Incidence of obesity,overweight and hypertension in children and adolescents in Ahvaz southwest of IRAN: Five-years study

ObjectiveThe purpose of this study was to investigate the incidence of obesity, overweight and hypertension in children and adolescents aged 10–15 in Ahvaz.MethodsThis is a epidemiologic study performed on 176 people aged 10–15 in Ahvaz. In 2009, 300 people underwent weight, height and blood pressure measurements. Five years later, the same people were reassessed for obesity, overweight and hypertension, of whom a total of 176 people agreed to repeat the procedure.ResultsThe study included 100 (57%) males and 76 (43%) females. Mean BMI was 22.1 ± 4.3 kg / m2 in year 2014, without any significant difference between the two sexes (P = 0.518). In the same year, the prevalence of obesity and overweight was 26 (14.8%) and 13 (7.4%), respectively. After 5years, BMI increased significantly (P < 0.001). Of the 150 norma participants with normal BMI in 2009, 15 (10%) and 6 (4%) became overweight and obese in 2014 respectively. The mean systolic and diastolic blood pressures increased significantly over 5 years P = 0.042 and P < 0.001.ConclusionsThis study shows an increase in mean BMI and mean systolic and diastolic blood pressures after 5 years among people aged 10–15 in Ahvaz.     

单纯性肥胖症学龄儿童肝脏脂肪含量的MRI研究

目的分析学龄儿童单纯性肥胖症的MRI表现及MRS特点,确定其肝脏脂肪的MRI定量评估方法。方法将2015年1月—2016年12月期间临床诊断单纯性肥胖症的学龄儿童52例(男31例,女21例)作为病例组,平均年龄(10.1±1.1)岁。同年龄组[平均年龄(9.8±0.9)岁]的正常健康儿童40例(男22例,女18例)作为对照组。采用SIEMENS 1.5 T Avanto MR设备行MRI和~1H-MRS检查。观察肝实质于同相位、反相位影像上的信号变化;通过~1H-MRS获得肝脏兴趣区的水峰峰值(P_w)、水峰下面积(A_w)、脂峰峰值(P_l)及脂峰下面积(A_l)并计算出脂肪分数(FF)。采用独立样本t检验比较正常儿童和肥胖症患儿间P_w、A_w、P_l、A_l、FF差异;采用单因素方差分析比较轻、中、重度肥胖症患儿间各项指标的差异。并利用受试者操作特征(ROC)曲线评估MRS诊断脂肪肝的敏感度、特异度及准确度。结果肥胖症患儿组于T_1WI反相位影像上信号不同程度减低,而正常组T_1WI同反相位影像信号一致。MRS结果如下:(1)正常组和肥胖症组的P_w、A_w差异无统计学意义(P0.05)。(2)肥胖症患儿P_l、A_l、FF明显高于正常组(均P0.05);其中FF的诊断效能最高,敏感度为100%,特异度为82%,准确度为85%。(3)随着肥胖分级的增加,肥胖患儿的P_l、A_l均增高。结论 T_1WI双回波同反相位技术和MRS是目前定量测量肝脏脂肪含量的有效方法,在前者对脂肪肝做出初步诊断的基础上, MRS可进一步对脂肪肝进行量化分级。     

The investigation of the effects of topiramate on the hypothalamic levels of fat mass/obesity-associated protein and neuropeptide Y in obese female rats

Objective: The aim of the present study is to investigate the effects of topiramate on the fat mass/obesity-associated protein (FTO) and on the neuropeptide Y (NPY) level in the hypothalamus depending on the recently increased prevalence of obesity.

Method: In this study, twenty-four female rats were divided into four equal groups: Non-obese control, obese control, non-obese topiramate, and obese topiramate. Obese groups were fed with a 40% high-fat diet. At the end of the 9th week, the drug treatment started and the subjects were treated with topiramate once a day for 6 weeks. All animals underwent cardiac perfusion under high-dose anesthesia on the 15th week. Tissues were analyzed using biochemical, histological, and stereological methods.

Results: In terms of neuron number in the arcuate nucleus area, a significant difference was observed among all groups (P?<?0.01). The neuron number of the non-obese topiramate group was found to be significantly higher than that of the non-obese control group (P?<?0.01). In the examination of the ventromedial nucleus of the entire group, it was observed that the neuron number of the non-obese control group was significantly lower than those of the other groups (P?<?0.01). A significant increase in the NPY levels of the obese groups compared to the groups treated with topiramate was observed. Furthermore, the amount of the FTO protein increased in obese rats, while FTO and NPY levels decreased in the groups treated with topiramate.

Discussion: In conclusion, the mechanism of the effect of topiramate to create a state of obesity is thought to involve the decrease in the levels of NPY and FTO.     

Altered pharmacokinetics of combined oral contraceptives in obesity — multistudy assessment

Objective

The objective was to evaluate the pharmacokinetics (PKs) of levonorgestrel (LNG)-containing combined oral contraceptives (COCs) in obese women.

有氧运动联合抗阻训练对男性肥胖青少年心血管危险因素的影响

目的 观察12周有氧运动联合抗阻训练对男性肥胖青少年心血管危险因素的影响。 方法 选取36例男性肥胖青少年（纳入肥胖组）以及36例年龄、性别相匹配的正常体重青少年（纳入对照组）作为研究对象。2组受试者均保持规律饮食习惯，肥胖组在此基础上进行12周有氧运动联合抗阻训练。于实验前、实验进行12周后分别检测2组受试者炎症因子、血脂、胰岛素敏感性、血管内皮功能以及身体成分等指标；并根据实验结束后内脏脂肪含量（VFM）变化值将肥胖组受试者进一步细分为VFM升高组和VFM降低组共2个亚组。 结果 实验前与对照组比较，发现肥胖组血清白细胞介素-1受体拮抗剂（IL-1Ra）、肿瘤坏死因子-α（TNF-α）、瘦素、胰岛素（Ins）和胰岛素抵抗指数（HOMA-IRI）、高敏C-反应蛋白（hs-CRP）及甘油三酯（TG）水平均明显升高（P<0.05），脂联素和高密度脂蛋白胆固醇（HDL-C）均明显降低（P<0.05）。实验后与实验前比较，发现肥胖组受试者体重无显著变化（P>0.05），血清IL-1Ra、干扰素-γ-诱导蛋白10（IP-10）、Ins及HOMA-IRI均明显降低（P<0.05）。亚组分析结果显示，实验后VFM降低组TG及HOMA-IRI下调幅度均较VFM升高组显著，组间差异均具有统计学意义（P<0.05）。 结论 12周有氧运动联合抗阻训练能减轻肥胖男性青少年体内炎症反应及胰岛素抵抗水平；并以运动后VFM减少者其血脂水平及胰岛素敏感性改善幅度较显著。     

Endoscopic gastroplasty to treat medically uncontrolled obesity needs more quality data: A systematic review

Endoscopic gastroplasty (EG) has been used in clinical practice to treat obesity. This systematic review has the objective of assessing if there is an acceptable level of scientific evidence on the safety and effectiveness of EG. A thorough search strategy was used up to October 2018, including the 2 most common techniques: endoscopic suturing and the primary obesity surgery endolumenal procedure. The quality of the studies was evaluated through the Joanna Briggs Institute Critical Appraisal tools for use in Systematic Reviews—“Checklist for Case Series”—and summarized using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Only 1 randomized controlled trial (moderate GRADE evidence) was found, and the remaining were case reports or small case series (very low GRADE evidence). The literature has low scientific quality. All studies, with 1 exception, are small case series with short follow-up. One of the randomized controlled trials did not meet the primary endpoint for weight loss in both groups (EG × sham) after 1-year follow-up. The case series reported from 16% to 19% total weight loss, but few had more than 6 months of follow-up. Serious adverse events ranged from 2% to 10%. Based on current literature, there is not enough quality scientific evidence regarding long-term weight loss and the procedure’s safety to recommend the use of EG in current clinical practice.