W／H^2和W／H^3指数在儿童少年肥胖评价中的适用性

身高体重指数因其测量计算简便、误差小而在儿童少年肥胖评价中逐渐受到重视，但Ｗ／Ｈ２和Ｗ／Ｈ３在儿童少年肥胖评价中的适用性仍有争议，为了探讨两指数在儿童少年肥胖评价中的适用性，在西安市７～１８岁儿童少年中进行了本研究，结果发现在７～１３岁间Ｗ／Ｈ３指数比Ｗ／Ｈ２指数好，而在１４岁以后Ｗ／Ｈ２比Ｗ／Ｈ３更合适。     

2022年欧洲临床营养与代谢学会和欧洲肥胖研究学会《肌肉减少性肥胖的定义和诊断标准共识》解读及启示

近年来,欧洲临床营养与代谢学会（ESPEN）和欧洲肥胖研究学会（EASO）的专家组成员对肌肉减少性肥胖（SO）的相关研究进行了系统地评价。2022年2月,ESPEN和EASO共同发布了《肌肉减少性肥胖的定义和诊断标准共识》,该共识对SO的定义和诊断进行了详细的阐述,旨在就SO的定义和诊断达成共识,为研究人员和临床工作者提供参考依据,以推进SO预防和治疗的发展。本文主要对《肌肉减少性肥胖的定义和诊断标准共识》中SO的定义,诊断流程包括筛查、诊断和分期标准,拟采用的方法和相关的参数等主要内容进行梳理和解读,旨在为国内医务工作者提供更多参考。     

高脂饮食诱导的内脏肥胖小鼠模型存在性别差异

目的:比较不同性别BALB/c小鼠采用高脂饮食建立肥胖模型的差异。方法:32只4周龄无特定病原体级BALB/c小鼠（雌雄各半）随机分为雌性对照组、雌性高脂组、雄性对照组和雄性高脂组,每组8只。雌性对照组和雄性对照组采用普通饮食,雌性高脂组和雄性高脂组采用高脂饲料喂养,喂养12周后测量小鼠体重、内脏脂肪比、空腹血糖、葡萄糖耐量、血脂、代谢相关激素水平,并采用16S rRNA测序检测小鼠粪便菌群构成。结果:高脂饮食干预导致雄性小鼠体重和内脏脂肪比明显增加,病理表现为单个脂肪面积明显增大,肝脏脂肪滴堆积,总胆固醇、空腹血糖、口服糖耐量试验时间-血糖曲线下面积以及血清胰岛素水平明显上升（均P<0.05）,并出现明显胰岛素抵抗（P<0.01）。而雌性高脂组体重、内脏脂肪比、血清胰岛素和瘦素水平与雌性对照组差异均无统计学意义（均P>0.05）。高脂干预后小鼠肥胖相关肠道菌群相对丰度显著变化并存在性别差异,其中雄性高脂组肥胖相关菌属（如布劳特菌）相对丰度明显增加,菌群结构变化更明显。结论:高脂饮食喂养12周4周龄BALB/c雄性小鼠可稳定建立以内脏脂肪堆积、代谢功能紊乱和肠道菌群变...     

肥胖相关性肾病诊疗研究进展

肥胖相关性肾病已呈流行发展趋势,已成为终末期肾病的主要原因之一。目前认为其发病机制主要与肥胖所致肾小球血流动力学改变和脂质异位沉积等相关,但其机制仍未完全阐明。减轻体重是治疗肥胖相关性肾病的重要方法,但常因环境、个人执行情况的影响而收效甚微,且有部分患者体重控制后肾病仍持续进展。综合应用有效的肥胖相关性肾病治疗方法,对控制其进展十分重要。该文综述肥胖相关性肾病的致病机制和诊疗进展,探讨中药在肥胖相关性肾病治疗中的价值,旨在为临床提供参考,提高肥胖相关性肾病一体化管理水平。     

Hypothalamic knife-cut hyperphagia and obesity in weanling rats

In previous reports weanling female rats fed a high-fat diet had a delayed response to hypothalamic knife cuts. In the present report similar cuts in similar rats fed a standard low fat diet became overweight without delay, suggesting that dietary fat is a critical variable in juvenile onset obesity. Adult rats given knife-cuts comparable to those in the weanlings gained weight far more rapidly and achieved higher weights than did those cut as weanlings, suggesting that appetite modulating axons can develop after weaning. Finally, group vs single housing did not influence the age of onset or the magnitude of knife-cut obesity.     

Mutation analysis of NR0B2 among 1545 Danish men identifies a novel c.278G>A (p.G93D) variant with reduced functional activity

Variations of the small heterodimer partner (SHP, NR0B2) gene, an atypical nuclear receptor that inhibits transactivation by hepatocyte nuclear factor (HNF)-4alpha, are associated with obesity among Japanese. The purpose of the study was to evaluate the prevalence of SHP variants among obese Danish men. Using combined SSCP and heteroduplex analysis, we analyzed the entire coding region of SHP for variants in a cohort of 750 Danish men with early-onset obesity and genotyped a cohort of 795 nonobese control subjects using PCR-RFLP. Functional analyses of the identified coding region variants were performed in both MIN6-m9 and HepG2 cell lines. A total of five novel variants, including three missense variants (c.100C>G [p.R34G], c.278G>A [p.G93D], and c.415C>A [p.P139H]) and two silent variants (c.65C>T [p.Y22Y] and c.339G>A [p.P113P]) were identified. Moreover, the previously reported c.512G>C [p.G171A] polymorphism was identified. The 171A allele was not associated with obesity (p = 0.07). The 34G, 93D, and 139H-alleles were rare variants, which were found only among obese subjects. Among the four coding region variants, the 93D-allele showed a reduced in vitro inhibition of the HNF-4alpha transactivation of the HNF-1alpha promoter expression when expressed in MIN6-m9 and HepG2 cell lines (p<0.01). In contrast to reported findings among obese Japanese, functional variants are rare among Danish men. A functional 93D variant of SHP was identified in 1 out of 750 obese and in none of 795 nonobese control subjects. Further large-scale population studies are necessary to assess the clinical impact of this rare variant on obesity risk among European subjects.     

Dietary obesity in exercising or cold-exposed Syrian hamsters

High-fat diet-feeding increases body weight and adiposity in Syrian hamsters (Mesocricetus auratus), effects due in part to decreased energy expenditure. The effects of voluntary exercise- or cold exposure-induced increases in energy expenditure were examined in fat- or chow-fed, female Syrian hamsters. In Experiment 1, voluntary exercise (10 weeks) caused a moderate hyperphagia and actually increased body weight in both diet groups through increases in lean body mass. Carcass lipid was not affected by by exercise in chow-fed hamsters and only slightly reduced in fat-fed animals. In Experiment 2, chronic (8 weeks) cold exposure (5 degrees C) increased energy intake to the same extent in both dietary groups relative to the warm-exposed (23 degrees C) controls. High-fat diet-induced obesity was largely prevented by cold exposure. Cold exposure reduced lean body mass in chow-fed hamsters, but this carcass component was spared by fat-feeding. These results indicate that the increased metabolic demands of cold exposure were more effective in preventing this form of diet-induced obesity than those of voluntary exercise (80% and 17% reductions in carcass lipid, respectively). These results are discussed in terms of possible beneficial effects of eating a lipid-rich diet prior to winter.     

PPARY2基因Pro12Ala和C1431T多态性及其单倍型与2型糖尿病和肥胖的相关性研究

目的 研究过氧化物体增殖活化受体γ2(peroxisome proliferator activated receptorγ2,PPARγ2)基因Pro12Ala和C1431T多态性及其单倍型与汉族人2型糖尿病、肥胖的关系.方法 应用聚合酶链反应-限制性片段长度多态性的方法,对207例2型糖尿病患者和101名非糖尿病对照者进行PPARγ2基因Pro12Ala和C1431T多态性研究.结果 (1)在非糖尿病对照人群中Aal 12等位基因频率是0.064,T1431等位基因频率是0.252.单倍型分析显示Pro12Ala和C1431T两个位点连锁不平衡(D'=0.63,r2=0.074),组成了3种常见单倍型Pro-C、Pro-T和Ala-T.(2)Pro12Ala和C1431T多态性分布及其单倍型分布频率在2型糖尿病组与对照组组间差异均无统计学意义(P>0.05).(3)Pro12Ala变异与糖尿病患者的血压、血脂相关,地等位基因降低非肥胖糖尿病患者的舒张压(P<0.05),而对肥胖糖尿病患者的血脂水平无保护作用(P<0.05);C1431T多态性与糖尿病患者的超重和肥胖相关,超重和肥胖的糖尿病者T等位基因频率相对较高(P<0.05).结论 Pro12Ala和C1431T多态性可能在汉族人糖尿病发病中不是起主要作用;C1431T多态性与糖尿病患者的超重和肥胖相关.     

Genotype and phenotype correlation in 103 individuals with 2q37 deletion syndrome reveals incomplete penetrance and supports HDAC4 as the primary genetic contributor

The 2q37 deletion syndrome, also described in the literature as brachydactyly‐mental retardation syndrome (MIM 600430), is caused by deletion or haploinsufficiency of the HDAC4 gene, which encodes the histone deacetylase 4 protein. Although the most commonly described hallmark features of the 2q37 deletion syndrome include brachydactyly type E, developmental delay, obesity, autistic features, and craniofacial or skeletal dysmorphism, a literature review of 101 published cases plus two newly reported individuals indicates that there is a high degree of variability in the presence of some of the features that are considered the most characteristic of the syndrome: overweight and obesity (34%), cognitive‐behavioral issues (79%), dysmorphic craniofacial features (86%), and type E brachydactyly (48%). These features overlap with other neurodevelopmental conditions, including Smith‐Magenis syndrome (SMS), and may be incompletely penetrant or demonstrate variable expressivity, depending on the specific chromosomal anomaly. With the advent of fluorescence in situ hybridization (FISH), array‐based comparative genomic hybridization, and next‐generation DNA sequencing, more detailed molecular diagnoses are possible than in years past, enabling refined characterization of the genotype–phenotype correlation for subjects with 2q37 deletions. In addition, investigations into molecular and gene expression networks are expanding in neurodevelopmental conditions, and we surveyed HDAC4 downstream gene expression by quantitative real‐time polymerase chain reaction, further implicating HDAC4 in its role in the regulation of RAI1. Correlation of clinical data defining the impact on downstream gene expression and the potential clinical associations across neurodevelopment will improve our understanding of these complex conditions and potentially lead to common therapeutic approaches.