weight loss.

  • 文章类型: Clinical Trial
    背景:多囊卵巢综合征(PCOS)是一种非常普遍的,复杂,异质,以代谢和生殖功能障碍为特征的多基因内分泌紊乱,影响全球8-13%的育龄妇女。PCOS的发病机制尚未完全阐明,包括遗传学、肥胖,胰岛素抵抗(IR)。PCOS的氧化应激(OS)独立于肥胖。它可以通过胰岛素后受体缺陷诱导IR,损害肌肉和脂肪组织中的葡萄糖摄取,并通过减少胰腺β细胞的胰岛素分泌来加剧IR。
    目的:为了研究热量限制饮食(CRD)的影响,高蛋白饮食(HPD),和高蛋白和高膳食纤维饮食(HPD+HDF)对身体成分,胰岛素抵抗,超重/肥胖PCOS患者的氧化应激。
    方法:选择90例PCOS超重/肥胖患者在北京大学第一医院接受为期8周的医学营养减肥干预。我们将他们随机分为CRD组(A组),HPD组(B组),和HPD+HDF组(C组),每组30名患者。我们测量了他们的身体成分,HOMA-IR指数,和氧化应激指标。t检验,Mann-WhitneyU测试,方差分析(ANOVA),采用Kruskal-WallisH检验比较3种方法的疗效。
    结果:八周后,三组的体重下降了6.32%,5.70%和7.24%,分别,内脏脂肪面积(VFA)值分别减少6.8cm2、13.4cm2和23.45cm2,尤其是C组(p>0.05)。瘦体重(LBM),也称为减肥后B组和C组的无脂质量(FFM)值,均高于A组(p>0.05)。减肥后,胰岛素抵抗(HOMA-IR)指数和丙二醛(MDA)的稳态模型评估降低。3组超氧化物歧化酶(SOD)均升高(p>0.05),B组和C组SOD和MDA的变化更为显著(p>0.05)。HOMA-IR指数与体重指数(BMI)呈正相关(r=0.195;p>0.05);MDA与体脂百分比(PBF)呈正相关(r=0.186;p>0.05),HOMA-IR指数呈正相关(r=0.422;p>0.01);SOD与LMI/FFMI呈正相关(r=0.195;p>0.05)。与HOMA-IR指数呈负相关(r=-0.433;p>0.01)。
    结论:三种饮食均可在8周内有效降低PCOS超重/肥胖患者体重5%以上,并可改善胰岛素抵抗和氧化应激损伤。与CRD相比,HPD和HPD+HDF饮食可以更好地保持瘦体重,并显着改善氧化应激损伤。
    背景:ChiCTR2100054961.
    BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a highly prevalent, complex, heterogeneous, polygenic endocrine disorder characterized by metabolic and reproductive dysfunction that affects 8-13% of women of reproductive age worldwide. The pathogenesis of PCOS has not been fully clarified and includes genetics, obesity, and insulin resistance (IR). Oxidative stress (OS) of PCOS is independent of obesity. It can induce IR through post-insulin receptor defects, impair glucose uptake in muscle and adipose tissue, and exacerbate IR by reducing insulin secretion from pancreatic β-cells.
    OBJECTIVE: To investigate the effects of Calorie Restricted Diet (CRD), High Protein Diet (HPD), and High Protein and High Dietary Fiber Diet (HPD+HDF) on body composition, insulin resistance, and oxidative stress in overweight/obese PCOS patients.
    METHODS: A total of 90 overweight/obese patients with PCOS were selected to receive an 8- week medical nutrition weight loss intervention at our First Hospital of Peking University, and we randomly divided them into the CRD group (group A), the HPD group (group B), and the HPD+HDF group (group C), with 30 patients in each group. We measured their body composition, HOMA-IR index, and oxidative stress indicators. The t-test, Mann-Whitney U test, analysis of variance (ANOVA), and Kruskal-Wallis H test were used to compare the efficacy of the three methods.
    RESULTS: After eight weeks, the body weights of the three groups decreased by 6.32%, 5.70% and 7.24%, respectively, and the Visceral Fat Area (VFA) values decreased by 6.8 cm2, 13.4 cm2 and 23.45 cm2, respectively, especially in group C (p >0.05). The lean body mass (LBM), also known as the Fat-Free Mass (FFM) values of group B and group C after weight loss, were higher than that of group A (p >0.05). After weight loss, the homeostatic model assessment of insulin resistance (HOMA-IR) index and malondialdehyde (MDA) were decreased. Superoxide dismutase (SOD) was increased in all three groups (p >0.05), and the changes in SOD and MDA in group B and group C were more significant (p >0.05). HOMA-IR index positively correlated with body mass index (BMI) (r=0.195; p >0.05); MDA positively correlated with percent of body fat (PBF) (r=0.186; p >0.05) and HOMA-IR index (r=0.422; p >0.01); SOD positively correlated with LMI/FFMI (r=0.195; p >0.05), negatively correlated with HOMA-IR index (r=-0.433; p >0.01).
    CONCLUSIONS: All three diets were effective in reducing the body weight of overweight/obese patients with PCOS by more than 5% within 8 weeks and could improve both insulin resistance and oxidative stress damage. Compared with CRD, HPD and HPD+HDF diets could better retain lean body mass and significantly improve oxidative stress damage.
    BACKGROUND: ChiCTR2100054961.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨司马鲁肽在非糖尿病人群中减肥的有效性和安全性。
    方法:在本研究中,选取2022年1月1日至2022年6月30日在我院门诊使用司马鲁肽减肥的84名非糖尿病患者,并比较体重变化,腰围,身体质量指数(BMI),空腹血糖,血压,脉搏,和身体成分(身体脂肪比,内脏脂肪面积,和骨骼肌)治疗前和治疗后12周,分析其减肥疗效和安全性。
    结果:服用司马鲁肽0.25mg后,0.5mg,0.75mg,或每周一次皮下1毫克,持续12周,84名参与者在这项研究中获得了5.91±3.37kg的平均体重减轻,相当于基线体重的6.15±4.28%,内脏脂肪面积也显著减少,血压略有下降。最常见的不良反应包括胃肠道反应(恶心,呕吐,和腹泻),温和,在1-2天内消退。无严重不良反应,如低血糖和低血压,被观察到。
    结论:已发现低剂量司马鲁肽对于非糖尿病人群的短期体重减轻是有效且安全的。
    OBJECTIVE: The study aimed to investigate the efficacy and safety of semaglutide in weight loss in non-diabetic people.
    METHODS: In this study, 84 non-diabetic people who used semaglutide to lose weight in the outpatient department of our hospital from January 1, 2022, to June 30, 2022, were enrolled and compared for changes in body weight, waist circumference, Body Mass Index (BMI), fasting blood glucose, blood pressure, pulse, and body composition (body fat ratio, visceral fat area, and skeletal muscle) before treatment and 12 weeks after the treatment to analyze the weight loss efficacy and safety.
    RESULTS: After administering semaglutide 0.25 mg, 0.5 mg, 0.75 mg, or 1 mg subcutaneously once a week for 12 weeks, 84 participants in this study obtained an average weight loss of 5.91 ± 3.37 kg, equivalent to 6.15 ± 4.28% of baseline body weight, and there was also a significant reduction in visceral fat area and a slight reduction in blood pressure. The most common adverse reactions included gastrointestinal reactions (nausea, vomiting, and diarrhea), which were mild and subsided within 1-2 days. No severe adverse reaction, such as hypoglycemia and hypotension, was observed.
    CONCLUSIONS: Low-dose semaglutide has been found to be effective and safe for short-term weight loss in non-diabetic people.
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  • 文章类型: Journal Article
    背景:恶病质通常与血清白细胞介素-6(IL.6)升高有关,因为它刺激肌肉蛋白的分解并促进消耗。
    目的:一项病例对照研究,以评估体重减轻,面部脂肪流失,和IL-6在抗逆转录病毒和接受治疗的参与者感染艾滋病毒/艾滋病。
    方法:IL-6通过高效液相色谱法(HPLC)在97例连续新诊断的初治抗逆转录病毒(ART-Na-ve)HIV/AIDS患者(年龄≥18岁)中进行检测;连续118例,目前正在接受高效抗逆转录病毒治疗(HAART)的年龄匹配参与者,以年龄为标准。在治疗组中,78名(66.7%)受试者服用齐多夫定,拉米夫定与奈韦拉平(Z+L+N);27(23.1%)替诺福韦,拉米夫定与恩曲他滨(T+L+E);5(4.3%)在齐多夫定,拉米夫定与恩曲他滨(ZLE);齐多夫定4(3.4%),拉米夫定与替诺福韦(Z+L+T);2(1.7%)拉米夫定,替诺福韦与奈韦拉平(L+T+N);1(0.9%)替诺福韦,齐多夫定,恩曲他滨(Z+T+E)。
    结果:共有215名参与者:97名接受ART治疗,118名接受HAART治疗,年龄匹配的受试者(40.3±9.6对42.7±10.20岁,p=0.08)。初治患者的平均IL-6明显高于治疗组(0.69±0.04对0.66±0.04pg/ml,p=0.002)。总之,73名受试者经历了体重减轻,56(76.7%)天真,17(23.3%)治疗,p<0.0001,在体重减轻的患者中IL-6明显更高(0.69±0.05对0.67±0.05pg/ml,p=0.047)。58名(27.0%)受试者面部脂肪减少,49(84.5%)天真,治疗9人(15.5%),p<0.0001,在面部脂肪减少的患者中IL-6明显更高(0.7±0.05对0.67±0.05pg/ml,p=0.0001)。IL-6与CD4+计数呈负相关(r=-0.141,p=0.041)。在逻辑回归中,体重减轻的独立预测因子包括:IL-6(调整后的赔率,aOR1.3,95CI0·1-2·6,p=0.047);HIV持续时间(aOR11.6,p<0.0001);AIDS定义疾病(aOR3.5,p<0.0001);CD4+计数(aOR3.2,p=0.004);HAART状态(aOR2.7,p<0.0001)。
    结论:HIV感染与血清白细胞介素-6的升高有关,这可能导致未治疗参与者的体重和面部脂肪减少;而HAART与IL-6水平抑制有关,从而改善体重和面部脂肪损失。血清IL-6与CD4+计数之间存在负相关关系;血清IL-6可以区分轻度至中度和重度免疫抑制状态。
    Cachexia is usually associated with elevated serum interleukin-6 (IL.6) as it stimulates the breakdown of muscle proteins and promotes wasting.
    A case-control study to evaluate the relationship between weight loss, facial fat loss, and IL-6 in antiretroviral-naïve and treated participants living with HIV/AIDS.
    IL-6 was assayed by High performance liquid chromatography (HPLC) in 97 in consecutive newly diagnosed antiretroviral-naive (ART-naïve) people living with HIV/AIDS (age ≥18 years); and 118 consecutive, age-matched participants currently on Highly Active Antiretroviral Therapy (HAART), using age as a criterion. In the treated group, 78 (66.7%) subjects were on zidovudine, lamivudine with nevirapine (Z+L+N); 27(23.1%) on tenofovir, lamivudine with emtricitabine (T+L+E); 5(4.3%) on zidovudine, lamivudine with emtricitabine (Z+L+E); 4(3.4%) on zidovudine, lamivudine with tenofovir (Z+L+T); 2(1.7%) on lamivudine, tenofovir with nevirapine (L+T+N); 1(0.9%) on tenofovir, zidovudine, emtricitabine (Z+T+E).
    A total of 215 participants: 97 ART-naive and 118 HAART-treated, age-matched subjects (40.3±9.6 versus 42.7±10.20years, p=0.08). The mean IL-6 was significantly higher in naïve than treated (0.69±0.04 versus 0.66±0.04 pg/ml, p =0.002). In all, 73 subjects experienced weight loss, 56(76.7%) naive, 17(23.3%) treated, p <0.0001, with significantly higher IL-6 in those with weight loss (0.69±0.05 versus 0.67±0.05pg/ml, p= 0.047). Fifty-eight (27.0%) subjects experienced facial fat loss, 49 (84.5%) naïve, and 9 (15.5%) treated, p <0.0001, with significantly higher IL-6 in those with facial fat loss (0.7 ± 0.05 versus 0.67±0.05pg/ml, p= 0.0001). Negative correlation exists between IL-6 and CD4+ count (r=-0.141, p=0.041). In logistic regression, independent predictors of weight loss include: IL-6 (Adjusted Odds Ratio, aOR 1.3, 95%CI 0·1-2·6, p=0.047); HIV duration (aOR 11.6, p <0.0001); AIDS-defining illness (aOR 3.5, p <0.0001); CD4+ count (aOR 3.2, p=0.004); HAART status (aOR 2.7, p<0.0001).
    HIV infection is associated with elevation of serum interleukin-6, which likely contributes to weight and facial fat loss among the treatment-naïve participants; while HAART is associated with suppressed IL-6 levels, thereby ameliorating weight and facial fat loss. Inverse relationship exists between serum IL-6 and CD4+ count; serum IL-6 could differentiate between mild- to moderate and severe immunosuppressive states.
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  • 文章类型: Journal Article
    2型糖尿病仍然是一个日益增长的健康问题,影响全球超过4.2亿人。预防和治疗糖尿病需要更好地了解相关的危险因素。睡眠呼吸紊乱,尤其是阻塞性睡眠呼吸暂停(OSA),可能是血糖控制不良的发病机制和加重的原因。我们回顾了解决OSA和2型糖尿病之间联系的关键流行病学数据,并提出了当前提出的这种关联的病理生理机制。几种生物学途径将OSA与增加的糖尿病倾向联系起来。我们基于糖尿病与睡眠呼吸暂停之间的关联,回顾了当前OSA治疗策略的影响。
    Type 2 diabetes mellitus remains a growing health concern, affecting more than 420 million people globally. Preventing and treating diabetes require a better understanding of the associated risk factors. Sleep-disordered breathing, especially obstructive sleep apnea (OSA), is likely a contributor to the pathogenesis and aggravation of poor glycemic control. We review key epidemiological data that address the link between OSA and type 2 diabetes and present the current proposed pathophysiological mechanisms underlying this association. Several biological pathways are linking OSA and an increased propensity to diabetes. We review the impact of current treatment strategies for OSA based on the association between diabetes and sleep apnea.
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  • 文章类型: Journal Article
    650 millions of adults are obese worldwide - in the US alone, forty percent of the adults are obese. Although the obesity pandemic is constantly expanding at very high costs for health care systems, the currently available options of pharmacotherapy for obesity are rather limited. Despite intensive research efforts, the vast majority of the anti-obesity drugs developed up to now have a rather limited efficacy and/or safety profile. In the last fifty years, various drugs reached advanced states of clinical development but were either never marketed or were initially approved but withdrawn later due to safety issues. However, the understanding of the pathophysiology of obesity has been steadily improving and new, promising drugs targeting various selective obesityassociated and energy-homeostasis-related pathways are now available. When lifestyle changes alone fail to combat, then additional pharmacotherapy with an acceptable efficacy and safety profile could provide a useful therapeutic option.
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  • 文章类型: Journal Article
    Several drugs have been currently approved for the treatment of obesity. The pharmacokinetic of liraglutide, as well as the treatment of type 2 diabetes mellitus, have been widely described.
    To analyze the published systematic reviews on the use of liraglutide for the treatment of obesity.
    Systematic reviews were found out through MEDLINE searches, through EBSCO host and the Cochrane Library based on the following terms: \"liraglutide\" as major term and using the following Medical Subject Headings (MesH) terms: \"obesity\", \"overweight\", \"weight loss\". A total of 3 systematic reviews were finally included to be analyzed.
    From the three systematic reviews selected, only two included the randomized clinical trials, while the third study reviewed both randomized and non-randomized clinical trials. Only one review performed statistical tests of heterogeneity and a meta-analysis, combining the results of individual studies. Another review showed the results of individual studies with odds ratio and confidence interval, but a second one just showed the means and confidence intervals. In all studies, weight loss was registered in persons treated with liraglutide in a dose dependent form, reaching a plateau at 3.0 mg dose, which was reached just in men. Most usual adverse events were gastrointestinal.
    More powerful and prospective studies are needed to assess all aspects related to liraglutide in the overweight and obesity treatment.
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  • 文章类型: Journal Article
    The relationship between obesity and hypertension has been established in both adults and children. The combination of obesity, hypertension and other cardiovascular risk factors significantly increases the likelihood of adverse cardiovascular effects and raises concerns about aggressive treatment strategies.
    Despite the impressive elements which indicate an important role for excessive weight gain in increasing blood pressure, not all obese patients are hypertensive. A subgroup of obese people may not develop hypertension. Furthermore, masked hypertension occurs more common among obese patients, and body fat distribution has a major role in the development of hypertension.
    We conducted a research of the relevant literature regarding obesity-induced hypertension and possible treatment strategies.
    Successful weight loss is correlated with blood pressure reduction and requires a multidisciplinary approach that includes personalized dietary interventions combined with regular exercise and cognitive behavioral therapy.
    Pharmacological therapy may be considered as part of a comprehensive obesity management strategy. More research and new treatment therapies are required in this field.
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  • 文章类型: Case Reports
    OBJECTIVE: Olmesartan-induced enteropathy consists a syndrome that mimics celiac disease both clinically and histologically. Cases of this entity have sporadically been reported since 2012 and are usually characterized by severe diarrhea and malabsorption, followed by significant weight loss.
    METHODS: Herein, we report an uncommon case of this syndrome, where weight loss preceded several months the onset of gastrointestinal symptoms.
    CONCLUSIONS: Physicians should be aware of unexplained weight loss in patients taking olmesartan, as prompt discontinuation of the drug may prevent the deleterious consequences of malabsorption.
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  • 文章类型: Journal Article
    The increasing prevalence of obesity is one of the major problems of today\'s society. Man needs food to continue living, daily activities, and even the metabolism of food; and appetite plays an important role in receiving foods. Appetite and weight reducing synthetic drugs, which are mostly costly and have significant side effects, are recommended for some patients, and have limited effectiveness in the treatment of obesity. Given the epidemic of obesity and the lack of satisfaction with synthetic drugs these days, people are more likely to use herbal medicines. Complementary medicine has always been considered for the choice of new treatment. This medicine has a long history. Persian Medicine is one of the traditional medicine systems. This study was a qualitative study on the Books of Canon and the Makhzan Al-Aladvia. Saffron has been introduced in both modern medicine and in Iranian medicine to reduce appetite. In the case of Purslane seed and Chio nut, Figs, Sesame seeds, Camphor, and Solomon\'s seal, and Opium poppy, which have been appetite suppressant in traditional medicine books, in the books and articles of modern medicine, they have not proved to be appetite reducing. Modern medicine has known Gourd as a weight reducing food with the effects on fat but there is no talk about its effects on appetite. According to traditional Iranian medicine, Chio nut causes anorexia due to weakness in the stomach. Therefore, it is not advisable for weight loss. More clinical studies are conducted to prove the effects of appetite suppressant and weight loss effects of these herbal medicines seem logical.
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  • 文章类型: Journal Article
    肥胖是一个日益严重的全球性健康问题,但是它的治疗还不是最佳的,尤其是长期的。出于这个原因,已经进行了关于基于脂肪间充质干细胞(AD-MSCs)的肥胖新治疗策略的临床前研究。我们系统评价的目的是总结这些来自动物模型的发现,以确定是否有足够的证据证明继续进行临床研究。
    文献检索,研究选择,方法和质量评估按照系统评价和荟萃分析(PRISMA)指南的首选报告项目进行。使用叙述方法整理数据。
    在检索到的578篇文章中,七项研究符合纳入标准,他们的分析揭示了几个主要发现。有强有力的证据表明,就体重而言,AD-MSCs在肥胖治疗中具有积极作用,葡萄糖代谢稳态,脂质分布,非酒精性脂肪性肝病和全身性炎症。此外,最近有一些研究的证据表明,AD-MSCs移植对肥胖相关激素状态的改善有显著作用,(即,瘦素)和身体成分模式,尽管这些调查可能需要进一步复制。
    AD-MSCs移植对肥胖的影响,在减肥和肥胖相关疾病方面,在动物模型中很有前途。在未来,应进行进一步精心设计的研究,以了解作用机制,并克服一些方法学上的局限性,例如小样本量和我们的系统评价中证明的偏倚风险,在评估AD-MSCs作为人类肥胖管理的潜在策略之前。
    Obesity is an increasing global health problem, but its treatment is not yet optimal, especially in the long term. For this reason, preclinical studies have been conducted relating to a new therapeutic strategy for obesity based on adipose-derived mesenchymal stem cells (AD-MSCs). The aim of our systematic review is to summarize these findings deriving from the animal model in order to establish whether there is sufficient evidence to justify going forward to clinical studies.
    Literature searches, study selection, methods and quality appraisal were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were collated using a narrative approach.
    Of the 578 articles retrieved, seven studies met the inclusion criteria, and their analysis revealed several main findings. There was a strong evidence of the positive effect of AD-MSCs in obesity treatment in terms of body weight, glucose metabolism homeostasis, lipid profiles, non-alcoholic fatty liver disease and systemic inflammation. Moreover, there was recent evidence from a few studies for a significant effect of AD-MSCs transplantation on the improvement of obesity-related hormonal status, (i.e., leptin) and body composition patterns, though these investigations may need further replication.
    The effects of AD-MSCs transplantation on obesity, in terms of weight loss and obesityrelated diseases, are promising in animal models. In the future, further well-designed studies should be performed to understand the mechanism of action and to overcome some methodological limitations such as the small sample sizes and risk of bias evidenced in our systematic review, before moving forward to assess AD-MSCs as a potential strategy for human obesity management.
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