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1.
Physiol Rep ; 12(17): e16169, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39261976

RESUMEN

Myostatin inhibition improves insulin sensitivity in preclinical and clinical models; however, studies investigating the relationship between serum myostatin levels and insulin sensitivity are discrepant. Sensitive and specific myostatin LC-MS/MS assays are now available to accurately assess serum myostatin level in vivo. We sought to determine whether higher serum myostatin levels are independently associated with lower insulin sensitivity in adults with overweight/obesity. Participants included 74 adults, 20-65 years old, BMI ≥25 kg/m2 without type 2 diabetes. Appendicular lean mass (ALM) was measured by dual-energy x-ray absorptiometry; visceral adipose tissue (VAT) was measured by computed tomography. Main outcome measures were serum myostatin levels (LC-MS/MS) and insulin sensitivity (Matsuda index). Mean age was 48 ± 12 years, and BMI was 33.1 ± 5.6 kg/m2 (mean ± SD). Men had higher mean serum myostatin levels versus women (8.3 ± 1.9 vs. 7.2 ± 1.9 ng/mL, p = 0.01) and higher serum myostatin levels were associated with higher ALM (R = 0.34, p = 0.003). Higher serum myostatin levels were associated with lower Matsuda index (R = -0.44, p = 0.0004), which remained significant after controlling for BMI, VAT, ALM, and sex. In conclusion, higher serum myostatin levels are independently associated with lower insulin sensitivity in adults with overweight/obesity and may be a marker of or play a mechanistic role in the development of insulin resistance.


Asunto(s)
Resistencia a la Insulina , Miostatina , Obesidad , Sobrepeso , Humanos , Miostatina/sangre , Masculino , Femenino , Persona de Mediana Edad , Adulto , Obesidad/sangre , Sobrepeso/sangre , Anciano
2.
BMC Gastroenterol ; 24(1): 296, 2024 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-39227769

RESUMEN

BACKGROUND: Irritable bowel syndrome (IBS) is a common disease with unknown etiology. Poor dietary intake with nutritional deficiency and overweight have been described to increase the risk of IBS. The aim of the present study was to compare weight and circulating levels of micronutrients in IBS compared with healthy controls. DESIGN: Cross-sectional study. METHODS: Patients diagnosed with IBS and healthy volunteers were recruited. Participants had to complete a dietary diary book and the questionnaires Rome IV, IBS-severity scoring system (IBS-SSS), and visual analog scale for IBS (VAS-IBS). Weight and height were measured, and blood samples were drawn. C-reactive protein (CRP), cobalamin, folate, iron, total iron-binding capacity (TIBC), and 25-hydroxy (25-OH) vitamin D were analyzed. Differences were calculated between groups and generalized linear model for regressions was adjusted for false discovery rate (FDR). RESULTS: IBS patients (n = 260) were elder than controls (n = 50) (44.00 (33.25-56.00) vs. 37.85 (30.18-45.48) years; p = 0.012). After adjustment for age, both weight (ß: 5.880; 95% CI: 1.433-10.327; p = 0.010, FDR = 0.020) and body mass index (BMI) (ß: 2.02; 95% CI: 0.68-3.36; p = 0.003, FDR = 0.012) were higher in patients. Among IBS participants, 48.1% were overweight/obese compared with 26.0% in controls (p = 0.007). Diarrhea-predominated IBS had highest weight (p < 0.001) and BMI (p = 0.077). CRP and cobalamin were higher in patients than controls (p = 0.010 vs. p = 0.007), whereas folate was highest in controls (p = 0.001). IBS patients had lower intake of vegetables (p = 0.026), dairy products (p = 0.004), and cereals (p = 0.010) compared with controls. Despite 21.5% of IBS patients were taking vitamin D supplements, 23.65% of them had vitamin D levels below 50 nmol/L, compared with 26.0% observed in the control group (p = 0.720). Vitamin D levels were lower in overweight than in normal weight IBS patients (60 (48-73) nmol/L vs. 65 (53-78) nmol/L, p = 0.022). Vitamin D correlated with cobalamin and folate but correlated inversely with TIBC and BMI. IBS patients had a high degree of gastrointestinal and extraintestinal symptoms, which were inversely associated with iron levels. Extraintestinal symptoms were associated with increased BMI. CONCLUSION: IBS patients were often overweight or obese, with low vitamin D levels. High burden of extraintestinal symptoms were associated with overweight and lower iron levels. REGISTRATION: ClinicalTrials.gov, NCT05192603 (Date of registration 11/29/2021) and NCT03306381 (Date of registration 09/18/2017), respectively.


Asunto(s)
Síndrome del Colon Irritable , Sobrepeso , Deficiencia de Vitamina D , Humanos , Síndrome del Colon Irritable/sangre , Síndrome del Colon Irritable/etiología , Estudios Transversales , Femenino , Masculino , Adulto , Persona de Mediana Edad , Sobrepeso/complicaciones , Sobrepeso/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/epidemiología , Estudios de Casos y Controles , Vitamina D/sangre , Vitamina D/análogos & derivados , Proteína C-Reactiva/análisis , Índice de Masa Corporal , Micronutrientes/deficiencia , Micronutrientes/sangre
3.
Sci Rep ; 14(1): 21398, 2024 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-39271793

RESUMEN

Gestational diabetes mellitus (GDM) adversely affects offspring glucose homeostasis and risk of developing obesity. Here, we examined the association between glycemia in pregnant women with overweight or obesity without GDM and offspring metabolic health. Maternal fasting glucose concentrations and glucose 2-h after an oral glucose tolerance test (OGTT) were measured in 208 women with a pre-pregnancy body mass index (BMI) of 28-45 kg/m2 without GDM. Offspring outcomes were collected at birth, 3, and 5 years of age. Linear mixed models with time as fixed factor and subject ID as random effects were used for analysis. No associations were found between maternal fasting or 2-h glucose concentrations with offspring glucose and insulin concentrations from birth to 5 years of age. However, maternal fasting glucose in GW 28 and 36, and 2-h OGTT glucose in GW 28 were positively associated with C-peptide concentration at birth. Maternal fasting glucose concentrations in GW 28 and 36 were positively associated with weight-for-length, and maternal fasting glucose in GW 36 was associated with BMI z-score at birth. In summary, blood glucose in pregnant women with overweight or obesity is positively associated with offspring C-peptide concentration, weight-for-length, and BMI z-score at birth, even in the absence of GDM.


Asunto(s)
Glucemia , Índice de Masa Corporal , Prueba de Tolerancia a la Glucosa , Homeostasis , Obesidad , Sobrepeso , Humanos , Femenino , Embarazo , Adulto , Glucemia/metabolismo , Obesidad/metabolismo , Obesidad/sangre , Sobrepeso/metabolismo , Sobrepeso/sangre , Diabetes Gestacional/metabolismo , Diabetes Gestacional/sangre , Recién Nacido , Preescolar , Insulina/sangre , Insulina/metabolismo , Péptido C/sangre , Ayuno/sangre , Complicaciones del Embarazo/metabolismo , Complicaciones del Embarazo/sangre
4.
Biomolecules ; 14(8)2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39199416

RESUMEN

Sedentary behavior (SB) is an essential risk factor for obesity, cardiovascular disease, and type 2 diabetes. Though certain levels of physical activity (PA) may attenuate the detrimental effects of SB, the inflammatory and cardiometabolic responses involved are still not fully understood. The focus of this secondary outcome analysis was to describe how light-intensity PA snacks (LIPASs, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affect inflammatory and cardiometabolic risk markers. Seventeen young adults with overweight and obesity participated in this study (eight females, 23.4 ± 3.3 years, body mass index (BMI) 29.7 ± 3.8 kg/m2, glycated hemoglobin A1C (HbA1c) 5.4 ± 0.3%, body fat 31.8 ± 8.2%). Participants were randomly assigned to the following conditions which were tested during an 8 h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND, 2.5 h total standing time), continuous standing (STAND), and continuous walking (1.6 km/h; WALK). Each condition also included a standardized non-relativized breakfast and lunch. Venous blood samples were obtained in a fasted state at baseline (T0), 1 h after lunch (T1) and 8 h after baseline (T2). Inflammatory and cardiometabolic risk markers included interleukin-6 (IL-6), c-reactive protein (CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), visceral fat area (VFA), triglyceride-glucose (TyG) index, two lipid ratio measures, TG/HDL-C and TC/HDL-C, albumin, amylase (pancreatic), total protein, uric acid, and urea. We found significant changes in a broad range of certain inflammatory and cardiometabolic risk markers during the intervention phase for IL-6 (p = 0.014), TG (p = 0.012), TC (p = 0.017), HDL-C (p = 0.020), LDL-C (p = 0.021), albumin (p = 0.003), total protein (p = 0.021), and uric acid (p = 0.040) in favor of light-intensity walking compared with uninterrupted prolonged sitting, alternate sitting and standing, and continuous standing. We found no significant changes in CRP (p = 0.529), creatinine (p = 0.199), TyG (p = 0.331), and the lipid ratios TG/HDL-C (p = 0.793) and TC/HDL-C (p = 0.221) in response to the PA snack. During a simulated 8 h work environment replacement and interruption of prolonged sitting with light-intensity walking, significant positive effects on certain inflammatory and cardiometabolic risk markers were found in young adults with overweight and obesity.


Asunto(s)
Biomarcadores , Factores de Riesgo Cardiometabólico , Ejercicio Físico , Inflamación , Obesidad , Sobrepeso , Conducta Sedentaria , Humanos , Femenino , Masculino , Adulto Joven , Adulto , Obesidad/sangre , Sobrepeso/sangre , Sobrepeso/metabolismo , Inflamación/sangre , Biomarcadores/sangre , Estudios Cruzados , Sedestación , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/sangre , Caminata/fisiología , Proteína C-Reactiva/metabolismo , Índice de Masa Corporal
5.
Nutrients ; 16(16)2024 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-39203787

RESUMEN

Thyroid hormones regulate metabolism and have a major impact in maintaining cardiovascular homeostasis. The purpose of our study was to examine the relation of thyrotropin (TSH) and thyroid hormones with cardiometabolic parameters in children and adolescents with obesity, overweight, and normal body mass index (BMI) before and after the implementation of a comprehensive, multidisciplinary, personalized, lifestyle intervention program for 1 year. One thousand three hundred and eleven (n = 1311) children and adolescents aged 2 to 18 years (mean age ± SD: 10.10 ± 2.92 years) were studied prospectively. Patients were categorized as having obesity (n = 727, 55.45%), overweight (n = 384, 29.29%) or normal BMI (n = 200, 15.26%) according to the International Obesity Task Force (IOTF) cutoff points. All patients received personalized guidance on diet, sleep, and physical activity at regular intervals throughout the 1-year period. Detailed clinical evaluation and hematologic, biochemical and endocrinologic investigations were performed at the beginning and the end of the study. Subjects with obesity had a more adverse cardiometabolic risk profile than subjects with overweight and normal BMI on both assessments. At initial evaluation, total T3 concentrations were positively associated with uric acid and HbA1C, and free T4 concentrations were negatively associated with insulin concentrations, while there was no association between TSH concentrations and cardiometabolic risk parameters. Following the 1 year of the multidisciplinary, lifestyle intervention program, the concentrations of lipids, HbA1C, ALT, and γGT improved significantly in all subjects. Changes in TSH concentrations were positively associated with changes in systolic blood pressure (SBP), glucose, triglycerides, and cholesterol concentrations. Changes in free T4 concentrations were negatively associated with changes in cholesterol and insulin concentrations. Furthermore, changes in T3 concentrations were positively associated with changes in HbA1C, glucose, uric acid, and triglyceride concentrations. These findings indicate that in children and adolescents with overweight and obesity, thyroid hormones are associated with indices conferring cardiometabolic risk.


Asunto(s)
Índice de Masa Corporal , Factores de Riesgo Cardiometabólico , Sobrepeso , Obesidad Infantil , Hormonas Tiroideas , Tirotropina , Humanos , Niño , Adolescente , Masculino , Femenino , Sobrepeso/sangre , Sobrepeso/terapia , Hormonas Tiroideas/sangre , Obesidad Infantil/sangre , Obesidad Infantil/terapia , Preescolar , Tirotropina/sangre , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/sangre , Estudios Prospectivos , Estilo de Vida , Ácido Úrico/sangre
6.
Obesity (Silver Spring) ; 32(9): 1689-1698, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39113385

RESUMEN

OBJECTIVE: The objective of this study was to explore how dietary macronutrient composition influences postprandial appetite hormone responses and subsequent energy intake. METHODS: A total of 20 adults (mean [SEM], age 30 [1] years, BMI 27.8 [1.3] kg/m2, n = 8 with normal weight, n = 6 with overweight, n = 6 with obesity) consumed a low-fat (LF) diet (10% fat, 75% carbohydrate) and a low-carbohydrate (LC) diet (10% carbohydrate, 75% fat) for 2 weeks each in an inpatient randomized crossover design. At the end of each diet, participants consumed isocaloric macronutrient-representative breakfast test meals, and 6-h postprandial responses were measured. Ad libitum energy intake was measured for the rest of the day. RESULTS: The LC meal resulted in greater mean postprandial plasma active glucagon-like peptide-1 (GLP-1; LC: 6.44 [0.78] pg/mL, LF: 2.46 [0.26] pg/mL; p < 0.0001), total glucose-dependent insulinotropic polypeptide (GIP; LC: 578 [60] pg/mL, LF: 319 [37] pg/mL; p = 0.0004), and peptide YY (PYY; LC: 65.6 [5.6] pg/mL, LF: 50.7 [3.8] pg/mL; p = 0.02), whereas total ghrelin (LC: 184 [25] pg/mL, LF: 261 [47] pg/mL; p = 0.0009), active ghrelin (LC: 91 [9] pg/mL, LF: 232 [28] pg/mL; p < 0.0001), and leptin (LC: 26.9 [6.5] ng/mL, LF: 35.2 [7.5] ng/mL; p = 0.01) were lower compared with LF. Participants ate more during LC at lunch (244 [85] kcal; p = 0.01) and dinner (193 [86] kcal; p = 0.04), increasing total subsequent energy intake for the day compared with LF (551 [103] kcal; p < 0.0001). CONCLUSIONS: In the short term, endogenous gut-derived appetite hormones do not necessarily determine ad libitum energy intake.


Asunto(s)
Apetito , Estudios Cruzados , Dieta Baja en Carbohidratos , Dieta con Restricción de Grasas , Ingestión de Energía , Polipéptido Inhibidor Gástrico , Ghrelina , Péptido 1 Similar al Glucagón , Péptido YY , Periodo Posprandial , Humanos , Adulto , Masculino , Femenino , Péptido 1 Similar al Glucagón/sangre , Ghrelina/sangre , Péptido YY/sangre , Polipéptido Inhibidor Gástrico/sangre , Dieta con Restricción de Grasas/métodos , Obesidad/sangre , Hormonas Gastrointestinales/sangre , Sobrepeso/sangre , Glucemia/metabolismo , Insulina/sangre
7.
BMC Pregnancy Childbirth ; 24(1): 535, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39143534

RESUMEN

BACKGROUND: Empirical evidence has demonstrated associations between pre-pregnancy obesity and perinatal maternal depressive symptoms. Omega-3 is an essential fatty acid derived from dietary sources that is critical for fetal brain development. Pre-pregnancy obesity is associated with higher omega-3 intake, but a weaker association between dietary intake and respective maternal and cord blood omega-3 levels. Further, lower intake of omega-3 during pregnancy has been linked to higher depressive symptoms. Yet, prior studies have not examined the interactive effects of pre-pregnancy overweight or obesity (OWOB) and prenatal maternal mental health symptoms on infant cord blood omega-3 levels. METHODS: Participants included 394 maternal-infant dyads from the NIH Environmental influences on Child Health Outcomes (ECHO) - Safe Passage Study in South Dakota. A pre-pregnancy body mass index (BMI) > 25 was used to dichotomize participants as OWOB (54%) vs. non-OWOB (46%). Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) and prenatal maternal anxiety symptoms were measured using the State-Trait Anxiety Inventory (STAI). We implemented linear regression models to examine the interaction term between pre-pregnancy BMI category and prenatal maternal mental health symptoms on cord blood omega-3 levels. Secondary analyses were stratified by pre-pregnancy BMI category. RESULTS: We observed a significant interaction between pre-pregnancy BMI category and prenatal maternal depressive symptoms with cord blood omega-3 (F(4,379) = 6.21, p < .0001, adj. R2 = 0.05). Stratified models revealed an association between prenatal maternal depressive symptoms with lower cord blood omega-3 levels only among individuals with pre-pregnancy OWOB (ß = -0.06, 95% CI = -0.11, -0.02; F (2,208) = 4.00, p < .05, adj R2 = 0.03). No associations were observed among non-OWOB participants. CONCLUSIONS: Findings suggest maternal-placental transfer of omega-3 may represent one pathway by which maternal metabolic and mental health impacts infant development.


Asunto(s)
Depresión , Ácidos Grasos Omega-3 , Sangre Fetal , Complicaciones del Embarazo , Humanos , Femenino , Sangre Fetal/química , Embarazo , Ácidos Grasos Omega-3/sangre , Adulto , Depresión/sangre , Depresión/psicología , Recién Nacido , Complicaciones del Embarazo/sangre , Complicaciones del Embarazo/psicología , Sobrepeso/sangre , Sobrepeso/psicología , Obesidad/sangre , Obesidad/psicología , Índice de Masa Corporal , Adulto Joven , Masculino
8.
Int J Mol Sci ; 25(15)2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39125635

RESUMEN

Exercise training is a valuable tool for improving body weight and composition in overweight or obese adults, which leads to a negative energy balance. It is relevant to consider whether exercise can help people lose weight or prevent weight gain because any energy expended in exercise increases the severity of hunger and promotes food consumption. Over the past decade, the identification of the circulating peptide ghrelin, which alerts the brain to the body's nutritional state, has significantly expanded our understanding of this homeostatic mechanism that controls appetite and body weight. To shed more light on this issue, we decided to investigate the effects of resistance and endurance training on plasma ghrelin and leptin levels. In addition, we sought to understand the mechanisms by which acute and chronic exercise can regulate hunger. This review analyzes studies published in the last fifteen years that focused on changes suffered by ghrelin, leptin, or both after physical exercise in overweight or obese individuals. Most studies have shown a decrease in leptin levels and an increase in ghrelin levels in these cases. Exercise regimens that support weight maintenance need further investigation.


Asunto(s)
Entrenamiento Aeróbico , Ghrelina , Leptina , Obesidad , Sobrepeso , Entrenamiento de Fuerza , Ghrelina/sangre , Humanos , Leptina/sangre , Obesidad/sangre , Obesidad/terapia , Entrenamiento Aeróbico/métodos , Sobrepeso/sangre , Sobrepeso/terapia , Sobrepeso/metabolismo , Ejercicio Físico/fisiología
9.
Sci Rep ; 14(1): 18624, 2024 08 11.
Artículo en Inglés | MEDLINE | ID: mdl-39128946

RESUMEN

The relationship of weight change has extended to accelerated ageing, yet little is known about the association between weight change and anti-aging protein α-Klotho. This study included 10,972 subjects from the National Health and Nutrition Examination Survey 2007-2016. Participants were measured body weight and height at baseline and recalled weight at young adulthood and middle adulthood. α-Klotho concentrations were quantified. Generalized linear regression models were used to assess the association between weight change and α-Klotho. Across adulthood, maximal overweight, non-obese to obese, and stable obesity were consistently associated with lower serum Klotho levels. Compared with participants who remained at normal weight, from middle to late adulthood, participants experiencing maximal overweight, moving from the non-obese to obese, and maintaining obesity had 27.97 (95% CI: - 46.57 to - 9.36), 39.16 (95% CI: - 61.15 to - 17.18), and 34.55 (95% CI: - 55.73 to - 13.37) pg/ml lower α-Klotho, respectively; similarly, from young to late adulthood, those had 29.21 (95% CI: - 47.00 to - 11.42) , 34.14 (95% CI: - 52.88 to - 15.40), and 36.61 (95% CI: - 65.01 to - 8.21) lower, respectively. Interestingly, from middle to late adulthood, the absolute weight change values of 590 participants who changed from obese to non-obese were negatively associated with serum α-Klotho. Each 1 kg of weight loss during the process of changing from obese to non-obese brought about a relative increase in α-Klotho levels of 3.03 pg/ml. The findings suggest the potential role of weight management across adulthood for aging.


Asunto(s)
Envejecimiento , Glucuronidasa , Proteínas Klotho , Obesidad , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Anciano , Obesidad/sangre , Glucuronidasa/sangre , Envejecimiento/sangre , Adulto , Peso Corporal , Encuestas Nutricionales , Índice de Masa Corporal , Sobrepeso/sangre
10.
J Nutr Biochem ; 133: 109718, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39103105

RESUMEN

Nonsoy legumes offer many health benefits, including improved arterial function, reduced cholesterol levels, and better management of cardiovascular diseases and type 2 diabetes. This systematic review and meta-analysis aim to clarify the inconclusive findings from randomized controlled trials (RCTs) by comprehensively evaluating the effects of nonsoy legumes consumption on serum levels of inflammatory biomarkers and Adiponectin. The search encompassed databases up to January 2024, including PubMed, EMBASE, MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL to retrieve all RCTs examining the effects of nonsoy legumes on inflammatory biomarkers or Adiponectin. The effect sizes quantified as mean differences (MD) and standard deviations (SD) of outcomes, and an overall effect estimate was derived using a random-effects model. RCTs examining serum levels of C-reactive protein (CRP), Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), Interleukin-1ß (IL-1ß), and Adiponectin were included in the final meta-analysis. Results revealed that consumption of nonsoy legumes increased Adiponectin serum levels (P=.0017) and reduced IL-1ß serum levels (P<.0001). However, it may not significantly affect CRP (P=.2951), IL-6 (P=.2286), and TNF-α (P=.6661) levels. Subgroup analyses showed that nonsoy legumes consumption significantly decreased TNF-α serum levels in studies involving healthy participants. Additionally, sensitivity analysis using the leave-one-out method suggested a potential significant reduction in serum levels of IL-6. This study indicates that consuming nonsoy legumes can increase levels of Adiponectin and decrease serum levels of IL-1ß in overweight or obese adults.


Asunto(s)
Adiponectina , Biomarcadores , Fabaceae , Obesidad , Sobrepeso , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Adiponectina/sangre , Biomarcadores/sangre , Sobrepeso/sangre , Obesidad/sangre , Adulto , Proteína C-Reactiva/metabolismo , Proteína C-Reactiva/análisis , Inflamación/sangre , Interleucina-1beta/sangre , Factor de Necrosis Tumoral alfa/sangre , Interleucina-6/sangre
11.
Elife ; 132024 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-39190027

RESUMEN

Background: Physical activity has been associated with preventing the development of type 2 diabetes and atherosclerotic cardiovascular disease. However, our understanding of the precise molecular mechanisms underlying these effects remains incomplete and good biomarkers to objectively assess physical activity are lacking. Methods: We analyzed 3072 serum proteins in 26 men, normal weight or overweight, undergoing 12 weeks of a combined strength and endurance exercise intervention. We estimated insulin sensitivity with hyperinsulinemic euglycemic clamp, maximum oxygen uptake, muscle strength, and used MRI/MRS to evaluate body composition and organ fat depots. Muscle and subcutaneous adipose tissue biopsies were used for mRNA sequencing. Additional association analyses were performed in samples from up to 47,747 individuals in the UK Biobank, as well as using two-sample Mendelian randomization and mice models. Results: Following 12 weeks of exercise intervention, we observed significant changes in 283 serum proteins. Notably, 66 of these proteins were elevated in overweight men and positively associated with liver fat before the exercise regimen, but were normalized after exercise. Furthermore, for 19.7 and 12.1% of the exercise-responsive proteins, corresponding changes in mRNA expression levels in muscle and fat, respectively, were shown. The protein CD300LG displayed consistent alterations in blood, muscle, and fat. Serum CD300LG exhibited positive associations with insulin sensitivity, and to angiogenesis-related gene expression in both muscle and fat. Furthermore, serum CD300LG was positively associated with physical activity and negatively associated with glucose levels in the UK Biobank. In this sample, the association between serum CD300LG and physical activity was significantly stronger in men than in women. Mendelian randomization analysis suggested potential causal relationships between levels of serum CD300LG and fasting glucose, 2 hr glucose after an oral glucose tolerance test, and HbA1c. Additionally, Cd300lg responded to exercise in a mouse model, and we observed signs of impaired glucose tolerance in male, but not female, Cd300lg knockout mice. Conclusions: Our study identified several novel proteins in serum whose levels change in response to prolonged exercise and were significantly associated with body composition, liver fat, and glucose homeostasis. Serum CD300LG increased with physical activity and is a potential causal link to improved glucose levels. CD300LG may be a promising exercise biomarker and a therapeutic target in type 2 diabetes. Funding: South-Eastern Norway Regional Health Authority, Simon Fougners Fund, Diabetesforbundet, Johan Selmer Kvanes' legat til forskning og bekjempelse av sukkersyke. The UK Biobank resource reference 53641. Australian National Health and Medical Research Council Investigator Grant (APP2017942). Australian Research Council Discovery Early Career Award (DE220101226). Research Council of Norway (Project grant: 325640 and Mobility grant: 287198). The Medical Student Research Program at the University of Oslo. Novo Nordisk Fonden Excellence Emerging Grant in Endocrinology and Metabolism 2023 (NNF23OC0082123). Clinical trial number: clinicaltrials.gov: NCT01803568.


Asunto(s)
Ejercicio Físico , Homeostasis , Adulto , Animales , Femenino , Humanos , Masculino , Ratones , Persona de Mediana Edad , Biomarcadores/sangre , Glucemia/metabolismo , Proteínas Sanguíneas/metabolismo , Proteínas Sanguíneas/análisis , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/sangre , Ejercicio Físico/fisiología , Glucosa/metabolismo , Resistencia a la Insulina , Músculo Esquelético/metabolismo , Sobrepeso/metabolismo , Sobrepeso/sangre , Proteómica
12.
Lipids Health Dis ; 23(1): 273, 2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-39198792

RESUMEN

INTRODUCTION: We previously documented the beneficial effects of rice bran oil (RBO) on cardiac function and atherogenic cardiometabolic factors in men with coronary artery disease. Therefore, the existing evidence in this area aims to be expanded by investigating the impact of adding RBO to a daily standard diet on emerging insulin resistance surrogate markers, lipid peroxidation, antioxidant status, and metabolic disturbances in individuals with metabolic syndrome (MetSyn) through an open-label controlled trial. METHODS: A total of 50 overweight/obese adults (mean body mass index (BMI) = 31.08 kg/m2) with at least 3 MetSyn components were randomly allocated to either the control group, which received a standard diet plan, or the intervention group, which was supplemented with 30 g/d RBO for 8 weeks. BMI, MetSyn components, metabolic score for insulin resistance (METS-IR), triglyceride‒glucose‒BMI (TyG‒BMI), malondialdehyde (MDA), total antioxidant capacity (TAC), and plasma polyphenol levels were measured before and after this open-label trial. RESULTS: Analysis of covariance (ANCOVA) adjusted for baseline values revealed that, compared with patients who received only a standard diet, those who were supplemented with 30 g/d RBO presented significantly lower total cholesterol (P value = 0.005; effect size (ES):-0.92), LDL-cholesterol (P value = 0.048; ES:-0.62), fasting blood glucose (P value = 0.014; ES:-0.77), MDA (P value = 0.002; ES: -1.01), METS-IR (P value < 0.001; ES: -1.24), and TyG-BMI (P value = 0.007; ES:-0.85) after 8 weeks. Additionally, RBO consumption resulted in significantly higher levels of HDL-C (P value = 0.004; ES:0.94) and TAC (P value < 0.0001; ES:2.05). However, no significant changes were noted in BMI, waist circumference, serum triglycerides, plasma polyphenols, or blood pressure. CONCLUSION: Although the current findings suggest that the hypocholesterolemic, antihyperglycemic, and antioxidative effects of 30 g/d RBO seem to be promising for MetSyn patients, they should be considered preliminary. Therefore, further well-designed clinical trials with larger sample sizes and longer durations are needed to confirm these findings.


Asunto(s)
Antioxidantes , Factores de Riesgo Cardiometabólico , Peroxidación de Lípido , Síndrome Metabólico , Obesidad , Sobrepeso , Aceite de Salvado de Arroz , Humanos , Síndrome Metabólico/dietoterapia , Síndrome Metabólico/sangre , Síndrome Metabólico/tratamiento farmacológico , Síndrome Metabólico/metabolismo , Masculino , Persona de Mediana Edad , Antioxidantes/metabolismo , Obesidad/dietoterapia , Obesidad/sangre , Obesidad/tratamiento farmacológico , Obesidad/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Adulto , Sobrepeso/dietoterapia , Sobrepeso/sangre , Femenino , Índice de Masa Corporal , Resistencia a la Insulina , Malondialdehído/sangre , Triglicéridos/sangre , Glucemia/metabolismo
13.
Rocz Panstw Zakl Hig ; 75(2): 161-167, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39140122

RESUMEN

BACKGROUND: Aronia melanocarpa is nowadays valued for its high content of biologically active substances, the main group of which are polyphenols, which include anthocyanins, flavonols, flavanols, proanthocyanidins and phenolic acids. From the available sources, we can conclude that extracts and juices from black chokeberry have a great potential in human nutrition and influence on their health. OBJECTIVE: The research was to evaluate the effect of regular consumption of 100% organic chokeberry juice on selected anthropometric and lipid parameters of overweight or obese women. MATERIAL AND METHODS: A clinical study consisted of 19 women with overweight and obesity, age from 44 to 63. The probands consumed 50 ml of chokeberry juice daily for 8 weeks as part of their regular diet. Body composition and biochemical indicators were monitored before consumption, after 4 and 8 weeks of nutritional intervention. Body composition was determined using multifrequency bioelectrical impedance analysis (MFBIA) - InBody 720. Biochemical analyzes of blood serum were performed using standard methods in an accredited laboratory using automatic biochemical analyzer a BioMajesty JCA-BM6010/C. RESULTS: The monitored group of probands is characterized by menopausale and postmenopausale women, overweight or obese women with hypercholesterolemia without pharmacological treatment. Statistically significant differences (p<0.05) were observed when evaluating the amount of body fat (BFM) of the probands before the start of consumption and after the consumption of chokeberry juice. We noted a statistically significant reduction especially in the assessment of visceral fat (VFA) (p<0.001). There were no fundamentally significant changes in the lipid profile of women in this intervention study. With short-term consumption of chokeberry juice (after 4 weeks), we recorded an average reduction in total cholesterol and LDL-cholesterol, but without statistical significant. We also focused on the evaluation of the inflammatory marker CRP and noted a significant beneficial reduction of CRP (p˂0.05). CONCLUSIONS: In the research, we evaluated the effect of 8 weeks consumption of 100% chokeberry juice on selected anthropometric parameters, focusing on changes in visceral fat and total fat in overweight and obese women. In conclusion, we can state that the regular consumption of chokeberry juice has a beneficial effect on fat tissue in women of reproductive age, which can reduce the risk of cardiovascular diseases.


Asunto(s)
Jugos de Frutas y Vegetales , Obesidad , Sobrepeso , Photinia , Humanos , Femenino , Persona de Mediana Edad , Photinia/química , Obesidad/dietoterapia , Adulto , Sobrepeso/dietoterapia , Sobrepeso/sangre , Composición Corporal , Lípidos/sangre
14.
J Lipid Res ; 65(8): 100588, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38969065

RESUMEN

Lipoprotein(a) [Lp(a)] contributes to cardiovascular disease risk. A genetically determined size polymorphism in apolipoprotein(a) [apo(a)], determined by the number of Kringle (K) repeats, inversely regulates Lp(a) levels. Nongenetic factors including dietary saturated fat influence Lp(a) levels. However, less is known about the effects of carbohydrates including dietary sugars. In this double-blind, parallel arm study among 32 overweight/obese adults, we investigated the effect of consuming glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks on Lp(a) level and assessed the role of the apo(a) size polymorphism. The mean (±SD) age of participants was 54 ± 8 years, 50% were women, and 75% were of European descent. Following the 10-week intervention, Lp(a) level was reduced by an average (±SEM) of -13.2% ± 4.3% in all participants (P = 0.005); -15.3% ± 7.8% in the 15 participants who consumed glucose (P = 0.07); and -11.3% ± 4.5% in the 17 participants who consumed fructose (P = 0.02), without any significant difference in the effect between the two sugar groups. Relative changes in Lp(a) levels were similar across subgroups of lower versus higher baseline Lp(a) level or carrier versus noncarrier of an atherogenic small (≤22K) apo(a) size. In contrast, LDL-C increased. In conclusion, in older, overweight/obese adults, consuming sugar-sweetened beverages reduced Lp(a) levels by ∼13% independently of apo(a) size variability and the type of sugar consumed. The Lp(a) response was opposite to that of LDL-C and triglyceride concentrations. These findings suggest that metabolic pathways might impact Lp(a) levels.


Asunto(s)
Lipoproteína(a) , Obesidad , Sobrepeso , Bebidas Azucaradas , Humanos , Femenino , Masculino , Persona de Mediana Edad , Obesidad/metabolismo , Obesidad/sangre , Sobrepeso/sangre , Sobrepeso/metabolismo , Lipoproteína(a)/sangre , Adulto , Dieta , Método Doble Ciego , Fructosa/administración & dosificación
15.
J Nutr ; 154(9): 2670-2679, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39025334

RESUMEN

BACKGROUND: Obesity is associated with low-grade inflammation and increased intestinal permeability (IP). The Brazil nut (BN) (Bertholletia excelsa H.B.K.) appears to be a promising dietary intervention to control inflammation by enhancing antioxidant defenses. OBJECTIVES: We aimed to assess the effect of daily BN consumption on inflammatory biomarkers and IP in the context of an energy-restricted intervention. Furthermore, we evaluated the correlation between the changes in these inflammatory markers and the changes in serum selenium and IP. METHODS: In this 8-wk nonrandomized controlled trial, 56 women with overweight or obesity were allocated into 2 groups, both following an energy-restricted diet (-500 kcal/d). The control group (CO) consumed a nut-free diet, while the BN group consumed 8 g BN/d, providing 347.2 µg selenium (Se). Inflammatory cytokines were analyzed in plasma and Se in serum. IP was assessed using the lactulose/mannitol test (LM ratio). RESULTS: Forty-six women completed the intervention. Both groups achieved similar energy restriction (CO Δ= -253.7 ± 169.4 kcal/d; BN Δ= -265.8 ± 141.8 kcal/d) and weight loss (CO Δ= -2.5 ± 0.5 kg; BN Δ= -3.5 ± 0.5 kg). The BN group showed lower values of C-reactive protein, tumor necrosis factor, interleukin (IL)1-ß, IL-8, percentage lactulose excretion, and LM ratio than the CO group. Additionally, changes in serum Se concentration were predictive of changes in IL-8 concentration (ß: -0.054; adjusted R2: 0.100; 95% confidence interval [CI]: -0.100; -0.007; P = 0.025), and changes in IL-8 were predictive of changes in the LM ratio (ß: 0.006; adjusted R2: 0.101; 95% CI: 0.001, 0.011; P = 0.024). CONCLUSIONS: Regular intake of BNs can be a promising complementary dietary strategy for controlling low-grade inflammation and improving IP in women with overweight/obesity undergoing energy-restricted treatment. However, the effects of BNs seem to be Se status-dependent. This trial was registered at the Brazilian Registry of Clinical Trials (ReBEC: https://ensaiosclinicos.gov.br/rg/RBR-3ntxrm/.


Asunto(s)
Bertholletia , Biomarcadores , Obesidad , Sobrepeso , Selenio , Humanos , Femenino , Bertholletia/química , Adulto , Obesidad/dietoterapia , Obesidad/sangre , Biomarcadores/sangre , Sobrepeso/dietoterapia , Sobrepeso/sangre , Persona de Mediana Edad , Selenio/sangre , Inflamación/sangre , Restricción Calórica , Permeabilidad , Brasil , Nueces , Citocinas/sangre , Funcion de la Barrera Intestinal
16.
Nutr Res ; 128: 24-37, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39002359

RESUMEN

Chronic low-grade inflammation is a common feature of obesity and plays a crucial role in the progression of its complications. Vitamin D (VitD) plays an important role in modulating the immune response and regulating inflammation. Thus, this systematic review and meta-analysis aimed to evaluate the effects of isolated VitD supplementation on main inflammatory markers in overweight and obese individuals with no comorbidities and with VitD deficiency. We hypothesized that the increase in serum VitD concentrations after supplementation would significantly reduce the concentrations of inflammatory markers. The search was conducted in Medline/PubMed, SCOPUS, EMBASE, and Web of Science. Eleven randomized placebo-controlled studies were included in the final analysis, with a total of 504 participants and daily (1000-7000 international units) or bolus (100,000-200,000 international units) doses of VitD lasting from 2 to 26 weeks. The VitD supplementation did not influence C-reactive protein (mean difference [MD]: 0.01; 95% confidence interval [CI] -0.37, 0.39; P = .97), interleukin-6 (MD: -0.34; 95% CI -1.09, 0.42; P = .38), and tumor necrosis factor concentrations (MD: -0.02; 95% CI -0.23, 0.19; P = .85). In the analysis considering the studies with a significant increase in serum VitD concentrations, VitD supplementation also did not influence C-reactive protein (MD: -0.17; 95% CI -0.88, 0.54; P = .64), interleukin-6 (MD: -0.47; 95% CI -1.31, 0.37; P = .27), and tumor necrosis factor concentrations (MD: 0.01; 95% CI -1.34, 1.37; P = .98). This meta-analysis suggests that VitD supplementation does not significantly alter inflammatory markers in overweight and obese individuals.


Asunto(s)
Suplementos Dietéticos , Inflamación , Obesidad , Sobrepeso , Vitamina D , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Inflamación/sangre , Interleucina-6/sangre , Obesidad/sangre , Obesidad/complicaciones , Sobrepeso/sangre , Ensayos Clínicos Controlados Aleatorios como Asunto , Factor de Necrosis Tumoral alfa/sangre , Vitamina D/sangre , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico
18.
Gynecol Endocrinol ; 40(1): 2364892, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38946240

RESUMEN

OBJECTIVE: To investigate the effect of body mass index (BMI) on progesterone (P) level on trigger day in gonadotropin-releasing hormone antagonist (GnRH-ant) cycles. METHODS: This study was a retrospective cohort study. From October 2017 to April 2022, 412 in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) patients who were treated with GnRH-ant protocol for controlled ovarian hyperstimulation (COH) in the reproductive center of our hospital were selected as the research objects. Patients were divided into three groups according to BMI level: normal weight group (n = 230):18.5 kg/m2≤BMI < 24 kg/m2; overweight group (n = 122): 24 kg/m2≤BMI < 28 kg/m2; Obesity group (n = 60): BMI ≥ 28 kg/m2. Variables with p < .10 in univariate analysis (BMI, basal FSH, basal P, FSH days, Gn starting dose and E2 level on trigger day) and variables that may affect P level on trigger day (infertility factors, basal LH, total FSH, HMG days and total HMG) were included in the multivariate logistic regression model to analyze the effect of BMI on P level on trigger day of GnRH-ant protocol. RESULTS: After adjustment for confounding factors, compared with that in normal weight patients, the risk of serum P elevation on trigger day was significantly lower in overweight and obese patients (OR = 0.434 and 0.199, respectively, p < .05). CONCLUSION: The risk of P elevation on trigger day in GnRH-ant cycles decreased with the increase of BMI, and BMI could be used as one of the predictors of P level on trigger day in GnRH-ant cycles.


Asunto(s)
Índice de Masa Corporal , Hormona Liberadora de Gonadotropina , Inducción de la Ovulación , Progesterona , Humanos , Femenino , Hormona Liberadora de Gonadotropina/antagonistas & inhibidores , Progesterona/sangre , Adulto , Estudios Retrospectivos , Inducción de la Ovulación/métodos , Antagonistas de Hormonas/administración & dosificación , Antagonistas de Hormonas/uso terapéutico , Fertilización In Vitro/métodos , Obesidad/sangre , Sobrepeso/sangre , Inyecciones de Esperma Intracitoplasmáticas , Embarazo
19.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 49(3): 426-434, 2024 Mar 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-38970517

RESUMEN

OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a common metabolic disorder in overweight and obese children, and its etiology and pathogenesis remain unclear, lacking effective preventive and therapeutic measures. This study aims to explore the association between whole blood copper, zinc, calcium, magnesium and iron levels and NAFLD in overweight and obese children aged 6 to 17 years, providing a scientific basis for the prevention and intervention of early NAFLD in overweight and obese children. METHODS: A cross-sectional study design was used to collect relevant data from overweight and obese children who visited the Hunan Children's Hospital from January 2019 to December 2021 through questionnaire surveys. Fasting blood samples were collected from the subjects, and various indicators such as blood glucose, blood lipid, and mineral elements were detected. All children were divided into an overweight group (n=400) and a NAFLD group (n=202). The NAFLD group was divided into 2 subgroups according to the ALT level: A non-alcoholic fatty liver (NAFL) group and a non-alcoholic steatohepatitis (NASH) group. Logistic regression analysis was used to analyze the association between minerals (copper, zinc, calcium, magnesium, and iron) and NAFLD, NAFL and NASH. RESULTS: A total of 602 subjects were included, of whom 73.6% were male, with a median age of 10 (9, 11) years, and a body mass index (BMI) of 24.9 (22.7, 27.4) kg/m2. The intergroup comparison results showed that compared with the overweight group, the NAFLD group had higher levels of age, BMI, diastolic blood pressure (DBP), systolic blood pressure (SBP), triglyceride (TG), low density lipoprotein (LDL), alanine transaminase (ALT) and aspartate aminotransferase (AST), and lower level of high density lipoprotein (HDL). The NAFL group had higher levels of age, BMI, DBP, SBP, ALT, and AST, and lower levels of HDL compared with the overweight group. The levels of age, BMI, DBP, SBP, TG, LDL, ALT, and AST of NASH were higher than those in the overweight group, while the level of HDL was lower than that in overweight group (all P<0.017). After adjusting for a variety of confounders, the OR of NAFLD for the highest quantile of iron was 1.79 (95% CI 1.07 to 3.00) compared to the lowest quantile, and no significant association was observed between copper, zinc, calcium, and magnesium, and NAFLD. The subgroup analysis of NAFLD showed that the OR for the highest quantile of iron in children with NAFL was 2.21 (95% CI 1.26 to 3.88), while no significant association was observed between iron level and NASH. In addition, no significant associations were observed between copper, zinc, calcium, and magnesium levels and NAFL or NASH. CONCLUSIONS: High iron level increases the risk of NAFLD (more likely NAFL) in overweight and obese children, while copper, zinc, calcium, magnesium, and other elements are not associated with the risk of NAFLD in overweight and obese children.


Asunto(s)
Calcio , Cobre , Hierro , Magnesio , Enfermedad del Hígado Graso no Alcohólico , Sobrepeso , Zinc , Humanos , Enfermedad del Hígado Graso no Alcohólico/sangre , Niño , Cobre/sangre , Magnesio/sangre , Zinc/sangre , Estudios Transversales , Masculino , Femenino , Adolescente , Sobrepeso/sangre , Sobrepeso/complicaciones , Hierro/sangre , Calcio/sangre , Obesidad Infantil/sangre , Obesidad Infantil/complicaciones
20.
Cardiovasc Diabetol ; 23(1): 226, 2024 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-38951808

RESUMEN

BACKGROUND: The atherogenic index of plasma (AIP) is closely associated with the onset of diabetes, with obesity being a significant risk factor for type 2 diabetes mellitus (T2DM). However, the association between the AIP and T2DM in overweight and obese populations has been infrequently studied. Therefore, this study aimed to explore this association in overweight and obese individuals with T2DM. METHODS: This cross-sectional analysis utilized data from 40,633 participants with a body mass index (BMI) ≥ 24 kg/m2 who were screened from January 2018 to December 2023 at Henan Provincial People's Hospital. Participants were categorized into groups of overweight and obese individuals with and without diabetes according to the T2DM criteria. The AIP, our dependent variable, was calculated using the formula log10 [(TG mol/L)/HDL-C (mol/L)]. We investigated the association between the AIP and T2DM in overweight and obese individuals using multivariate logistic regression, subgroup analysis, generalized additive models, smoothed curve fitting, and threshold effect analysis. Additionally, mediation analysis evaluated the role of inflammatory cells in AIP-related T2DM. RESULTS: Overweight and obese patients with T2DM exhibited higher AIP levels than those without diabetes. After adjusting for confounders, our results indicated a significant association between the AIP and the risk of T2DM in overweight and obese individuals (odds ratio (OR) = 5.17, 95% confidence interval (CI) 4.69-5.69). Notably, participants with a high baseline AIP (Q4 group) had a significantly greater risk of T2DM than those in the Q1 group, with an OR of 3.18 (95% CI 2.94-3.45). Subgroup analysis revealed that the association between the AIP and T2DM decreased with increasing age (interaction P < 0.001). In overweight and obese populations, the association between AIP and T2DM risk displayed a J-shaped nonlinear pattern, with AIP > - 0.07 indicating a significant increase in T2DM risk. Various inflammatory cells, including neutrophils, leukocytes, and monocytes, mediated 4.66%, 4.16%, and 1.93% of the associations, respectively. CONCLUSION: In overweight and obese individuals, the AIP was independently associated with T2DM, exhibiting a nonlinear association. Additionally, the association between the AIP and T2DM decreased with advancing age. Multiple types of inflammatory cells mediate this association.


Asunto(s)
Biomarcadores , Diabetes Mellitus Tipo 2 , Obesidad , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Aterosclerosis/epidemiología , Aterosclerosis/sangre , Aterosclerosis/diagnóstico , Biomarcadores/sangre , Índice de Masa Corporal , China/epidemiología , HDL-Colesterol/sangre , Estudios Transversales , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Pueblos del Este de Asia , Obesidad/diagnóstico , Obesidad/sangre , Obesidad/epidemiología , Sobrepeso/epidemiología , Sobrepeso/sangre , Sobrepeso/diagnóstico , Sobrepeso/complicaciones , Pronóstico , Medición de Riesgo , Factores de Riesgo , Triglicéridos/sangre
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