海参脑苷脂及其长链碱基对肥胖小鼠脂代谢和糖代谢的影响

目的:研究海参脑苷脂(sea cucumber cerebroside,SCC)及其长链碱基(long-chain base,LCB)对营养性肥胖小鼠的脂质代谢的影响。方法:将C57/BL6小鼠随机分为4组:对照组、模型组、海参脑苷脂组(0.025%SCC)和海参脑苷脂长链碱基组(0.025%LCB),每组8只。通过高脂饲料建立肥胖模型,观察记录小鼠饮食及体重,喂食4周后测定糖耐量,5周后测定脂肪组织重量、脏器指数、血清脂质及血糖含量、肝脏脂质含量。结果:经实验饲料喂食4周后,SCC组和LCB组的糖耐量有明显改善,血糖浓度和脂肪组织重量降低,肝脏TG的含量减少,与模型组比差异均有统计学意义(P<0.01,P<0.05)。结论:海参脑苷脂及其长链碱基对营养性肥胖小鼠糖代谢和脂代谢具有明显的改善作用。     

中链甘油三酯饮食对神经肽Y及瘦素的作用研究

目的观察中链甘油三酯(MCT)对血清和下丘脑瘦素、神经肽Y(NPY)浓度,下丘脑长型瘦素受体(Ob-Rb)、mRNA表达的影响。方法20只Wistar雄性大鼠,用含30%MCT或长链甘油三酯(LCT)的饲料喂养8周,用ELISA法测定血清和下丘脑瘦素的水平,用放射免疫法检测外周血和下丘脑NPY的浓度,用real-time RT-PCR技术测定下丘脑NPY、瘦素受体(Ob-Rb)基因表达水平的差异。结果MCT组大鼠体重增长量和体脂含量均小于LCT组(P<0.01),MCT组瘦素脑/血比明显高于LCT组,MCT组大鼠下丘脑ob-Rb mRNA表达水平明显高于LCT组(P<0.01),下丘脑及血清NPY浓度明显低于LCT组(P<0.01)。结论MCT通过促进Ob-Rb基因表达,抑制NPY合成和分泌。     

Effect of body mass index on surgical site wound infection,mortality, and postoperative hospital stay in subjects undergoing possibly curative surgery for colorectal cancer: A meta-analysis

We performed a meta-analysis to evaluate the effect of body mass index on surgical site wound infection, mortality, and postoperative hospital stay in subjects undergoing possibly curative surgery for colorectal cancer. A systematic literature search up to March 2022 was performed and 2247 subjects with possibly curative surgery for colorectal cancer at the baseline of the studies; 2889 of them were obese, and 9358 were non-obese. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the effect of body mass index on surgical site wound infection, mortality, and postoperative hospital stay in subjects undergoing possibly curative surgery for colorectal cancer using the dichotomous or contentious methods with a random or fixed-effect model. The obese subjects had a significantly higher surgical site wound infection after colorectal surgery (OR, 1.87; 95% CI, 1.62-2.15, P < .001), and higher mortality (OR, 1.58; 95% CI, 1.07-2.32, P = .02) in subjects with possibly curative surgery for colorectal cancer compared with non-obese. However, obese did not show any significant difference in postoperative hospital stay (MD, 0.81; 95% CI, −0.030 to 1.92, P = .15) compared with non-obese in subjects with possibly curative surgery for colorectal cancer. The obese subjects had a significantly higher surgical site wound infection after colorectal surgery, higher mortality, and no significant difference in postoperative hospital stay compared with non-obese in subjects with possibly curative surgery for colorectal cancer. The analysis of outcomes should be with caution because of the low number of studies in certain comparisons.     

Cemented Versus Cementless Total Knee Arthroplasty in Obese Patients With Body Mass Index ≥35 kg/m2: A Contemporary Analysis of 812 Patients

BackgroundCemented total knee arthroplasty (TKA) has been shown to have higher failure rates in obese patients, and cementless TKA may provide more durable fixation. This study compared outcomes and survivorship of obese patients undergoing cemented and cementless TKA of the same modern design.MethodsWe identified a consecutive series of 406 primary cementless TKA performed in obese patients with body mass index (BMI) ≥35 kg/m² in 2013-2018. Each case was matched 1:1 with 406 cemented TKA based on age, sex, BMI, bearing surface, and year of surgery. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement and Short Form-12 were collected preoperatively, at 6 months and 2 years. Implant survivorship was recorded at mean 4.0 years (range 2.0-7.8).ResultsThere was no difference in mean BMI between the cemented (38.6 ± 3.4 kg/m²; range, 35-60) and cementless cohorts (38.7 ± 3.3 kg/m²; range, 35-54; P = .706). Both groups had similar final postoperative scores and improvement in scores at 2 years. Furthermore, a similar percentage met the minimal clinically important difference (Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, 70.0% vs 71.2%, P = .700; Short Form-12 Physical, 74.1% vs 70.4%, P = .240). Both groups demonstrated high 7-year survivorship free from aseptic revision (99.0% vs 99.5%, P = .665).ConclusionObese patients with BMI ≥35 kg/m² undergoing cementless and cemented TKA of the same modern design had similar outcomes and survivorship at early to mid-term follow-up. Continued surveillance of this high-risk population is necessary.     

利拉鲁肽联合二甲双胍治疗肥胖型2型糖尿病的效果及对氧化应激指标的影响

目的 分析利拉鲁肽联合二甲双胍治疗肥胖型2型糖尿病的效果及对氧化应激指标的影响.方法 回顾性选取2019年1月至2021年1月本院收治的96例肥胖型2型糖尿病患者为研究对象,依据治疗方法将其分为利拉鲁肽联合二甲双胍治疗组(联合治疗组)和二甲双胍单独治疗组(单独治疗组),各48例.比较两组患者的BMI、血糖指标、临床疗效...     

Bariatric surgery improves metabolic and nonalcoholic fatty liver disease markers in metabolically healthy patients with morbid obesity at 5 years

BackgroundNo studies have evaluated the effect of metabolic and bariatric surgery (MBS) on nonalcoholic fatty liver disease (NAFLD) and cardiometabolic markers in metabolically healthy patients with morbid obesity (MHMO) at midterm.ObjectivesTo assess the effect of MBS on NAFLD and cardiometabolic markers in MHMO patients and ascertain whether metabolically unhealthy patients with morbid obesity (MUMO) remain metabolically healthy at 5 years after MBS.SettingUniversity hospital.MethodsA total of 191 patients with a body mass index >40 kg/m² and at least 5 years of follow-up were retrospectively analyzed. Lost to follow-up were 37.6% (151 of 401 patients). Patients were classified as MHMO if 1 or 0 of the cardiometabolic markers were present using the Wildman criteria. The degree of liver fibrosis was assessed using the NAFLD fibrosis score (NFS).ResultsForty-one patients (21.5%) fulfilled the criteria for MHMO. They showed significant improvements in blood pressure (from 135.1 ± 22.1 and 84.2 ± 14.3 mm Hg to 117.7 ± 19.2 and 73.0 ± 10.9 mm Hg), plasma glucose (from 91.0 ± 5.6 mg/dL to 87.2 ± 5.2 mg/dL), homeostatic model assessment for insulin resistance (from 2.2 ± .9 to 1.0 ± .8), triglycerides (from 88.0 [range, 79.5–103.5] mg/dL to 61.0 [range, 2.0–76.5] mg/dL), alanine aminotransferase, gamma-glutamyl transpeptidase NFS (from −1.0 ± 1.0 to −1.9 ± 1.2), and high-density lipoprotein cholesterol (from 56.9 ± 10.5 mg/dL to 77.9 ± 17.4 mg/dL) at 5 years after surgery. A total of 108 MUMO patients (84.4%) who became metabolically healthy after 1 year stayed healthy at 5 years.ConclusionsMBS induced a midterm improvement in cardiometabolic and NAFLD markers in MHMO patients. Seventy-six percent of MUMO patients became metabolically healthy at 5 years after MBS.     

FLUOXETINE ALTERS MU OPIOID RECEPTOR EXPRESSION IN OBESE ZUCKER RAT EXTRAHYPOTHALAMIC REGIONS

The aim of this article was to describe the effects of chronic fluoxetine on mu opioid receptor expression in obese Zucker rat extrahypothalamic regions. Male obese Zucker (fa/fa) rats were administered with fluoxetine (10 mg/kg; i.p.) daily for two weeks. Brain regional immunostaining for mu opioid receptor was carried out. An increase in the numbers of neural cells immunostained for mu opioid receptor in caudatus-putamen, dentate gyrus, lateral septum, amygdala, and frontal, parietal, and piriform cortices was observed. Increased mu opioid receptor expression in the central amygdaloid nuclei suggests a decreased opioidergic tone at this level that could be involved in fluoxetine anorectic action.     

减肥药的研究进展

肥胖不但影响形象及身体功能,且常导致许多疾病的患病率增高,及引起和加重并发症,兹就减肥药物治疗领域出现的新理论、新概念及新药物的研究进展做一综述.