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BACKGROUND: Understanding the clustering of two or more risk factors of non-communicable disease, such as smoking, overweight/obesity, and hypertension, among women of reproductive age could facilitate the design and implementation of strategies for prevention and control measures. This study examined the factors associated with smoking, overweight/obesity, and hypertension among Nepalese women of reproductive age (15-49 years). METHODS: This study used the Nepal Demographic and Health Surveys (NDHS) 2016 (6,079 women for smoking and overweight/obesity, 6076 for hypertension) and 2022 (6,957 women for overweight/obesity and smoking status and 3,749 women for hypertension) for comparison of trends of NCD risk factors among women aged 15-49 years. Additionally, for each participant, risk factors score (range of 0 to 3) was created by summing individual risk factors. We assessed the determinants of risk factor clustering using multivariable Poisson regression models with robust sandwich variance estimator to calculate adjusted prevalence ratios using NDHS 2022. RESULTS: The national prevalence of overweight/obesity increased from 22.2% in 2016 to 29.2% in 2022 among women of reproductive age. In 2022, the prevalence for smoking, overweight/obesity, and hypertension were 3.8%, 29.2%, and 9.6%, respectively. More than one in four women (28.7%) had one NCD risk factor, while 6.5% had two such risk factors. Higher aged women (40-49 years) were more likely to have multiple NCD risk factors than those aged 15-29 years (APR: 3.19; 95% CI: 2.68-3.80). Those in the richest wealth quintile (APR: 1.52; 95% CI: 1.24-1.85), as well as married (APR: 3.02; 95% CI: 2.43-3.76) and widowed/divorced (APR: 2.85; 95% CI: 2.14-3.80) were more likely to have multiple NCD risk factors. Women from Koshi province (APR: 1.74; 95% CI: 1.41-2.15) had more NCD risk factors than those from the Sudurpaschim province. Working women also had a higher prevalence of NCD risk factors compared to non-working women (APR: 1.23; 95% CI: 1.06-1.43). Additionally, Hill Janajatis (APR: 1.44; 95% CI: 1.21-1.72) and Dalits (APR: 1.42; 95% CI: 1.15-1.75) women were more likely to have NCD risk factors compared to women of Brahmin hill origin. CONCLUSIONS: Clustering of two or more NCD risk factors was higher among women aged ≥30 years, those who are currently married or widowed/divorced/separated, working women, and individuals from the wealthiest socioeconomic groups. A higher burden of risk factors underscores the importance of targeted public health interventions, particularly among women from advantaged socio-economic groups, those of affluent regions, and in the workplace.
Assuntos
Hipertensão , Obesidade , Humanos , Feminino , Adulto , Nepal/epidemiologia , Adolescente , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem , Hipertensão/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , Prevalência , Sobrepeso/epidemiologia , Análise por Conglomerados , Doenças não Transmissíveis/epidemiologia , Inquéritos EpidemiológicosRESUMO
BACKGROUND: Older adults in the USA have worse health and wider socioeconomic inequalities in health compared with those in Britain. Less is known about how health in the two countries compares in mid-life, a time of emerging health decline, including inequalities in health. METHODS: We compare measures of current regular smoking status, obesity, self-rated health, cholesterol, blood pressure and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N = 9665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the USA (N = 12â300), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position. RESULTS: US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health and current regular smoking was worse in Britain. We found smaller socioeconomic inequalities in mid-life health in Britain compared with the USA. For some outcomes (e.g. smoking), the most socioeconomically advantaged group in the USA was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain. CONCLUSIONS: US adults have worse cardiometabolic health than British counterparts, even in early mid-life. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems or other environmental risk factors.
Assuntos
Disparidades nos Níveis de Saúde , Hipertensão , Obesidade , Fumar , Fatores Socioeconômicos , Humanos , Reino Unido/epidemiologia , Estados Unidos/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fumar/epidemiologia , Obesidade/epidemiologia , Hipertensão/epidemiologia , Estudos Longitudinais , Pressão Sanguínea , Colesterol/sangue , Nível de Saúde , Hemoglobinas Glicadas/análise , Estudos de CoortesRESUMO
Antiretroviral therapy (ART) has improved the survival of people living with HIV (PLHIV) but this success has been accompanied by an increase in noncommunicable diseases. We conducted a prospective cohort study of 4000 adult PLHIV who were initiating ART in Dar es Salaam, Tanzania, to assess weight gain during the first year of treatment and associated sociodemographic and clinical factors. Anthropometric data were collected at ART initiation and monthly follow-up visits. The mean weight gain during the first year of treatment was 2.6 ± 0.3â kg, and the prevalence of overweight or obesity increased from 26.3% at baseline to 40.7%. Female sex, greater household wealth, lower CD4-T-cell counts, higher WHO HIV disease stage, and pulmonary tuberculosis were associated with a greater increase in body mass index (P < .05). Weight gain following ART initiation was common but was greater among females and PLHIV with advanced HIV or comorbidities.
Assuntos
Infecções por HIV , Aumento de Peso , Humanos , Feminino , Tanzânia/epidemiologia , Masculino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/complicações , Adulto , Aumento de Peso/efeitos dos fármacos , Estudos Prospectivos , Pessoa de Meia-Idade , Fármacos Anti-HIV/uso terapêutico , Índice de Massa Corporal , Adulto Jovem , Contagem de Linfócito CD4 , Obesidade/epidemiologia , Obesidade/complicações , População Urbana/estatística & dados numéricos , Antirretrovirais/uso terapêutico , Sobrepeso/epidemiologiaRESUMO
BACKGROUND: It has been suggested that up to 40% of dementia cases worldwide are associated with modifiable risk factors; however, these estimates are not known in Canada. Furthermore, sleep disturbances, an emerging factor, has not been incorporated into the life-course model of dementia prevention. OBJECTIVE: To estimate the population impact of 12 modifiable risk factors in Canadian adults including sleep disturbances, by sex and age groups, and to compare with other countries. DESIGN: Cross-sectional analysis of Canadian Longitudinal Study on Aging baseline data. SETTING: Community. PARTICIPANTS: 30,097 adults aged 45 years and older. MEASUREMMENTS: Prevalence and Population Attributable Fractions (PAFs) associated with less education, hearing loss, traumatic brain injury, hypertension, excessive alcohol, obesity, smoking, depression, social isolation, physical inactivity, diabetes, and sleep disturbances. RESULTS: The risk factors with the largest PAF were later life physical inactivity (10.2%; 95% CI, 6.8% to 13%), midlife hearing loss (6.5%; 3.7% to 9.3%), midlife obesity (6.4%; 4.1% to 7.7%), and midlife hypertension (6.2%; 2.7% to 9.3%). The PAF of later life sleep disturbances was 3.0% (95% CI, 1.8% to 3.8%). The 12 risk factors accounted for 51.9% (32.2% to 68.0%) of dementia among men and 52.4% (32.5% to 68.7%) among women. Overall, the combined PAF of all risk factors was 49.2% (31.1% to 64.9%), and it increased with age. CONCLUSION: Nearly up to 50% of dementia cases in Canada are attributable to 12 modifiable risk factors across the lifespan. Canadian risk reduction strategies should prioritize targeting physical inactivity, hearing loss, obesity, and hypertension.
Assuntos
Demência , Humanos , Canadá/epidemiologia , Masculino , Feminino , Demência/epidemiologia , Demência/prevenção & controle , Fatores de Risco , Estudos Longitudinais , Idoso , Pessoa de Meia-Idade , Estudos Transversais , Envelhecimento , Prevalência , Idoso de 80 Anos ou mais , Obesidade/epidemiologia , Hipertensão/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Perda Auditiva/epidemiologiaRESUMO
Objective. Studies that have evaluated correlation between body mass index (BMI) and novel lipid indices such as triglycerides (TG)/high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC)/HDL-C, and low-density lipoprotein cholesterol (LDL-C)/HDL-C in type 2 diabetes mellitus (T2DM) are scarce. Hence, the aim of the present study was to explore the correlation between BMI and novel lipid indices in Bosnian patients with T2DM. Methods. Present study included 117 patients with T2DM (mean age: 66.51 years) and 68 controls (mean age: 68.37 years). BMI was calculated as weight/height². Lipids were measured by standard methods. TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratios were separately calculated. The differences between the groups were assessed by Student's t-test or Man Whitney U test. Correlations were determined by Spearman's test. Results. In a total sample of T2DM patients, 41.0% were overweight and 44.4% were obese. In the control group, 51.5% of subjects were overweight and 25.0% were obese. In T2DM group, a significant correlation was observed between BMI and HDL-C, LDL-C, TG/HDL, TC/HDL-C, and LDL-C/HDL-C ratios. In the control group, there was a significant correlation found between BMI and HDL-C, TG, TG/HDL, TC/HDL-C, and LDL-C/HDL-C-ratios. Correlation between BMI and other lipid parameters in T2DM and the control group was not determined. Conclusion. The present study showed significant correlation between BMI and novel lipid indices in both T2DM patients and the control group of subjects. Possible explanation for the observed results might be prevalence of overweight and obese participants in this study sample. Since novel lipid indices are used in the prediction of cardiometabolic risk, results obtained in the present study have valuable clinical implications.
Assuntos
Índice de Massa Corporal , HDL-Colesterol , Diabetes Mellitus Tipo 2 , Obesidade , Triglicerídeos , Humanos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Bósnia e Herzegóvina/epidemiologia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Triglicerídeos/sangue , HDL-Colesterol/sangue , Obesidade/sangue , Obesidade/epidemiologia , LDL-Colesterol/sangue , Sobrepeso/sangue , Sobrepeso/epidemiologia , Lipídeos/sangue , Estudos de Casos e ControlesRESUMO
OBJECTIVES: The dietary composition is able to rapidly and significantly influence the diversity of the gut microbiome. This article focuses on how various types of diet affect the composition of the gut microbiome and how dietary changes are able to prevent or slow down the development of non-communicable diseases including obesity, type 2 diabetes mellitus, cardiovascular diseases, and low-grade inflammation. METHODS: A review in PubMed and a hand search using references in identified articles were performed. Studies published in English from 2000 to 2024 were included. RESULTS: The studies showed the significant effect of diet on the development of non-communicable diseases dependent on the state of the gut microbiota and molecules it produces. The Western diet that continues to gain in popularity for Czech people, leads to dysbiosis and production of bacterial lipopolysaccharide or trimethylamine N-oxide causing systemic chronic inflammation in the body and thus promoting the development of non-communicable diseases. CONCLUSIONS: Findings from this review emphasize the importance of healthy eating habits in the prevention of intestinal dysbiosis and still increasing prevalence and incidence of obesity and other non-communicable diseases.
Assuntos
Dieta , Microbioma Gastrointestinal , Doenças não Transmissíveis , Humanos , Microbioma Gastrointestinal/fisiologia , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/prevenção & controle , Obesidade/microbiologia , Obesidade/epidemiologia , Disbiose , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/epidemiologia , República Tcheca/epidemiologia , InflamaçãoRESUMO
OBJECTIVE: To examine the relationship between C-reactive protein (CRP) and knee pain, and further explore whether this association is mediated by obesity. METHODS: The population was derived from 1999 to 2004 National Health and Nutrition Examination Survey. Logistic regression was used to analyze the relationship between CRP and knee pain in three different models, and the linear trend was analyzed. A restricted cubic spline model to assess the nonlinear dose-response relationship between CRP and knee pain. Mediation analyses were used to assess the potential mediating role of obesity. Subgroup analyses and sensitivity analyses were performed to ensure robustness. RESULTS: Compared with adults with lower CRP (first quartile), those with higher CRP had higher risks of knee pain (odds ratio 1.39, 95% confidence interval 1.12-1.72 in third quartile; 1.56, 1.25-1.95 in fourth quartile) after adjusting for covariates (except body mass index [BMI]), and the proportion mediated by BMI was 76.10% (p < .001). BMI and CRP were linear dose-response correlated with knee pain. The odds ratio for those with obesity compared with normal to knee pain was 2.27 (1.42-3.65) in the first quartile of CRP, 1.99 (1.38-2.86) in the second, 2.15 (1.38-3.33) in the third, and 2.92 (1.72-4.97) in the fourth. CONCLUSION: Obesity mediated the systemic inflammation results in knee pain in US adults. Moreover, higher BMI was associated with higher knee pain risk in different degree CRP subgroups, supporting an important role of weight loss in reducing knee pain caused by systemic inflammation.
Assuntos
Índice de Massa Corporal , Proteína C-Reativa , Inquéritos Nutricionais , Obesidade , Humanos , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/complicações , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Masculino , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Articulação do Joelho , Dor/epidemiologia , Dor/sangue , Dor/etiologia , Artralgia/sangue , Artralgia/epidemiologia , Artralgia/etiologia , Idoso , Fatores de Risco , Razão de ChancesRESUMO
BACKGROUND: The comorbidity between obesity and smoking and its association with cardiometabolic risk factors has been little explored. OBJECTIVES: Describe the prevalence of such comorbidity and to explore its association with cardiometabolic risk factors. METHODS: The study was based on the 2016-2017 Chilean National Health Survey and included 6,233 participants. The independent variables were general obesity according to Body Mass Index (BMI), central obesity measured by Waist-to-Height Ratio (WTHR) and Waist Circumference (WC), and daily tobacco consumption (DTC). The dependent variables were blood lipids, fasting glucose and blood pressure. The association analysis was performed by multivariate logistic regression and excluded subjects with a medical record of hypertension, diabetes mellitus and dyslipidemia to avoid reverse causality. RESULTS: The prevalence of General obesity-DTC comorbidity was 7.7%, WTHR risk-DTC was 10.8% and elevated WC-DTC was 13.2%. A total of 3,132 participants were included in logistic regressions. General obesity alone, and DTC-general obesity comorbidity had statistically significant association with elevated triglycerides, decreased HDL, elevated non-HDL and total cholesterol, elevated fasting glucose, and elevated blood pressure. The comorbidities DTC-risk WTHR and DTC-increased WC were associated with increased triglycerides and non-HDL cholesterol. DTC alone was associated with elevated systolic blood pressure. CONCLUSION: DTC-general obesity comorbidity is more frequently associated with the cardiometabolic risk factors explored than DTC-central obesity comorbidity. Smoking cessation can be a cost-effective intervention in this risk comorbidity.
Assuntos
Fatores de Risco Cardiometabólico , Comorbidade , Inquéritos Epidemiológicos , Obesidade , Fumar , Humanos , Masculino , Feminino , Chile/epidemiologia , Pessoa de Meia-Idade , Adulto , Obesidade/epidemiologia , Fumar/epidemiologia , Prevalência , Adulto Jovem , Índice de Massa Corporal , Circunferência da Cintura , Idoso , Adolescente , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Fatores de Risco , Modelos LogísticosRESUMO
Introduction: Second-Generation Antipsychotics (SGAs) are widely used for treating psychiatric disorders due to their favorable side effect profile compared to First-Generation Antipsychotics (FGAs). However, SGAs are associated with significant metabolic side effects. This study aims to explore the sociodemographic and health differences between individuals using SGAs and those not using them. Methods: A comparative cross-sectional study was conducted with 148 participants, including 102 SGA users and 46 non-users. Data were collected from patients and medical records, encompassing sociodemographic factors and health variables including diabetes mellitus, hypertension, cardiovascular disease, hyperlipidemia, waist circumference, fasting blood glucose, cholesterol, triglycerides, HDL, LDL, and BMI. Statistical analyses included chi-square and Fisher's exact tests to compare the two groups. Results: SGA users had higher rates of overweight and obesity compared to non-users (p = 0.000), with 30.4% overweight and 29.4% obese among SGA users versus 21.7% overweight and 4.3% obese among non-users. A higher prevalence of cardiovascular disease was observed in SGA users (11.8% vs. 2.2%, p = 0.076). Although not statistically significant, trends indicated higher rates of diabetes mellitus and hyperlipidemia in non-users (30.4% vs. 18.6%, p = 0.110 and 7% vs. 0%, p = 0.083, respectively). Conclusion: This study highlights significant differences in BMI and cardiovascular disease prevalence between SGA users and non-users, reinforcing the need for comprehensive metabolic monitoring in patients treated with SGAs. The findings underscore the importance of considering sociodemographic factors in managing the health risks associated with SGA use. Further research with larger sample sizes and longitudinal designs is warranted to better understand these associations and develop targeted interventions.
Assuntos
Antipsicóticos , Síndrome Metabólica , Humanos , Estudos Transversais , Masculino , Feminino , Antipsicóticos/efeitos adversos , Antipsicóticos/administração & dosagem , Arábia Saudita/epidemiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/induzido quimicamente , Pessoa de Meia-Idade , Adulto , Transtornos Mentais/epidemiologia , Transtornos Mentais/tratamento farmacológico , Prevalência , Obesidade/epidemiologia , Obesidade/induzido quimicamente , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/induzido quimicamente , Sobrepeso/epidemiologia , Sobrepeso/induzido quimicamenteRESUMO
Obesity in adolescents is a global health concern associated with several diseases and complications in adulthood. Obesity has been reported to be strongly associated with oral habits. To investigate the association between tooth brushing during lunchtime and the prevalence of obesity among adolescents in a nationally representative sample of South Korean adolescents. Data from the 2018-2021 Korea Youth Risk Behavior Web-Based Survey were used in this cross-sectional study. Obesity was measured based on the body mass index. The chi-square test was used to investigate and compare tooth brushing habits during lunchtime in the study population, and multivariate logistic regression analysis was performed to analyze the relationship between tooth brushing during lunchtime and the prevalence of obesity. The odds of obesity were lower in the group that brushed their teeth during lunchtime (adjusted odd ratio: 0.90, 95% confidence interval: 0.88-0.93). Furthermore, the odds of obesity were significantly higher in high school students; boys; those with a low household income, low subjective health status awareness, medical history (asthma or atrophy), and history of sealant use; and those who responded after the coronavirus disease 2019 pandemic. A significant inverse relationship was found between tooth brushing habits during lunchtime and the prevalence of obesity. This relationship was consistent regardless of socioeconomic and lifestyle factors.
Assuntos
Escovação Dentária , Humanos , Escovação Dentária/estatística & dados numéricos , Adolescente , República da Coreia/epidemiologia , Masculino , Feminino , Estudos Transversais , Almoço , Prevalência , Obesidade/epidemiologia , COVID-19/epidemiologia , Obesidade Infantil/epidemiologia , Índice de Massa Corporal , Criança , Inquéritos e QuestionáriosRESUMO
This study aimed to assess the prevalence of thyroid dysfunction, as measured by hormone levels, in Saudi women with type 2 diabetes mellitus (T2DM). The study will also assess thyroid hormones and leptin, angiopoietin like 8 (ANGPTL8), obesity, and cardiovascular diseases (CVD) in T2D patients. A total of 250 women aged 40 to 60 years with T2DM were retrospectively studied between 2021 and 2022. This research examined medical records for T2DM patients. In this investigation, no T2DM patients had thyroid autoantibodies in their medical records. These patients were chosen for their FT4 and TSH values. All participants were Saudi females with T2DM, aged 54.5 years. Of the 250 participants, 32% had hypothyroidism, 14.8% had hyperthyroidism, and 40.8% (102) had no thyroid disease. Hypothyroidism (7.8â ±â 0.67 mmol/L) exhibited greater fasting blood glucose (FBG) levels than hyperthyroidism (7.1â ±â 0.64 mmol/L) (Pâ <â .05). Hypothyroid and hyperthyroid females had significant differences in high density lipoprotein-cholestrol (HDL-C), triglycerides, triglyceride glucose (TyG) index, body mass index (BMI), waist circumstance (WC), high-sensitivity C-reactive protein (hs-CRP), leptin, ANGPTL8, insulin resistance (IR), and insulin levels (Pâ <â .05). Pearson's correlation test showed that T2DM patients' HDL-C levels were favorably but negatively correlated with leptin and ANGPTL8 levels. In hypothyroidism, thyroid stimulation hormone (TSH) is favorably linked with glycated hemoglobin (HbA1c), triglyscride (TG), TyG index, BMI, WC, leptin, ANGPTL8, hs-CRP, and IR. T2DM is linked to thyroid malfunction, notably hypothyroidism, which correlates positively with TSH. TSH variations due to increasing leptin, ANGPTL8, and TyG index may enhance the risk of insulin resistance diseases, such as obesity and CVD, in Saudi females with T2DM.
Assuntos
Proteína 8 Semelhante a Angiopoietina , Proteínas Semelhantes a Angiopoietina , Diabetes Mellitus Tipo 2 , Hipotireoidismo , Leptina , Hormônios Tireóideos , Humanos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Leptina/sangue , Pessoa de Meia-Idade , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto , Proteínas Semelhantes a Angiopoietina/sangue , Hormônios Tireóideos/sangue , Hipotireoidismo/sangue , Hipotireoidismo/epidemiologia , Hipertireoidismo/sangue , Hipertireoidismo/epidemiologia , Índice de Massa Corporal , Glicemia/análise , Glicemia/metabolismo , Obesidade/sangue , Obesidade/epidemiologia , Tireotropina/sangue , Hormônios PeptídicosRESUMO
Weight-adjusted-waist index (WWI) is an emerging parameter for evaluating obesity. We sought to ascertain the link between WWI and circadian syndrome (CircS). The study population consisted of 8275 eligible subjects who were included in the ultimate analysis from the NHANES 2011-2018. By using multivariable regression models, the association of WWI and CircS was analyzed. In subgroup analysis, we explored the relationship in different groups and tested the stability of the intergroup connection using interaction testing. To investigate whether WWI and CircS had a potential non-linear relationship, smooth curve fittings, and threshold effects tests were also constructed. In a multivariate linear regression model, WWI is significantly positively related to CircS (OR = 1.77, 95% CI 1.50-2.08). Through subgroup analysis and interaction testing, the stability of this positive association was also validated. It was further found that there was an inverted U-shaped association, with a turning point of 11.84, between WWI and CircS. Our findings supported a strong association between WWI values and CircS. Central obesity management is pivotal for preventing or alleviating CircS.
Assuntos
Circunferência da Cintura , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Peso Corporal , Obesidade/epidemiologia , Transtornos Cronobiológicos/fisiopatologia , Índice de Massa Corporal , Idoso , Inquéritos NutricionaisRESUMO
BACKGROUND: Numerous digestive system adverse events (dsAEs) have been observed during the use of anti-obesity medications (AOMs), leading to concerns about the safety of these medications. However, most current studies are limited to the association of one class of drugs with specific digestive disorders, and there is no cascading analysis of AOMs in the digestive system. This study aims to use data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) for a stratified analysis of the reported associations between AOMs and dsAEs. METHODS: We analyzed adverse event reports submitted to FAERS between January 2015 and December 2023 related to obesity treatment. It is important to note that FAERS data cannot establish causality or incidence rates. Pharmacovigilance (PV) signals were detected by disproportionate analyses through proportionate reporting ratio (PRR), reporting odds ratios (ROR), and information components (IC) to detect dsAEs associated with AOMs. Reporting rates, severity, and response outcomes of digestive adverse events were compared across AOMs by multivariate logistic regression analysis. RESULTS: Among 34,396 adverse events (AEs) related to obesity treatment, 8844 dsAEs were analyzed. Comparing with semaglutide and liraglutide, tirzepatide exhibited fewer reported dsAEs while semaglutide and liraglutide showed a high correlation with non-lethal pancreatitis reports. Bupropion-naltrexone (31.65%) reported the highest number of dsAEs, and a PV signal was detected in mouth and lips AEs (ROR = 2.97, 95% CI: 2.42-3.6). Orlistat (ROR = 3.30, 95% CI: 3.08-3.55) exhibited the highest association with gastrointestinal AEs compared to other AOMs. PV signal for hepatobiliary AEs (ROR = 6.13, 95% CI: 3.45-10.88) with phentermine-topiramate still needs further clarification. CONCLUSIONS: Tirzepatide may be considered for patients with a history of digestive system disease or an elevated risk of pancreatitis based on the pattern of reported dsAEs. Caution is needed for the orofacial AEs when using bupropion-naltrexone. Orlistat has a higher reporting rate of gastrointestinal AEs, but these events are typically less severe. Phentermine-topiramate's association with liver impairment requires further clinical investigation. This article provides insights into the reported associations between AOMs and dsAEs, which may aid clinicians in making more informed decisions about individualizing medication and managing potential adverse events.
Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Fármacos Antiobesidade , Farmacovigilância , United States Food and Drug Administration , Humanos , Estados Unidos/epidemiologia , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Fármacos Antiobesidade/efeitos adversos , Fármacos Antiobesidade/uso terapêutico , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Bases de Dados Factuais , Idoso , Adulto Jovem , Doenças do Sistema Digestório/induzido quimicamente , Doenças do Sistema Digestório/epidemiologia , Obesidade/epidemiologia , Liraglutida/uso terapêutico , Liraglutida/efeitos adversos , AdolescenteRESUMO
Introduction: Obesity is a major public health challenge. In Spain the prevalence of excess of weight and obesity and is 56 % and 19 %, respectively, and it is linked to numerous preventable chronic diseases. Nutritional epidemiology focused on nutrients has evolved towards the study of dietary patterns that consider synergistic interactions between foods and nutrients. This study aims to investigate the relationship between obesity and its treatment by healthy dietary patterns. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), based on plant products, whole grains and low levels of salt, sugars and red meat, have been shown to promote weight loss and reduce comorbidities associated with obesity. Although vegetarian and vegan diets are adequate options for disease management and prevention, they require planning to avoid nutritional deficiencies. In conclusion, healthy dietary patterns such as the Mediterranean diet, DASH and vegetarian options are effective in both the prevention and treatment of obesity, highlighting the importance of considering the synergy between foods and nutrients in the management of this health condition.
Introducción: La obesidad es un importante desafío de salud pública. En España, la prevalencia de exceso de peso y obesidad es del 56 % y del 19 %, respectivamente. Además, se vincula con numerosas enfermedades crónicas prevenibles. La epidemiología nutricional centrada en nutrientes ha evolucionado hacia el estudio de patrones dietéticos que consideran las interacciones sinérgicas entre alimentos y nutrientes. Este estudio tiene como objetivo investigar la relación entre la obesidad y su tratamiento mediante patrones dietéticos saludables. La dieta mediterránea y la dieta para detener la hipertensión (o dieta DASH), basadas en productos vegetales, cereales integrales y bajos niveles de sal, azúcares y carnes rojas, han demostrado favorecer la pérdida de peso y reducir comorbilidades asociadas a la obesidad. Aunque las dietas vegetarianas y veganas son opciones adecuadas en el manejo y en la prevención de la enfermedad, requieren planificación para evitar deficiencias nutricionales. En conclusión, patrones dietéticos saludables como la dieta mediterránea, la DASH y las opciones vegetarianas son efectivas tanto en la prevención como en el tratamiento de la obesidad. Destaca la importancia de considerar la sinergia entre alimentos y nutrientes en la gestión de esta condición de salud.
Assuntos
Comorbidade , Dieta Mediterrânea , Obesidade , Humanos , Obesidade/epidemiologia , Obesidade/dietoterapia , Espanha/epidemiologia , Abordagens Dietéticas para Conter a Hipertensão , Dieta , Dieta Vegetariana , Comportamento Alimentar , Padrões DietéticosRESUMO
OBJECTIVE: To analyze the relationship between body mass index(BMI) and blood pressure among Tibetan primary and secondary school students in Lhasa City. METHODS: From August to October 2020, 1929 Tibetan students were selected from 12 primary and secondary schools in Lhasa City to conduct questionnaire surveys on demographic characteristics, smoking, drinking, living habits, and food consumption frequency, and physical examinations such as height, weight and blood pressure measurements. The association between BMI and blood pressure was analyzed with multivariate logistic regression model and linear regression model. RESULTS: A total of 843 boys(43.70%)and 1086 girls(56.30%)were surveyed, with an average age of(14.25±2.71) years old.925 people(47.95%)were in urban areas and 1004 people(52.05%)were in rural areas. There were 726 people(37.64%)inprimary school students, 692 people(35.87%)in junior high school, 363 people(18.82%)in high school, and 148 people(7.67%)in vocational high school. There were 541 people(28.05%)who were emaciated, 183 people(9.49%)who were overweight, and 87 people(4.51%)who were obese. The wasting, overweight and obesity rates of Tibetan primary and secondary school students were 28.05%, 9.49% and 4.51%, respectively. The high blood pressure rate was 8.76%. The BMI value of the high blood pressure group of students was higher than that of the students in the normal blood pressure group, and the difference was statistically significant(t=4.63, P<0.05). The result of the multi-factor logistic regression model showed that among the study subjects, the risk of high blood pressure, high systolic blood pressure, and high diastolic blood pressure were 3.07 times higher than those of people with normal BMI(95% CI 1.71-5.51, P<0.01), 2.83 times(95% CI 1.38-5.81, P<0.01), 4.19 times(95% CI 2.11-8.32, P<0.01). The risk of high blood pressure in overweight people was 1.17 times that of people with normal BMI(95% CI 1.04-2.84, P=0.04). The result of the linear regression model showed that mild wasting(ß=-2.41, 95% CI-3.95--0.87) and moderate to severe wasting(ß=-4.71, 95% CI-6.19--3.23) was negatively correlated with systolic blood pressure, while overweight(ß=2.56, 95% CI 0.88-4.24) and obesity(ß=5.55, 95% CI 3.20-7.91) were positively correlated with systolic blood pressure, moderate to severe wasting(ß=-2.46, 95% CI-3.88--1.04) was negatively correlated with diastolic blood pressure, and obesity(ß=3.42, 95% CI 1.16-5.68) was positively correlated with diastolic blood pressure. CONCLUSION: Obesity is positively correlated with blood pressure and high blood pressure among Tibetan primary and secondary school students.
Assuntos
Pressão Sanguínea , Índice de Massa Corporal , Hipertensão , Estudantes , Humanos , Masculino , Feminino , Tibet , Adolescente , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Hipertensão/epidemiologia , Sobrepeso/epidemiologia , Instituições Acadêmicas , Criança , Obesidade/epidemiologia , Modelos LogísticosRESUMO
Obesity is a treatable chronic disease of high prevalence in the U.S. It has various direct and indirect adverse health effects in terms of morbidity and mortality. It not only increases cardiovascular mortality but is also associated with an increased risk of multiple cancers. However, unlike other chronic diseases, obesity diagnosis often misses patients' and providers' attention and historically has been undertreated. This article is written to highlight the impact of obesity on health with special reference to cardiovascular disease, stimulate the quest among the masses and primary care providers for the diagnosis and treatment of obesity, its complications, and benefits obtained from its treatment.
Assuntos
Doenças Cardiovasculares , Obesidade , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Doença Crônica , Estados Unidos/epidemiologia , Fatores de RiscoRESUMO
OBJECTIVE: The relationship between vitiligo and cardiovascular diseases remains controversial. This study aimed to systematically review the evidence comparing cardiovascular disease risk factors between patients with vitiligo and controls and to perform a meta-analysis of the results. DATA SOURCES: A comprehensive database search was performed for all studies in PubMed, EMBASE, and Cochrane Central Register databases from inception to November, 2023. The main keywords used were vitiligo, hypertension, diabetes, hyperlipidemia, metabolic syndrome, obesity, smoking, alcohol consumption, C-reactive protein, and homocysteine. STUDY SELECTION: Only observational studies and no randomized controlled trials were included. Of the 1269 studies initially selected, the full texts of 108 were assessed for eligibility, and 74 were ultimately included in the analysis. DATA EXTRACTION AND SYNTHESIS: Three reviewers independently extracted the following data: study design, number and characteristics of participants, inclusion indicators, and disease duration. A meta-analysis of the single-group rates was performed for the diabetes, hypertension, hyperlipidemia, and obesity groups. Random-effects or fixed-effects models were used to calculate the sample-size weighted averages for the indicators included in the studies. MAIN OUTCOMES AND MEASURES: The primary outcomes were co-morbidity analysis and co-morbidity rates of vitiligo with metabolic syndrome, obesity, hyperlipidemia, hypertension, and diabetes mellitus. Secondary outcomes were factors associated with vitiligo and cardiovascular disease. RESULTS: This meta-analysis concluded that comorbidities in patients with vitiligo included metabolic syndrome, diabetes, obesity, hyperlipidemia, and hypertension, with comorbidity rates of 28.3%, 6.0%, 38.5%, 43.0%, and 15.8%, respectively. Simultaneously, we showed that the vitiligo group differed significantly from the control group in the following aspects: fasting blood glucose, insulin, systolic and diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, homocysteine, C-reactive protein, smoking, and alcohol consumption. However, no significant differences were observed between the vitiligo and control groups in terms of waist circumference, body mass index, or phospholipid levels. LIMITATIONS: The vast majority of the studies were from Eastern countries; therefore, extrapolation of these results to Western populations is questionable. The significant heterogeneity may be due to different protocols, doses, durations, center settings, population registries, etc., which severely compromise the validity of the results. CONCLUSION: This study summarized not only the factors associated with, but also those not associated with, cardiovascular disease in patients with vitiligo. This study provides a foundation for the prevention and treatment of cardiovascular disease in patients with vitiligo.
The relationship between vitiligo and cardiovascular diseases remains controversial.This meta-analysis concluded that comorbidities in patients with vitiligo include metabolic syndrome, diabetes, obesity, hyperlipidemia, and hypertension, with comorbidity rates of 28.3%, 6.0%, 38.5%, 43.0%, and 15.8%.Our study identified cardiovascular disease risk factors in patients with vitiligo, including smoking, alcohol consumption, high serum SBP, DBP, FBG, CRP, TC, TG, LDL, insulin, and Hcy, and low serum HDL levels.
Assuntos
Doenças Cardiovasculares , Hipertensão , Síndrome Metabólica , Obesidade , Vitiligo , Vitiligo/epidemiologia , Vitiligo/complicações , Humanos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/complicações , Hipertensão/epidemiologia , Hipertensão/complicações , Obesidade/complicações , Obesidade/epidemiologia , Hiperlipidemias/epidemiologia , Hiperlipidemias/complicações , Diabetes Mellitus/epidemiologia , Fatores de Risco , Comorbidade , Fatores de Risco de Doenças CardíacasRESUMO
BACKGROUND: Cardiovascular diseases (CVDs) are a leading cause of disability-adjusted life years in Indonesia. Although obesity is a known risk factor for CVDs, the relative contributions of overall versus abdominal obesity are less clear. We aimed to estimate the 10-year CVD risks of the Indonesian population and investigate the separate and joint associations of overall and abdominal obesity with these risks. METHODS: Using nationally representative data from the Indonesian Health Survey (n = 33,786), the 10-year CVD risk was estimated using the Framingham Score. The score was calculated as %-risk, with >20% indicating high risk. Overall obesity was measured by BMI, while abdominal obesity was measured by waist circumference. We performed sex-stratified multivariable linear regressions to examine the associations of standardized units of BMI and waist circumference with the 10-year CVD risk, mutually adjusted for waist circumference and BMI. RESULTS: Mean (SD) 10-year CVD risks were 14.3(8.9)% in men and 8.0(9.3)% in women, with 37.3% of men and 14.1% of women having high (>20%) risks. After mutual adjustment, one SD in BMI and waist circumference were associated with 0.75(0.50-1.01) and 0.95(0.72-1.18) increase in the %-risk of CVD in men, whereas in women, the ß(95% CIs) were 0.43(0.25-0.61) and 1.06(0.87-1.26). CONCLUSION: Abdominal fat accumulation showed stronger associations with 10-year CVD risks than overall adiposity, particularly in women. Although men had higher overall CVD risks, women experienced more detrimental cardiovascular effects of obesity. Raising awareness of abdominal/visceral obesity and its more damaging cardiovascular effects in women is crucial in preventing CVD-related morbidity and mortality.
Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares , Inquéritos Epidemiológicos , Obesidade Abdominal , Circunferência da Cintura , Humanos , Masculino , Feminino , Indonésia/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/complicações , Pessoa de Meia-Idade , Adulto , Fatores de Risco , Fatores Sexuais , Obesidade/epidemiologia , Obesidade/complicações , IdosoRESUMO
OBJECTIVE: The objective of this study was to determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in young compared with older adults. METHODS: Individuals (n = 1420) with (63%) and without type 2 diabetes mellitus (T2D; 37%) who attended internal medicine clinics and did not have a known history of MASLD underwent laboratory evaluation and transient elastography to assess for hepatic steatosis and fibrosis. Magnetic resonance elastography and liver biopsy were recommended when indicated. RESULTS: A total of 243 participants were ages <45 years, and 1177 were ages ≥45 years. Obesity, T2D, and metabolic syndrome were highly prevalent in young adults. Frequencies of steatosis and fibrosis were high in young adults (50.2% and 7.5% vs. older adults 52.7% and 9.9%, respectively) and were significantly higher in those with both obesity and T2D (71.1% and 15.7%, respectively; p < 0.01). In young adults, T2D and obesity were the strongest risk factors for hepatic fibrosis (odds ratios 4.33 [95% CI: 1.37-13.68] and 1.16 [95% CI: 1.07-1.25], respectively; p < 0.05). CONCLUSIONS: There is a high prevalence of clinically significant hepatic fibrosis in young adults with cardiometabolic risk factors. Up to one in seven young adults with obesity and T2D had clinically significant hepatic fibrosis on elastography. This highlights the need to screen young adults with cardiometabolic risk factors for MASLD for early detection and intervention.