Obesity and Its Related Complications—Current Treatments and Future Aspects

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (15 February 2024) | Viewed by 21047

Special Issue Editors


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Guest Editor
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Interests: epidemiology; genetics; epigenetics; inflammation; dietary interventions; clinical nutrition; non-alcoholic fatty liver disease; obesity; aging
Special Issues, Collections and Topics in MDPI journals
1. Division of Cardiology, Soroka University Medical Center, Beer-Sheva 84101, Israel
2. The Health & Nutrition Innovative International Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel
Interests: cardiovascular diseases; vascular stiffness; atrial fibrillation; metabolic syndrome; adiposity; lifestyle interventions; obesity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The obesity epidemic has nearly tripled worldwide in the past five decades and has become a significant risk factor for non-communicable diseases. Individuals with obesity are at a higher risk of all-cause mortality, diabetes mellitus, hypertension, dyslipidemia, hepatosteatosis, cardiovascular diseases, sleep disorders, and more. These obesity-mediated conditions affect the patient both physically and mentally.

Obesity also has a sizeable economic impact beyond the individual’s physiological and psychological health—obesity results in direct economic costs that may be dichotomized into medical or non-medical. The indirect costs are the loss of productivity (morbidity and mortality costs). These considerations also promote obesity-related disease treatment.

Current obesity therapies mainly target weight loss and range from invasive bariatric surgery, through pharmaceutical treatment, to behavioral and lifestyle modifications, often combined to achieve maximal results. Weight loss is a treatment goal that may benefit cardiometabolic diseases. However, dietary interventions effectively prevent cardiovascular disease and death, with and without respect to weight loss, both in primary and secondary prevention settings. Modern nutritional research has been extended beyond general dietary concepts, testing the effects of specific added dietary components, such as PUFAs, dietary fibers, polyphenols, and dietary modifications, such as reducing red and processed meat. Further, it has come to an understanding that “one diet does not fit all,” and tailored nutrition might achieve better long-lasting results.

This Special Issue aims to provide an update on the different aspects of obesity, its related cardiometabolic diseases, and current and future prevention strategies and treatments. We also aim to spotlight strategies to reduce obesity and cardiometabolic diseases’ physiological, emotional, sociological, and economic burden.

Dr. Anat Yaskolka Meir
Dr. Gal Tsaban
Guest Editors

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Keywords

  • behavioral therapy
  • lifestyle interventions
  • pharmacologic treatment
  • bariatric surgery
  • precision nutrition
  • non-alcoholic fatty liver disease
  • diabetes mellitus
  • insulin resistance
  • metabolic syndrome
  • cardiovascular disease

Published Papers (12 papers)

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Editorial

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4 pages, 192 KiB  
Editorial
Dietary Strategies to Reduce Obesity Burden—Polyphenols as a Game-Changer?
by Anat Yaskolka Meir and Gal Tsaban
Healthcare 2022, 10(12), 2430; https://doi.org/10.3390/healthcare10122430 - 02 Dec 2022
Cited by 2 | Viewed by 961
Abstract
The obesity epidemic has nearly tripled worldwide over the past five decades and has become a significant risk factor for noncommunicable diseases [...] Full article

Research

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13 pages, 400 KiB  
Article
Are Higher Body Mass Index and Worse Metabolic Parameters Associated with More Aggressive Differentiated Thyroid Cancer? A Retrospective Cohort Study
by Yasmin Abu Arar, Michael Shilo, Natalya Bilenko, Michael Friger, Hagit Marsha, David Fisher, Merav Fraenkel and Uri Yoel
Healthcare 2024, 12(5), 581; https://doi.org/10.3390/healthcare12050581 - 02 Mar 2024
Viewed by 620
Abstract
Obesity is a risk factor for differentiated thyroid cancer (DTC), but the association with DTC aggressiveness is controversial. To evaluate the association between preoperative body mass index (BMI)/other metabolic parameters and DTC aggressiveness in our surgical cohort, we retrospectively evaluated patients following thyroid [...] Read more.
Obesity is a risk factor for differentiated thyroid cancer (DTC), but the association with DTC aggressiveness is controversial. To evaluate the association between preoperative body mass index (BMI)/other metabolic parameters and DTC aggressiveness in our surgical cohort, we retrospectively evaluated patients following thyroid surgery who were diagnosed with DTC between December 2013 and January 2021. Baseline characteristics, histopathological features, treatment modalities, and follow-up data were studied. We conducted logistic regression to analyze the association between BMI/other metabolic parameters and adverse DTC features. The final study cohort included 211 patients (79.6% women; mean age± standard deviation 48.7 ± 15.9 years): 66 (31.3%) with normal weight, 81 (38.4%) with overweight, and 64 (30.3%) with obesity. The median follow-up was 51 months (range 7–93). Complete versus partial thyroidectomy was more common among patients living with overweight or obesity than in normal weight patients (79.7% versus 61.7%, p = 0.017, respectively). Logistic regression demonstrated that higher BMI was associated with mildly increased risk for lymph nodes metastases (odds ratio [OR] 1.077, 95% CI: 1.013–1.145), and higher triglycerides/high-density lipoprotein–cholesterol (TG/HDL-C) ratio was associated with aggressive histological variants of DTC (OR 1.269, 95% CI 1.001–1.61). To conclude, specific adverse clinical and histopathological DTC features were indeed associated with higher BMI and higher TG/HDL-C ratio. Full article
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10 pages, 520 KiB  
Article
The Utilization of Glucagon-like Peptide 1 Agonists and Risk of Following External Eye Diseases in Type 2 Diabetes Mellitus Individuals: A Population-Based Study
by Ying-Chi Fan, Shu-Yen Peng, Chao-Kai Chang, Chia-Yi Lee, Jing-Yang Huang, Ming-Ju Hsieh and Shun-Fa Yang
Healthcare 2023, 11(20), 2749; https://doi.org/10.3390/healthcare11202749 - 17 Oct 2023
Viewed by 793
Abstract
The glucagon-like peptide 1 (GLP-1) agonist showed anti-hyperglycemic and anti-inflammatory effects, which may retard the risk of external eye disease. The protective effect of GLP-1 agonist and dry eye disease (DED) was found, while the relationship between GLP-1 agonist and other corneal diseases [...] Read more.
The glucagon-like peptide 1 (GLP-1) agonist showed anti-hyperglycemic and anti-inflammatory effects, which may retard the risk of external eye disease. The protective effect of GLP-1 agonist and dry eye disease (DED) was found, while the relationship between GLP-1 agonist and other corneal diseases was not clear. Herein, we aim to evaluate the association between the usage of GLP-1 agonists and the development of the following external eye disease in type 2 diabetes mellitus (T2DM) patients. A retrospective cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan was conducted. The T2DM patients were divided into those with GLP-1 treatment and those without GLP-1 treatment and matched with a 1:2 ratio. The main outcomes were the development of dry eye disease (DED), superficial keratitis, and infectious keratitis. The Cox proportional hazard regression was adopted to produce the adjusted hazard ratio (aHR) with a 95% confidence interval (CI) of external eye diseases between groups. There were 115, 54, and 11 episodes of DED, superficial keratitis, and infectious keratitis in the GLP-1 group. Another 280, 168, and 31 events of DED, superficial keratitis, and infectious keratitis were recorded in the control group. The GLP-1 group demonstrated a significantly lower incidence of DED (aHR: 0.853, 95% CI: 0.668–0.989, p = 0.0356) and superficial keratitis (aHR: 0.670, 95% CI: 0.475–0.945, p = 0.0107) compared to the control group. In the subgroup analyses, the correlation of GLP-1 agonist and DED development was more prominent in patients younger than 60 years old (p = 0.0018). In conclusion, the GLP-1 agonist treatments are significantly associated with a lower incidence of subsequent DED and superficial keratitis, while the relationship was not significant between GLP-1 agonist usage and infectious keratitis. Full article
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23 pages, 803 KiB  
Article
Interactions between Metabolic Syndrome, MASLD, and Arterial Stiffening: A Single-Center Cross-Sectional Study
by Adelaida Solomon, Mihai Octavian Negrea, Călin Remus Cipăian, Adrian Boicean, Romeo Mihaila, Cristina Rezi, Bianca Andreea Cristinescu, Cristian Stefan Berghea-Neamtu, Mirela Livia Popa, Minodora Teodoru, Oana Stoia and Bogdan Neamtu
Healthcare 2023, 11(19), 2696; https://doi.org/10.3390/healthcare11192696 - 09 Oct 2023
Cited by 3 | Viewed by 1320
Abstract
Metabolic-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), has emerged as a prominent global cause of chronic liver disease and is increasingly recognized as associated with atherosclerotic vascular illness, consolidating its position along traditional cardiovascular risk factors. Individuals with [...] Read more.
Metabolic-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), has emerged as a prominent global cause of chronic liver disease and is increasingly recognized as associated with atherosclerotic vascular illness, consolidating its position along traditional cardiovascular risk factors. Individuals with MASLD exhibit a combination of metabolic syndrome risk factors, carotid atherosclerosis, and increased arterial stiffness, hinting at shared pathogenesis. In this study, we aim to explore liver involvement and arterial stiffness within metabolic syndrome. We enrolled 75 patients (30 male and 45 female) with either liver steatosis on conventional ultrasound, altered liver function tests, or the presence of cardiometabolic risk factors after excluding liver pathology other than MASLD. Clinical evaluation, laboratory measurements, abdominal and carotid ultrasounds, vibration-controlled transient elastography (VCTE, Fibroscan), and assessment with the Arteriograph (Tensiomed) were performed. The 26 patients diagnosed with MetS had significantly higher liver involvement as quantified via the hepatic steatosis index (HSI), Fibrosis-4 (FIB4), aspartate aminotransferase to platelet ratio index (APRI) category, and VCTE measurements, as well as Agile 3+ and Agile 4 scores which use a combination of clinical and laboratory parameters together with results obtained from VCTE to reflect the probability of advanced liver fibrosis or cirrhosis. Patients with MetS also exhibited more pronounced vascular involvement as quantified via arterial stiffness measurements and CIMT (carotid intima–media thickness). We applied a two-step clustering algorithm to enhance our analysis, which gave us pertinent insight into the interplay between metabolic syndrome elements and typologies of hepatic steatosis and arterial stiffness degrees. Notably, of the three obtained clusters, the cluster showing increased levels of hepatic steatosis and arterial stiffness also exhibited the highest prevalence of metabolic syndrome and its constituting components. The results have significant clinical implications, advocating for a comprehensive diagnostic approach when MetS or MASLD is suspected. Full article
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12 pages, 871 KiB  
Article
Prevalence of Type 2 Diabetes, Impaired Fasting Glucose, and Diabetes Risk in an Adult and Older North-Eastern Portuguese Population
by Pedro M. Magalhães, José E. Teixeira, João P. Bragada, Carlos M. Duarte and José A. Bragada
Healthcare 2023, 11(12), 1712; https://doi.org/10.3390/healthcare11121712 - 11 Jun 2023
Cited by 1 | Viewed by 865
Abstract
The aims of this study were (1) to evaluate the prevalence of type 2 diabetes (T2D) in a middle-aged north-eastern Portuguese population, (2) to analyze the prevalence of impaired fasting glucose (IFG), and (3) to assess the risk of T2D in this community-based [...] Read more.
The aims of this study were (1) to evaluate the prevalence of type 2 diabetes (T2D) in a middle-aged north-eastern Portuguese population, (2) to analyze the prevalence of impaired fasting glucose (IFG), and (3) to assess the risk of T2D in this community-based sample. An exploratory, retrospective, and cross-sectional study was conducted from a total of 6570 individuals aged 18–102 years, among which 3865 were women (57.4 ± 18.1 years) and 2705 were men (60.0 ± 16.8 years). T2D diagnosis, IFG, and the diabetes risk score (low to very high risk) were assessed. The prevalence of T2D in this adult and an older north-eastern Portuguese population was 17.4%. A higher prevalence of T2D was reported in men (22.2%) than in women (14.0%); however, this was without significant differences (p = 0.086). Otherwise, the prevalence of T2D was significantly different among the age groups and increased with age (p < 0.001). Regarding IFG, a higher percentage of cases was observed in men (14.1%) than in women (8.4%) (p < 0.001). The risk of developing T2D in the next 10 years showed an association with sex and age group (p < 0.001) with a small-to-moderate effect (V = 0.1–0.3). Men and the elderly had the highest percentage of cases in the moderate-to-very high-risk bands. The current research confirmed a higher prevalence of T2D, IFG, and diabetes risk than previous Portuguese epidemiological reports. The results also suggest potential prediabetes cases, which should be carefully monitored. The current research adds evidence to the worldwide trend of the increasing prevalence of T2D and intermediate hyperglycemia (i.e., prediabetes). Full article
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14 pages, 1086 KiB  
Article
Gastric Myoelectric Activity and Body Composition Changes during Weight Loss via Sleeve Gastrectomy and Lifestyle Modification: Prospective Cohort Study
by Mahmoud M. A. Abulmeaty, Dara Aldisi, Mohamed Al Zaben, Ghadeer S. Aljuraiban, Abdulaziz Alkhathaami, Ali M. Almajwal, Eman El Shorbagy, Yara Almuhtadi, Zaid Aldossari, Thamer Alsager, Suhail Razak and Mohamed Berika
Healthcare 2023, 11(8), 1105; https://doi.org/10.3390/healthcare11081105 - 12 Apr 2023
Viewed by 1093
Abstract
The capability of bariatric surgery (BS) and lifestyle intervention (LSI) in ameliorating obesity-associated altered gastric myoelectric activity (GMA) in relation to body composition is underinvestigated. This work studied GMA during weight loss via sleeve gastrectomy and multimodal lifestyle intervention. Seventy-nine participants with morbid [...] Read more.
The capability of bariatric surgery (BS) and lifestyle intervention (LSI) in ameliorating obesity-associated altered gastric myoelectric activity (GMA) in relation to body composition is underinvestigated. This work studied GMA during weight loss via sleeve gastrectomy and multimodal lifestyle intervention. Seventy-nine participants with morbid obesity were assigned into three groups: bariatric surgery (BS group, n = 27), in which laparoscopic sleeve gastrectomy was performed; lifestyle intervention (LS group, n = 22), in which a calorie-deficit balanced diet with gradual physical activity and personalized behavioral modification were carried out; and waitlist control (C group, n = 30). For all participants, multichannel electrogastrography (EGG) with water-load testing and bioelectric impedance body composition analysis were done at baseline, after three months, and at six months. In the BS group, the water-load volume was decreased but without improvement in the bradygastria. In the LS group, preprandial bradygastria were reduced and some postprandial normogastria were increased throughout the study period. Except for fat-free mass and total body water, the parameters of body composition changes were superior in the BS group. In the LS group, the amount of fat-mass loss was negatively correlated with bradygastria times and positively correlated with preprandial and the early postprandial average dominant frequency (ADF). In addition, in the BS group, fat-mass loss was positively correlated with the ADF at late postprandial times. In conclusion, compared to BS, LS produced moderate normalization of GMA with the preservation of fat-free mass. The GMA changes were significantly associated with the amount of fat loss, regardless of the method of obesity management. Full article
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17 pages, 1856 KiB  
Article
Self-Compassion May Have Benefits for Body Image among Women with a Higher Body Mass Index and Internalized Weight Bias
by Bethany A. Nightingale and Stephanie E. Cassin
Healthcare 2023, 11(7), 970; https://doi.org/10.3390/healthcare11070970 - 29 Mar 2023
Cited by 2 | Viewed by 2546
Abstract
Negative attitudes towards one’s own body are common among women and are linked to adverse consequences including negative affect, low self-esteem, and eating pathology. Self-compassion has been found effective in improving body image; however, few published studies have examined self-compassion in populations with [...] Read more.
Negative attitudes towards one’s own body are common among women and are linked to adverse consequences including negative affect, low self-esteem, and eating pathology. Self-compassion has been found effective in improving body image; however, few published studies have examined self-compassion in populations with higher BMIs despite the positive correlation between weight and body dissatisfaction. The current study examined the efficacy of a self-compassion letter-writing exercise versus two active control groups in response to a negative body image induction. The sample of college-aged females (M age = 20.91 years; SD = 5.47) was split between higher and lower BMI to determine whether self-compassion affects body image, affect, and self-esteem differently across weight groups. Weight bias internalization (WBI: i.e., internalization of society’s negative stigma against those with higher BMIs) was examined as a moderator of this relationship in the higher BMI group. Results suggest that letter writing improved body image regardless of condition (p < 0.001). The self-compassion exercise promoted more adaptive body image (p = 0.007) and self-compassion (p = 0.013) than one control condition for those with high WBI. Results suggest that self-compassion can be helpful in ameliorating negative body image for females of all sizes, and that levels of WBI may alter the effect of body image interventions. Full article
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10 pages, 279 KiB  
Article
How Soon Do Depression and Anxiety Symptoms Improve after Bariatric Surgery?
by Laura Aylward, Christa Lilly, Madeline Konsor, Stephanie Cox, Salim Abunnaja, Nova Szoka and Lawrence Tabone
Healthcare 2023, 11(6), 862; https://doi.org/10.3390/healthcare11060862 - 15 Mar 2023
Cited by 2 | Viewed by 2170
Abstract
Depression and anxiety are prevalent among bariatric surgery candidates, yet little is known about the course of symptoms after surgery. This study aimed to identify how soon changes in depression and anxiety occur after surgery. A retrospective review of patients treated at a [...] Read more.
Depression and anxiety are prevalent among bariatric surgery candidates, yet little is known about the course of symptoms after surgery. This study aimed to identify how soon changes in depression and anxiety occur after surgery. A retrospective review of patients treated at a university hospital was conducted. Participants attended a presurgical psychological evaluation, completed surgery, and attended follow-up visits with bariatric medical providers (2 weeks, 6 weeks, 3 months, and 6 months postoperatively). Depression and anxiety symptoms were assessed at all time points by the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety. Generalized estimating equations models with repeated measures by person over time were used to examine change in depression and anxiety symptoms across time. Among 27 patients, anxiety (incident rate ratio (IRR) = 0.81, p = 0.04) and depression (IRR = 0.78, p = 0.05) significantly improved both 6 weeks and 3–6 months after bariatric surgery, after controlling for education, marital status, surgery type, age, and baseline body mass index. This is the first known study to show faster improvement in anxiety compared to depression after bariatric surgery. Understanding reductions in anxiety and depression symptoms may be important for postoperative care and timing of weight maintenance interventions. Full article
10 pages, 1480 KiB  
Article
Obstructive Sleep Apnea and Obesity Are Associated with Hypertension in a Particular Pattern: A Retrospective Study
by Yunyan Xia, Caihong Liang, Junxin Kang, Kai You and Yuanping Xiong
Healthcare 2023, 11(3), 402; https://doi.org/10.3390/healthcare11030402 - 31 Jan 2023
Cited by 1 | Viewed by 1571
Abstract
Obstructive sleep apnea (OSA) and obesity can increase the risk of hypertension, but the combined effects of these two conditions on hypertension are not yet known. We collected the basic characteristics, sleep parameters, and glucose levels of subjects with a polysomnography test and [...] Read more.
Obstructive sleep apnea (OSA) and obesity can increase the risk of hypertension, but the combined effects of these two conditions on hypertension are not yet known. We collected the basic characteristics, sleep parameters, and glucose levels of subjects with a polysomnography test and divided them into four groups, according to whether they had severe OSA and obesity or not. The main effects of severe OSA and obesity and the interactions of the two on systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels were detected using analysis of covariance. The association between obesity and severe OSA and abnormal blood pressure and their combined effects were detected with logistic regression. In total, 686 subjects were included. After adjusting for multiple confounding factors, the strong main effects of obesity and severe OSA were detected in the SBP and DBP levels, with no combined effects from the two conditions on SBP or DBP. Obesity was independently associated with the presence of hyper-systolic blood pressure (hyper-SBP) and hypertension, and severe OSA was independently associated with the presence of hyper diastolic blood pressure (hyper-DBP) and hypertension. No effects of the interaction between severe OSA and obesity on the presence of abnormal blood pressure were observed. Both severe OSA and obesity were associated with hypertension, while obesity was closely associated with hyper-SBP, and severe OSA was associated with hyper-DBP. No effects of the interaction between these two on hypertension were observed. Full article
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10 pages, 1116 KiB  
Article
Effect of Bariatric Surgery on Metabolic Syndrome, Framingham Risk Scores and Thyroid Function during One-Year Follow-Up: A Saudi Retrospective Study
by Nuha Alamro, Afnan S. Azhri, Asma Almuqati, Firas Azzeh, Wedad Azhar, Alaa Qadhi, Najlaa H. Almohmadi, Wafaa F. Abusudah and Khloud Ghafouri
Healthcare 2022, 10(12), 2530; https://doi.org/10.3390/healthcare10122530 - 14 Dec 2022
Viewed by 1761
Abstract
Bariatric surgery (BS) has been demonstrated to achieve sustained weight loss with significant metabolic improvement, including a reduction in cardiovascular disease and diabetes. The aim of this retrospective study is to measure the effect of BS on the Framingham risk score (FRS) and [...] Read more.
Bariatric surgery (BS) has been demonstrated to achieve sustained weight loss with significant metabolic improvement, including a reduction in cardiovascular disease and diabetes. The aim of this retrospective study is to measure the effect of BS on the Framingham risk score (FRS) and metabolic syndrome (MetS) among patients who underwent bariatric surgery. Additionally, we determine the effect of BS on thyroid-stimulating hormone (TSH) among euthyroid obese patients. A retrospective follow-up study was conducted at King Abdullah Medical City, Makkah, Saudi Arabia. A total of 160 patients underwent BS and completed one-year follow-up visits. Medical history, anthropometric, biochemical, and hormonal parameters were evaluated at baseline and 3–12 months after BS. The International Diabetes Federation (IDF) criteria were used to diagnose MetS. There was a significant decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), glycated hemoglobin (Hba1c), TSH, low-density lipoprotein (LDL), triglycerides, and total cholesterol (p < 0.001). A significant decrease was seen in MetS, BMI, FRS, SBP, DBP, Hba1c, LDL, triglycerides, cholesterol, and liver enzymes, with a significant increase in high-density lipoprotein levels 12 months postoperatively (p < 0.001). At 12 months, the prevalence of MetS, DM, and HTN and the FRS significantly decreased from 72.5%, 43.1%, 78.1%, and 11.4 to 16.3%, 9.4%, 22.5%, and 5.4, respectively. In addition to achieving substantial weight loss, BS improves MetS prevalence and cardiovascular risk profiles. Full article
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10 pages, 972 KiB  
Article
Sex-Specific Association between Fasting Plasma Glucose and Serum Selenium Levels in Adults from Southern Mexico
by María Judith Rios-Lugo, Ana Gabriela Palos-Lucio, Claudia Inés Victoria-Campos, Angel Lugo-Trampe, Karina Del Carmen Trujillo-Murillo, Maximiliano Arahon López-García, Marisol Espinoza-Ruiz, Elizabeth Teresita Romero-Guzmán, Héctor Hernández-Mendoza and Consuelo Chang-Rueda
Healthcare 2022, 10(9), 1665; https://doi.org/10.3390/healthcare10091665 - 31 Aug 2022
Cited by 5 | Viewed by 1480
Abstract
Selenium (Se) is an essential trace element that by its antioxidant properties has been studied to elucidate its participation in the development of obesity and type 2 diabetes. We evaluated the association between cardiometabolic traits and serum Se levels in a sample of [...] Read more.
Selenium (Se) is an essential trace element that by its antioxidant properties has been studied to elucidate its participation in the development of obesity and type 2 diabetes. We evaluated the association between cardiometabolic traits and serum Se levels in a sample of adults from southern Mexico. In 96 nondiabetic individuals, anthropometric data and clinical biochemistry measurements were analyzed. Serum total Se levels were measured with inductively coupled plasma mass spectrometry (ICP-MS). Serum Se level in the whole sample was 10.309 ± 3.031 μg mL−1 and no difference between the women and men was observed (p = 0.09). Additionally, fasting plasma glucose (FPG) was significantly associated with serum Se level (β = −0.07 ± 0.03, p = 0.02, analysis adjusted for age, sex and BMI). Furthermore, sex shows significant interaction with FPG on the serum Se levels (p = 0.01). A follow-up analysis revealed the particular association between FPG and Se levels in women (β = −0.10 ± 0.04, p = 0.01). In conclusion, our data evidenced a women-specific association between FPG and serum Se levels in a sample of adults from southern Mexico. Full article
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Review

Jump to: Editorial, Research

18 pages, 1173 KiB  
Review
Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention
by Francesco Perone, Annachiara Pingitore, Edoardo Conte, Geza Halasz, Marco Ambrosetti, Mariangela Peruzzi and Elena Cavarretta
Healthcare 2023, 11(6), 902; https://doi.org/10.3390/healthcare11060902 - 21 Mar 2023
Cited by 17 | Viewed by 4656
Abstract
Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as [...] Read more.
Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes. Full article
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