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 05/17/2013] [Indexed: 02/07/2023] Open
Abstract
Background Back pain is one of the most common complaints that patients report to physicians and two-thirds of the population has an elevated body mass index (BMI), indicating they are either overweight or obese. It was once assumed that extra body weight would stress the low back and lead to pain, however, researchers have reported inconsistencies association between body weight and back pain. In contrast, more recent studies do indicate that an elevated BMI is associated with back pain and other musculoskeletal pain syndromes due to the presence of a chronic systemic inflammatory state, suggesting that the relationship between BMI and musculoskeletal pains be considered in more detail. Objective To describe how an elevated BMI can be associated with chronic systemic inflammation and pain expression. To outline measurable risk factors for chronic inflammation that can be used in clinical practice and discuss basic treatment considerations. Discussion Adiposopathy, or “sick fat” syndrome, is a term that refers to an elevated BMI that is associated with a chronic systemic inflammatory state most commonly referred to as the metabolic syndrome. The best available evidence suggests that the presence of adiposopathy determines if an elevated BMI will contribute to musculoskeletal pain expression. It is not uncommon for physicians to fail to identify the presence of adiposopathy/metabolic syndrome. Conclusion Patients with an elevated BMI should be further examined to identify inflammatory factors associated with adiposopathy, such as the metabolic syndrome, which may be promoting back pain and other musculoskeletal pain syndromes.
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Affiliation(s)
- David R Seaman
- National University of Health Sciences, SPC-Health Education Center, 7200 66th St, Pinellas Park, FL 33781, USA.
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Zha BS, Wan X, Zhang X, Zha W, Zhou J, Wabitsch M, Wang G, Lyall V, Hylemon PB, Zhou H. HIV protease inhibitors disrupt lipid metabolism by activating endoplasmic reticulum stress and inhibiting autophagy activity in adipocytes. PLoS One 2013; 8:e59514. [PMID: 23533630 PMCID: PMC3606318 DOI: 10.1371/journal.pone.0059514] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 02/15/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND HIV protease inhibitors (PI) are core components of Highly Active Antiretroviral Therapy (HAART), the most effective treatment for HIV infection currently available. However, HIV PIs have now been linked to lipodystrophy and dyslipidemia, which are major risk factors for cardiovascular disease and metabolic syndrome. Our previous studies have shown that HIV PIs activate endoplasmic reticulum (ER) stress and disrupt lipid metabolism in hepatocytes and macrophages. Yet, little is known on how HIV PIs disrupt lipid metabolism in adipocytes, a major cell type involved in the pathogenesis of metabolic syndrome. METHODOLOGY AND PRINCIPAL FINDINGS Cultured and primary mouse adipocytes and human adipocytes were used to examine the effect of frequently used HIV PIs in the clinic, lopinavir/ritonavir, on adipocyte differentiation and further identify the underlying molecular mechanism of HIV PI-induced dysregulation of lipid metabolism in adipocytes. The results indicated that lopinavir alone or in combination with ritonavir, significantly activated the ER stress response, inhibited cell differentiation, and induced cell apoptosis in adipocytes. In addition, HIV PI-induced ER stress was closely linked to inhibition of autophagy activity. We also identified through the use of primary adipocytes of CHOP(-/-) mice that CHOP, the major transcriptional factor of the ER stress signaling pathway, is involved in lopinavir/ritonavir-induced inhibition of cell differentiation in adipocytes. In addition, lopinavir/ritonavir-induced ER stress appears to be associated with inhibition of autophagy activity in adipocytes. CONCLUSION AND SIGNIFICANCE Activation of ER stress and impairment of autophagy activity are involved in HIV PI-induced dysregulation of lipid metabolism in adipocytes. The key components of ER stress and autophagy signaling pathways are potential therapeutic targets for HIV PI-induced metabolic side effects in HIV patients.
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Affiliation(s)
- Beth S. Zha
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Xiaoshan Wan
- School of Pharmacy, Wenzhou Medical College, Wenzhou, Zhejiang, P.R. China
| | - Xiaoxuan Zhang
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, Jiangsu, P.R. China
| | - Weibin Zha
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, Jiangsu, P.R. China
| | - Jun Zhou
- School of Pharmacy, Wenzhou Medical College, Wenzhou, Zhejiang, P.R. China
| | - Martin Wabitsch
- Division of Pediatric Endocrinology and Diabetes, University of Ulm, Ulm, Germany
| | - Guangji Wang
- Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, Jiangsu, P.R. China
| | - Vijay Lyall
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Phillip B. Hylemon
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
- McGuire Veterans Affairs Medical Center, Richmond, Virginia, United States of America
| | - Huiping Zhou
- Department of Microbiology and Immunology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
- School of Pharmacy, Wenzhou Medical College, Wenzhou, Zhejiang, P.R. China
- McGuire Veterans Affairs Medical Center, Richmond, Virginia, United States of America
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Duntas L, Micic D. Adiposopathy and thyroid disease: tracing the pathway to cardiovascular risk. Expert Rev Cardiovasc Ther 2013; 10:797-803. [PMID: 22894634 DOI: 10.1586/erc.12.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Adiposopathy, defined as functionally disturbed adipose tissue mainly composed of large adipocytes and induced by chronic excess of food intake, has been associated with immune, metabolic and endocrine derangements promoting inflammation and, eventually, cardiovascular disease. Adiposopathy may positively influence thyrotropin-stimulating hormone, by raising leptin levels, and triggering autoimmunity. In this regard, it is hypothesized that the increased thyrotropin-stimulating hormone is independent of the negative regulation of the thyroid hormone, thereby constituting a secondary phenomenon and not a causal effect. Replacement therapy with thyroid hormones should therefore be applied following strict individualized consideration. Leptin is involved in the immune response and neuroendocrine appetite regulation, while leptin resistance may further promote autoimmune disease. The lipid derangement in adiposopathy may be aggravated in the presence of hypothyroidism and thus considerably augment cardiovascular risk. Lifestyle-modification counselling, including low-fat dietary intake and regular physical exercise, is today the cornerstone of adiposopathy treatment. Meanwhile, new drug formulations, such as leptin and leptin analogs, 5-HT2C-receptor agonist, and potent thyromimetics, currently comprise a promising armamentarium against adiposity and adiposopathy.
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Affiliation(s)
- Leonidas Duntas
- Endocrine Unit, Evgenidion Hospital, University of Athens Medical School, Athens, Greece.
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Intestinal permeability parameters in obese patients are correlated with metabolic syndrome risk factors. Clin Nutr 2012; 31:735-40. [DOI: 10.1016/j.clnu.2012.02.009] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 02/09/2012] [Accepted: 02/17/2012] [Indexed: 01/20/2023]
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ER Stress and Lipid Metabolism in Adipocytes. Biochem Res Int 2012; 2012:312943. [PMID: 22400114 PMCID: PMC3287011 DOI: 10.1155/2012/312943] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2011] [Accepted: 10/28/2011] [Indexed: 12/29/2022] Open
Abstract
The role of endoplasmic reticulum (ER) stress is a rapidly emerging field of interest in the pathogenesis of metabolic diseases. Recent studies have shown that chronic activation of ER stress is closely linked to dysregulation of lipid metabolism in several metabolically important cells including hepatocytes, macrophages, β-cells, and adipocytes. Adipocytes are one of the major cell types involved in the pathogenesis of the metabolic syndrome. Recent advances in dissecting the cellular and molecular mechanisms involved in the regulation of adipogenesis and lipid metabolism indicate that activation of ER stress plays a central role in regulating adipocyte function. In this paper, we discuss the current understanding of the potential role of ER stress in lipid metabolism in adipocytes. In addition, we touch upon the interaction of ER stress and autophagy as well as inflammation. Inhibition of ER stress has the potential of decreasing the pathology in adipose tissue that is seen with energy overbalance.
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Mittendorfer B. Origins of metabolic complications in obesity: adipose tissue and free fatty acid trafficking. Curr Opin Clin Nutr Metab Care 2011; 14:535-41. [PMID: 21849896 PMCID: PMC3711689 DOI: 10.1097/mco.0b013e32834ad8b6] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Obesity is associated with a number of serious medical complications that are risk factors for cardiovascular disease (e.g., insulin resistance, dyslipidemia, and liver fat accumulation). Alterations in fatty acid trafficking, both between tissues and within cells, represent a key feature in the pathophysiology of the metabolic complications in obese patients. The ways by which fatty acid 're-routing' may affect metabolic function are summarized in this article. RECENT FINDINGS Ectopic fat accumulation (i.e., fat accumulation in nonadipose tissues) appears to be a key feature distinguishing metabolically healthy from metabolically abnormal patients. This observation has led to the belief that an imbalance in fatty acid trafficking away from adipose tissue toward nonadipose tissues is a primary cause for the development of metabolic alterations in obese patients. More recently, however, it has become apparent that fatty acid trafficking within nonadipose tissues cells (i.e., toward storage - in the form of triglycerides - and oxidation) may be equally important in determining a person's risk for development of metabolic disease. SUMMARY The pathophysiology of the metabolic alterations associated with obesity is probably multifactorial within a complex network of coordinated physiological responses. Only through the integration of multiple concepts, will it be possible to further our understanding in this area and to help prevent the metabolic alterations associated with obesity.
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Affiliation(s)
- Bettina Mittendorfer
- Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, St. Louis, Missouri, USA.
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