超重与肥胖对SD大鼠SUI模型的影响及分子机制

目的研究超重和肥胖对SD大鼠SUI模型的影响及可能的分子生物学机制。 方法采用高脂饲养SD大鼠,建立SD大鼠超重和肥胖模型;采用模拟妊娠、难产产伤和卵巢去势建立SD大鼠正常体重SUI模型、超重SUI模型和肥胖SUI模型;采用体质量指数（BMI）检测模型鼠超重和肥胖临床特征;采用喷嚏实验、尿动力学实验和HE染色病理学检测模型鼠SUI临床特征;采用FCM检测尿道括约肌凋亡率;采用ELISA检测尿道括约肌SOD和CAT活力、GSH和MDA含量;采用qRT-PCR和western blotting检测尿道括约肌bcl-2、bax、caspase-3 mRNA和蛋白表达变化。 结果高脂饲养法成功建立SD大鼠超重模型和肥胖模型,模拟妊娠和难产产伤、卵巢去势成功建立SD大鼠SUI模型。SD大鼠SUI模型尿道括约肌凋亡率与BMI呈正相关,与对照组比较差异有统计学意义（P<0.05）,SOD活力、CAT活力和GSH含量与BMI呈正相关,MDA与BMI呈负相关,与对照组比较差异有统计学意义（P<0.05）,伴随bcl-2下调,bax和caspase-3上调,与对照组比较差异有统计学意义（P<0.05）。 结论超重和肥胖能诱发SD大鼠SUI发生发展,其分子机制可能与超重和肥胖诱发尿道括约肌氧化应激反应,引起细胞膜损伤进而诱导凋亡相关。     

Self-efficacy for temptations is a better predictor of weight loss than motivation and global self-efficacy: Evidence from two prospective studies among overweight/obese women at high risk of breast cancer

Objectives

Identifying predictors of weight loss could help to triage people who will benefit most from programs and identify those who require additional support. The present research was designed to address statistical, conceptual and operational difficulties associated with the role of self-efficacy in predicting weight loss.

Methods

In Study 1, 115 dieting overweight/obese women at high risk of breast cancer were weighed and completed questionnaires assessing motivation, global self-efficacy and self-efficacy for temptations. The main outcome measure was weight, measured 3-months post-baseline. Study 2 was identical (n = 107), except changes in psychological variables were computed, and used to predict weight 6-months post-baseline.

Results

In Study 1, self-efficacy for temptations was a significant predictor of weight loss at 3-month follow-up. In Study 2, improved self-efficacy for temptations between baseline and four-weeks was predictive of lower weight at 6 months.

Conclusion

The key finding was that self-efficacy for temptations, as opposed to motivation and global self-efficacy, was predictive of subsequent weight loss.

Practice implications

The implication is that augmenting dieters’ capability for dealing with temptations might boost the impact of weight loss programs.     

骨钙素在老年2型糖尿病患者中的血糖调控作用及其影响因素研究

背景　骨钙素是骨基质中含量最丰富的非胶原蛋白,由成骨细胞特异性合成并分泌,在骨基质矿化中起调节作用,但越来越多的研究发现骨钙素在调节糖代谢方面也起着重要作用。目的　探讨骨钙素在老年2型糖尿病（T2DM）患者中的血糖调节作用,同时讨论骨钙素血糖调节作用的影响因素。方法　本研究采用随机抽样方法,选取2017-2018年在兰州大学第一医院因T2DM住院的60岁及以上患者329例作为研究对象。入院时记录患者的一般资料,包括：性别、年龄、体质指数（BMI）、T2DM病程;收集患者的实验室检查指标,包括：同型半胱氨酸（Hcy）、尿酸（UA）、血肌酐（Scr）、25-羟基维生素D（25-OH-VD）、骨钙素、糖化血红蛋白（HbA1c）、促甲状腺激素（TSH）、血清总甲状腺素（TT4）、空腹血糖（FPG）、餐后2 h血糖（2 hPG）;采用Spearman秩相关分析评估不同临床指标之间的相关性。收集患者糖耐量+胰岛素释放试验检测指标,包括：餐后0、30、60、120、180 min时静脉血葡萄糖和胰岛素水平,基础状态下胰岛素敏感性采用稳态模型胰岛素抵抗指数（HOMA-IR）评估,基础状态下胰岛素分泌功能由稳态模型胰岛β细胞功能（HOMA-β）反映,糖负荷状态下胰岛素分泌功能由0~120 min胰岛素曲线下面积（AUCINS120）和0~120 min葡萄糖曲线下面积（AUCGLU120）的比值反映,即AUCINS120/AUCGLU120。根据患者骨钙素水平中位数（11.73 μg/L）,将患者分为两组：低骨钙素水平组（OL组,165例）与高骨钙素水平组（OH组,164例）。结果　Spearman秩相关性分析显示,老年T2DM患者骨钙素与HbA1c、FPG、2 hPG呈负相关,与TSH呈正相关（P<0.05）。OL组患者TSH水平低于OH组,男性比例、FPG与2 hPG水平高于OH组（P<0.05）。OL组患者HbA1c、HOMA-IR高于OH组（P<0.05）;不同骨钙素水平患者HOMA-β、AUCINS120/AUCGLU120比较,差异均无统计学意义（P>0.05）。根据患者是否合并亚临床甲状腺功能减退症（简称甲减）,分为亚临床甲减患者139例和甲状腺功能正常患者190例。亚临床甲减患者中,OL组HOMA-IR高于OH组（P<0.05）;OL组与OH组HbA1c、HOMA-β、AUCINS120/AUCGLU120比较,差异均无统计学意义（P>0.05）。甲状腺功能正常患者中,OL组HbA1c、HOMA-IR高于OH组（P<0.05）;OL组与OH组HOMA-β、AUCINS120/AUCGLU120比较,差异均无统计学意义（P>0.05）。根据患者是否合并超重,分为超重患者187例和非超重患者142例。超重患者中,OL组与OH组HbA1c、HOMA-IR、HOMA-β、AUCINS120/AUCGLU120比较,差异均无统计学意义（P>0.05）。非超重患者中,OL组患者的HOMA-IR高于OH组（P<0.05）;OL组与OH组HbA1c、HOMA-β、AUCINS120/AUCGLU120比较,差异均无统计学意义（P>0.05）。结论　骨钙素对老年T2DM患者的胰岛素敏感性、胰岛素分泌功能具有积极的调控作用,为进一步研究骨钙素相关的治疗糖尿病的药物提供了依据。当合并亚临床甲减及超重时,老年T2DM患者骨钙素调控糖代谢的作用减弱,提示临床治疗T2DM应重视亚临床甲减及超重对胰岛素敏感性的影响。     

肥胖高血压患者早期肾功能受损发生情况及影响因素研究

背景　肥胖高血压患者出现尿微量白蛋白（MAU）,除了肥胖本身这个因素外,其他相关的危险因素研究则较少。目的　探讨初诊肥胖高血压患者早期肾功能受损发生情况及其相关危险因素。方法　选择2015年12月-2017年12月在常德市第一人民医院门诊首次就诊的高血压患者456例,其中肥胖组111例,超重组210例,正常体质量组135例。比较三组患者一般资料、肾功能指标、诊室血压、动态血压,分析早期肾功能受损发生情况。然后将肥胖组患者依据尿微量白蛋白肌酐比值（ACR）分为MAU阳性组和阴性组,比较两组临床资料,并采用多因素Logistic回归分析肥胖患者发生MAU的影响因素。结果　肥胖、超重与体质量正常组患者性别、体质指数（BMI）、高密度脂蛋白胆固醇、三酰甘油、MAU阳性率、肌酐、尿酸、诊室收缩压和舒张压、24 h收缩压、白昼收缩压和舒张压、夜间收缩压比较,差异有统计学意义（P<0.05）。MAU阳性组肥胖患者的空腹血糖、诊室收缩压和舒张压、24 h收缩压和舒张压、白昼收缩压和舒张压、夜间收缩压和舒张压高于阴性组,夜间收缩压下降率低于阴性组,差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示,空腹血糖〔OR（95%CI）=8.289（2.221,30.936）〕、白昼收缩压〔OR（95%CI）=5.528（1.019,30.588）〕、夜间收缩压下降率〔OR（95%CI）=0.117（0.038,0.360）〕是肥胖高血压患者发生MAU的影响因素（P<0.05）。结论　肥胖高血压患者是早期肾功能损害的高危人群,空腹血糖、白昼收缩压和夜间收缩压下降率与肥胖高血压患者发生早期肾功能受损相关联。     

超重或肥胖者执行功能研究的可视化分析

目的 了解超重或肥胖与执行功能的研究现状与发展趋势,把握当前该领域研究热点。方法 以Web of Science核心合集数据库收录的、发表于2010年-2021年的1 321篇以“超重或肥胖与执行功能”为主题的文献为分析对象,采用CiteSpace与VOSviewer绘制知识图谱,通过发文量、研究国家和地区、研究机构以及关键词的共现、聚类和突现进行可视化分析。结果 ①发文量增长趋势方面,2010年-2021年,超重或肥胖与执行功能研究的发文状况分为三个阶段,2010年-2014年、2017年-2021年这两个阶段发文量快速增长,2014年-2017年发文量增长较平缓;②参与研究的国家和地区方面,共有64个国家和地区参与该领域的研究,其中美国的发文量最多,与其他国家和地区的合作交流最频繁、影响力最大,居该研究领域核心地位;③研究机构方面,共有1 627所机构参与该领域的研究,其中伊利诺伊大学（Illinois University）发文量最多且与多所高产机构合作紧密,形成了具有一定规模的研究团体;④关键词分析方面,研究内容主要涉及饮食行为研究、预防与干预研究、风险因素评估以及不同群体特征分析。结论 超重或肥胖与执行功能研究整体呈快速发展态势,国际关注度高且研究范围广泛。     

Increased Body Mass Index Associated with Increased Risky Sexual Behaviors

Study ObjectiveThe increasing prevalence of adolescent obesity has led to consideration of the potential effect of obesity on risky sexual behaviors. In the current study we examined whether body mass index (BMI) was related to age at sexual debut, type of sexual behavior, partner number, and condom use in a population of adolescent women at high risk for obesity and risky sexual behaviors.Design, Setting, and ParticipantsCross-sectional examination of 860 sexually active, predominantly minority, adolescent women who received medical care at an urban health center from 2007 through 2013.Intervention and Main Outcome MeasuresSelf-reported age at sexual debut, types of sexual intercourse, number of partners and condom use was compared with clinically assessed BMI.ResultsBMI was positively associated with number of sexual partners (P = .001) and history of attempted anal intercourse (P = .002). An inverse association was observed with age at first anal intercourse (P = .040).ConclusionIn this sample of adolescent women, increased BMI was associated with riskier sexual practices at a younger age. Results of this study suggest that overweight and obese adolescents are a vulnerable population who might need targeted sexual health counseling.     

Effects of social contexts on overweight and normal-weight children's food intake

This study investigates the effects of peer influence on the food intake of overweight and normal-weight children. A mixed factorial design was employed, with children's weight status (overweight vs. normal-weight) as a between-subjects factor, and social context (alone vs. group) as a within-subjects factor. A total of 32 children (n=17 overweight and n=15 normal-weight) between the ages of 6-10 years participated in this study. Findings from the random regression model indicated that overweight children ate more when with others than when alone, while in contrast normal-weight ate more with others than they did when alone. Therefore, social context differentially impacts the eating behavior of overweight and normal-weight children. This study underscores differences in responses to the social environment between overweight and non-overweight youths, and suggests that social involvement may be an important tool in treatment and prevention programs for overweight and obesity.     

The role of dental practitioners in addressing overweight and obesity among children: A scoping review of current interventions and strategies

IntroductionWith the growing prevalence of childhood obesity worldwide, there is a need for interventions to identify and address overweight and obesity in childhood. Although guidelines recommend general practitioners routinely screen for overweight and obesity among children, research suggests this is often not done. To address this, dental practitioners may be able to play a role in identifying and addressing overweight and obesity among children.MethodsThis review aimed to explore the evidence and efficacy of existing obesity and overweight interventions targeting children in the dental setting. A systematic search of nine electronic databases was conducted to identify relevant published and grey literature. This was expanded to also include strategies for promoting oral health in the dental setting.ResultsA total of 11 records were included in this review, which focussed on the current role and effectiveness of dental practitioners in addressing obesity among children, and the available strategies and resources. Although there was a paucity of research on the training of dental practitioners in this area and their efficacy in identifying and addressing obesity among children, evidence suggests that parents found it acceptable for dental practitioners to promote healthy practices to children who experience overweight or obesity. This review also identified screening tools and strategies for identifying and addressing overweight and obesity among children in dental practice.ConclusionThere is a clear role for dental practitioners in addressing overweight and obesity among children, however further research is required to identify the most effective interventions to implement in dental practice.     

持续性超重与胆囊结石、胆囊息肉发病率的相关性分析

目的 探讨肥胖、非酒精性脂肪肝(NAFLD)与胆囊结石、胆囊息肉发病率相关性。 方法 选择2012—2016年在西安交通大学第一附属医院体检中心连续查体,2016年新发胆囊结石或胆囊息肉患者306例,其中胆囊息肉239例,胆囊结石67例,年龄范围为30～80岁,匹配职业、年龄、性别、空腹血糖、血压,健康对照组765例,测患者身高、体质量,计算体质量指数(BMI),测空腹血糖、血压,肝胆胰脾超声,STSS 19.0统计软件处理,χ²检验分析两组胆囊结石或胆囊息肉发病率;logistic相关回归分析胆囊结石或胆囊息肉发病相关因素。 结果 BMI≥24 kg·m-2组胆囊结石或胆囊息肉发病率明显高于BMI<24 kg·m-2组,两组之间差异有统计学意义(χ²=11.119,P=0.001),NAFLD组与无NAFLD组胆囊结石或胆囊息肉发病率比较,差异无统计学意义(χ²=2.832,P=0.092),超重合并NAFLD组胆囊结石或胆囊息肉发病率明显高于未超重且无NAFLD组(χ²=5.930,P=0.015)。多因素logistic分析提示,超重与胆囊结石或胆囊息肉发病关联(OR=24.457,95%CI:11.080~53.983,P<0.001),NAFLD与胆囊结石或胆囊息肉发病关联性不大(OR=0.633,95%CI:0.394～1.017,P=0.058)。 结论 肥胖是胆囊结石或胆囊息肉发病的独立危险因素,NAFLD可能协同肥胖促进该类疾病发生。