International Journal of Obesity最新文献

{"title":"Irisin reverses high-fat diet-induced metabolic dysfunction via activation of brown adipose tissue in mice.","authors":"Jingyue Dai, Yufei Zhao, Yue Chen, Yang Jiang, Rui Sun, Xingzhe Tang, Ying Cui, Hui Mao, Xin-Gui Peng","doi":"10.1038/s41366-025-01739-z","DOIUrl":"10.1038/s41366-025-01739-z","url":null,"abstract":"<p><strong>Background: </strong>High-fat diet (HFD) induces negative effects on the activity of interscapular brown adipose tissue (iBAT) and systemic energy metabolism. Irisin, a small hormonal agent known to modulate metabolism has been used for intervening HFD-induced obesity. However, its mechanism of action on iBAT function remains to be fully elucidated. This study sought to investigate whether irisin intervention could restore the thermogenic function of iBAT in mice with HFD-induced obesity, thereby regulating systemic metabolism.</p><p><strong>Methods: </strong>Magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) were used to monitor changes of thermogenic capacity of iBAT and systemic metabolism in mice with HFD-induced obesity and iBAT deficiency during 2-week or 4-week irisin intervention. Pathological and molecular biology analyses were performed on tissue and blood samples.</p><p><strong>Results: </strong>Prolonged HFD feeding in mice induced obesity and impaired the thermogenic capacity of iBAT. MRI results showed that irisin intervention for 4-week reduced lipid content in iBAT, increased uncoupling protein 1 (UCP 1) expression and enhanced glucose analogue uptake capacity. These improvements of functions in iBAT activity were accompanied by an improvement in systemic metabolism. The positive effects of irisin appears to be dependent on the length of intervention time. When iBAT was removed, the beneficial effects of irisin were partially suppressed, suggesting that irisin regulates metabolism through the restoration of the thermogenic function of iBAT.</p><p><strong>Conclusions: </strong>HFD results in reduced thermogenic capacity of iBAT, while irisin intervention can effectively restore iBAT function, leading to improvement in overall glucose and lipid metabolism.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1066-1075"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering key factors in weight loss effectiveness through machine learning.","authors":"Hui-Wen Yang, Rocío De la Peña-Armada, Haoqi Sun, Yu-Qi Peng, Men-Tzung Lo, Frank A J L Scheer, Kun Hu, Marta Garaulet","doi":"10.1038/s41366-025-01766-w","DOIUrl":"10.1038/s41366-025-01766-w","url":null,"abstract":"<p><strong>Background/objectives: </strong>One of the main challenges in weight loss is the dramatic interindividual variability in response to treatment. We aim to systematically identify factors relevant to weight loss effectiveness using machine learning (ML).</p><p><strong>Subjects/methods: </strong>We studied 1810 participants in the ONTIME program, which is based on cognitive-behavioral therapy for obesity (CBT-OB). We assessed 138 variables representing participants' characteristics, clinical history, metabolic status, dietary intake, physical activity, sleep habits, chronotype, emotional eating, and social and environmental barriers to losing weight. We used XGBoost (extreme gradient boosting) to predict treatment response and SHAP (SHapley Additive exPlanations) to identify the most relevant factors for weight loss effectiveness.</p><p><strong>Results: </strong>The total weight loss was 8.45% of the initial weight, the rate of weight loss was 543 g/wk., and attrition was 33%. Treatment duration (mean ± SD: 14.33 ± 8.61 weeks) and initial BMI (28.9 ± 3.33) were crucial factors for all three outcomes. The lack of motivation emerged as the most significant barrier to total weight loss and also influenced the rate of weight loss and attrition. Participants who maintained their motivation lost 1.4% more of their initial body weight than those who lost motivation during treatment (P < 0.0001). The second and third critical factors for decreased total weight loss were lower \"self-monitoring\" and \"eating habits during treatment\" (particularly higher snacking). Higher physical activity was a key variable for the greater rate of weight loss.</p><p><strong>Conclusions: </strong>Machine learning analysis revealed key modifiable lifestyle factors during treatment, highlighting avenues for targeted interventions in future weight loss programs. Specifically, interventions should prioritize strategies to sustain motivation, address snacking behaviors, and enhance self-monitoring techniques. Further research is warranted to evaluate the efficacy of these strategies in improving weight loss outcomes.</p><p><strong>Trial registration: </strong>clinicaltrials.gov: NCT02829619.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1189-1199"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neck circumference as a metabolic health marker among women with polycystic ovary syndrome (PCOS): a systematic review and meta-analysis.","authors":"Suvi M Haapakangas, Noona V S Koskenkari, Elisa L Hurskainen, Riikka K Arffman, Meri-Maija Ollila, Terhi T Piltonen","doi":"10.1038/s41366-025-01753-1","DOIUrl":"10.1038/s41366-025-01753-1","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is associated with obesity, insulin resistance (IR), metabolic syndrome (MetS), and abnormal fat distribution, especially fat excess in the upper body. Neck circumference (NC) reflects the adiposity accumulation in the upper body and may be a valuable and simple screening tool for metabolic risk among women with PCOS.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed/Medline and Scopus based on the search terms \"neck circumference\" and \"PCOS\". Studies that examined associations of NC and anthropometric measurements, blood pressure (BP), lipid values, glucose metabolism, MetS, IR, or related disorders among women with PCOS were included. A meta-analysis was performed to compare NC values between women with PCOS and non-PCOS controls.</p><p><strong>Results: </strong>Of 139 publications, 13 full texts that met the selection criteria were included in the systematic review. Eight studies had non-PCOS controls and were thus eligible for the meta-analysis. Women with PCOS had significantly larger NC compared to non-PCOS controls (SMD: 0.78, 95% CI: 0.31-1.25, p = 0.0012). We found a positive association between larger NC and higher waist circumference, hip circumference, triglycerides, systolic BP, fasting insulin, and HOMA-IR or lower HOMA%S and higher prevalence of MetS or IR in the majority of the included studies. Neck circumference cut-off values for MetS varied from 33 cm to 34.25 cm and for IR 34.25 cm up to 42 cm among women with PCOS. Most of the studies were done with Asian populations thus limiting applicability of the study results to other ethnicities.</p><p><strong>Conclusions: </strong>This meta-analysis demonstrated increased NC among women with PCOS compared to healthy controls. Women with PCOS and larger NC were more insulin resistant and had more MetS-related abnormalities when compared to women with smaller NC with or without PCOS. Data considering NC cut-off values for MetS and IR among women with PCOS are scarce, and further studies are needed, particularly among more varied ethnic populations.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"998-1012"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of novel metabolic status with asymptomatic intracranial arterial stenosis: A cross-sectional study.","authors":"Liying Guo, Yongli Pan, Yumeng Yang, Xianglong Kong, Shiqing Song, Maoyu Li, Yuanyuan Zhao, Xiaotong Ma, Xiang Wang, Qinjian Sun","doi":"10.1038/s41366-025-01723-7","DOIUrl":"10.1038/s41366-025-01723-7","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association of metabolic status newly defined or obesity with asymptomatic intracranial arterial stenosis (aICAS) among populations in rural China.</p><p><strong>Methods: </strong>The cross-sectional study is based on the Rose asymptomatic IntraCranial Artery Stenosis (RICAS) cohort, which enrolled 2005 participants aged 40 years or older without a history of clinical stroke or transient ischemic attack. Metabolically healthy status (MH) was defined by a newly proposed criterion: (1) systolic blood pressure (SBP) < 130 mmHg and without antihypertensive medication; (2) a waist-to-hip ratio (WHR) below 1.03 for men and below 0.95 for women; (3) no diabetes. All participants were categorized based on their metabolic status and obesity. Multivariate logistic regression models were used to investigate the association between metabolic status or obesity and aICAS.</p><p><strong>Results: </strong>Among 2005 participants, 1597 (79.65%) were defined as metabolically unhealthy status (MU) according to the new criterion. MU was significantly associated with aICAS (OR 2.02, 95% CI 1.11-3.68, P = 0.021), especially moderate-to-severe aICAS (OR 2.43, 95% CI 1.04-5.72, P = 0.042). The prevalence of aICAS increased with the numbers of metabolic disorders (P for linear trend <0.001). Both metabolically unhealthy normal-weight (MUN) (OR 2.11, 95% CI 1.10-4.03, P = 0.025) and metabolically unhealthy obesity (MUO) (OR 3.30, 95% CI 1.64-6.64, P = 0.001) were significantly correlated with aICAS, but not metabolically healthy obesity (MHO). Subgroup analysis further confirmed the association between MU and aICAS risk only in men (P for interaction = 0.042).</p><p><strong>Conclusions: </strong>MU defined by the new criterion was significantly associated with aICAS, especially with moderate-to-severe aICAS. This novel criterion effectively identifies individuals with a high prevalence of aICAS among populations with obesity, which could be crucial for stroke prevention.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1024-1030"},"PeriodicalIF":4.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human milk cortisol is inversely associated with infant BMI and mediates the association between maternal plasma and infant salivary cortisol concentrations.","authors":"Ana Luz Kruger, Agustina Malpeli, Marisa Sala, Carla Casado, Ignacio Mendez, Lucrecia Fotia, Andrea Tournier, María Victoria Fasano, María F Andreoli","doi":"10.1038/s41366-025-01815-4","DOIUrl":"https://doi.org/10.1038/s41366-025-01815-4","url":null,"abstract":"<p><strong>Purpose: </strong>The pathways through which milk cortisol affects infant body weight and adiposity remain poorly understood.</p><p><strong>Aims: </strong>To assess the influence of maternal weight status on maternal cortisol concentrations and infant outcomes; to evaluate the relationship between maternal plasma and milk cortisol concentrations and infant salivary cortisol, body weight and adiposity during the first 3 months of life in a cohort of exclusively breastfed infants; to determine whether milk cortisol mediates these effects; and to explore the association between infant salivary cortisol and measures of body weight and adiposity.</p><p><strong>Methods: </strong>In this prospective observational study, we measured cortisol concentrations in plasma and milk samples from lactating women at 10 days (n = 68) and 3 months postpartum (n = 34), and in saliva samples from their 3-month-old infants (n = 34). Multiple linear regression and mediation analysis were conducted to determine the relationship between maternal characteristics and infant anthropometric measurements or salivary cortisol concentration and whether they were mediated by milk cortisol.</p><p><strong>Results: </strong>Plasma and milk cortisol concentrations were inversely associated with gestational weight gain and postpartum weight retention at 10 days postpartum. Maternal plasma and milk cortisol concentrations were directly with infant salivary cortisol concentration [Beta (95% CI): 0.05 (0.00, 0.09), p = 0.038; 0.95 (0.51, 1.39), p < 0.001], and inversely associated with infant BMI z-score [Beta (95% CI): -0.11 (-0.17, -0.04), p = 0.004; -1.04 (-1.69, -0.39), p = 0.003] at 3 months of lactation, the former mediated by milk cortisol (p = 0.039). Infant salivary cortisol was not associated with body weight and adiposity at 3 months of lactation.</p><p><strong>Conclusion: </strong>Our study shows that in exclusively breastfed infants, milk cortisol is inversely associated with BMI z-score and influences salivary cortisol at 3 months postpartum. Further research is warranted to explore the mechanisms involved and how these interactions evolve across different stages of lactation.</p><p><strong>Trial registration: </strong>This study was registered at clinicaltrials.gov as NCT05798676.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effects of body composition on lifespan: Mendelian randomization analysis.","authors":"Zhu Liduzi Jiesisibieke, C Mary Schooling","doi":"10.1038/s41366-025-01799-1","DOIUrl":"https://doi.org/10.1038/s41366-025-01799-1","url":null,"abstract":"<p><strong>Background: </strong>Observational studies examining the relation of body composition with lifespan are inconsistent. We conducted a Mendelian Randomization (MR) study to assess effects of key features of body composition on lifespan.</p><p><strong>Methods: </strong>We conducted a MR study using inverse variance weighting to investigate the impact of measures of body composition on lifespan, and we also adjusted fat-free mass and appendicular lean mass for potential confounding by fat mass, and assessed mediation by waist circumference in men and women.</p><p><strong>Results: </strong>In univariable MR, genetically predicted fat mass (per standard deviation higher) decreased men's lifespan by 2.69 years (95% confidence interval [CI] -3.14 to -2.23) and women's by 2.48 years (95% CI -3.04 to -1.93), with similar findings for body fat percentage and waist circumference. Appendicular lean mass and grip strength were positively associated with lifespan in men, but not women. In multivariable MR, fat-free mass was also beneficial for men. The effect of BMI on lifespan was largely mediated by waist circumference.</p><p><strong>Conclusion: </strong>Our study provides additional evidence highlighting the role of body composition rather than relying solely on BMI, with possibly a greater role of lean or fat-free mass in men. Waist circumference is a key target of intervention for men and women.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing traditional adiposity indicators and mammary adipocyte size in women with breast cancer.","authors":"Kaoutar Ennour-Idrissi, Sofia Laforest, André Tchernof, Francine Durocher, Caroline Diorio","doi":"10.1038/s41366-025-01814-5","DOIUrl":"https://doi.org/10.1038/s41366-025-01814-5","url":null,"abstract":"<p><strong>Background: </strong>Mammary adipocyte size reflects both local excess of adiposity and adipose tissue dysfunction relevant to breast cancer biology.</p><p><strong>Objective: </strong>To identify modifiable factors that are associated with both traditional adiposity indicators and mammary adipocyte size in women with breast cancer, and to compare the individual and simultaneous effect of these factors.</p><p><strong>Methods: </strong>Data were collected prospectively from 160 consecutive breast cancer patients (biobank of a breast cancer reference center): factors that may influence body weight and composition (telephone interview), dietary intakes (DHQ-I) and adiposity measurements (anthropometric indices and mammary adipocyte size). Relationships between determinants of adiposity identified in the literature were summarized in a directed acyclic graph. Principal component analysis was conducted to capture dietary intakes from major nutrient intakes. Robust univariate and multivariable linear regression models were used to estimate the associations.</p><p><strong>Results: </strong>Menopausal status, ever smoking, tumour grade and higher weight at 18 years old were consistently associated with higher adiposity. Higher animal fat intakes was consistently associated with higher body mass index (BMI). High educational attainment was consistently associated with lower BMI and waist-to-height ratio. Higher physical activity was associated with lower adiposity and adipocyte cell size, whereas higher age was associated with higher adiposity and adipocyte cell size only in univariate models. Only menopausal status was consistently associated with higher mammary adipocyte size.</p><p><strong>Conclusions: </strong>While excess adiposity is a complex condition that cannot be attributed to a single factor, menopausal status seems to be the main determinant of excess adiposity in women with breast cancer and the only independent determinant of mammary adipocyte size. Among lifestyle factors, ever smoking was the strongest independent determinant of higher adiposity, followed by high intakes of fats, particularly animal fats. If targeted efficiently, some of these modifiable factors could reduce the burden among breast cancer patients.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy intake and energy expenditure are minimally impacted by acute cold exposure in individuals living with obesity.","authors":"Kurt McInnis, Alexanne Larocque, Noémie Beauregard, Luzia Jaeger Hintze, Graham Finlayson, François Haman, Éric Doucet","doi":"10.1038/s41366-025-01809-2","DOIUrl":"https://doi.org/10.1038/s41366-025-01809-2","url":null,"abstract":"<p><strong>Context: </strong>Cold exposure (CE) has been purported to be a possible weight loss strategy and to be anorexigenic, however, the impacts of CE on appetite and energy intake have not been fully explored, more so in individuals living with obesity.</p><p><strong>Objective: </strong>Determine the effects of a single dose of moderate CE on energy expenditure, intake, and appetite regulation in individuals living with obesity.</p><p><strong>Design: </strong>Forty-seven individuals living with obesity (18 males) underwent two experimental sessions, one 90-min CE (10 °C fluid using a liquid conditioned suit) and one control. Energy expenditure (indirect calorimetry), energy intake (food menu), subjective appetite (Visual analogue scales), food reward (Leeds Food Preference Questionnaire), appetite-related peptides (ELISA), skin temperature (Thermocouples), thermal comfort and thermal sensation (Likert scales) were assessed.</p><p><strong>Results: </strong>CE produced a small (18%) but significant increase in energy expenditure over 90 min (p < 0.001). Energy intake during lunch increased slightly (10%), yet significantly following CE (p = 0.008) before decreasing for the remainder of the day (p = 0.049). There were no differences in subjective appetite (p > 0.05), but there was a decrease in the rewarding value of low-fat sweet foods (p < 0.05). Leptin concentrations decreased significantly (p = 0.004), whereas GLP-1 concentrations were increased (p = 0.003) in response to CE. Thermal comfort and sensation also both decreased significantly during exposure (p < 0.001).</p><p><strong>Conclusion: </strong>Although both energy expenditure and intake significantly changed, CE caused minimal impacts to energy balance in individuals living with obesity. When combined with the high levels of discomfort, these results question the efficiency of CE as an intervention able to produce meaningful changes in body weight and composition in individuals living with obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the value for money, from a policy maker perspective, of 24 randomised controlled trial designs for an online weight maintenance guided self-help intervention: an expected value of sample information analysis.","authors":"Penny Breeze, Katharine Pidd, Daniel Pollard, Shijie Ren, Sarah Bates, Chloe Thomas, Amy Ahern, Simon Griffin, Alan Brennan","doi":"10.1038/s41366-025-01804-7","DOIUrl":"https://doi.org/10.1038/s41366-025-01804-7","url":null,"abstract":"<p><strong>Objective: </strong>To analyse whether conducting a randomised controlled trial (RCT) to evaluate an online weight maintenance guided self-help intervention (Supporting Weight Management (SWiM)) would offer good value for money in the United Kingdom.</p><p><strong>Method: </strong>We examined 24 RCT designs by varying inclusion criteria (participants completing behavioural weight management, specialist-led weight management, diabetes prevention programme, type 2 diabetes remission, digital weight management, all weight management services), trial duration (1-2 years), and sample size (n = 500 or 2000). Trial benefits were estimated by the method of expected value of sample information analysis using a health economic model. The model examines how the proposed intervention affects weight maintenance over time (with uncertainty), and generates estimated lifetime Quality Adjusted Life Years (QALYs) and National Health Service (NHS) costs. Structured expert elicitation with 4 experts was undertaken to quantify pre-trial uncertainty in the effectiveness of SWiM compared with usual care. All trial designs were simulated to estimate trial benefits: the reduction in the costs of an inefficient decision for future populations over 10 years. Trial designs offer value for money if trial benefits exceed trial costs.</p><p><strong>Results: </strong>For three inclusion criteria options (groups recently completing 'diabetes remission', 'digital weight management' or 'specialist weight management'), the cost of the proposed trials was estimated to exceed the estimated trial benefit (value of the reduction in decision uncertainty) over 10 years. For the other three inclusion criteria options (groups recently completed 'behavioural weight management', 'diabetes prevention programme', or 'all weight loss programmes'), 12 trial designs produced greater benefits than costs. The optimal trial design option would include 'all weight loss programmes', with 2 years follow-up and sample size n = 2000.</p><p><strong>Conclusion: </strong>Investment in a large RCT to evaluate the SWiM intervention for patients completing a range of weight loss interventions offers the greatest value to the NHS.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolically healthy abdominal obesity is associated with higher odds of left ventricular geometric remodeling in children: Evidence from two school-based studies in China.","authors":"Lili Yang, Menglong Li, Huan Wang, Min Zhao, Costan G Magnussen, Yifei Hu, Bo Xi","doi":"10.1038/s41366-025-01800-x","DOIUrl":"https://doi.org/10.1038/s41366-025-01800-x","url":null,"abstract":"<p><strong>Objectives: </strong>The association between metabolically healthy abdominal obesity (MHO) and subclinical cardiovascular outcomes in the general pediatric population remains largely unexplored. We aimed to investigate the relationship of MHO with left ventricular geometric (LVG) remodeling in Chinese children.</p><p><strong>Methods: </strong>Data were obtained from two school-based cross-sectional studies in China, involving 2866 children aged 6-11 years. Abdominal obesity was defined using waist-to-height ratio (WHtR) or waist circumference references. The metabolically healthy phenotype was defined by the absence of four cardiovascular risk factors: elevated blood pressure, elevated triglycerides, elevated fasting blood glucose, and decreased high-density lipoprotein cholesterol. LVG was categorized into four patterns (normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy) based on two indices including left ventricular mass index and relative wall thickness.</p><p><strong>Results: </strong>Using WHtR to define abdominal obesity, 543 (18.9%) children were classified as MHO. In the multivariable logistic regression models, compared with children with metabolically healthy normal WHtR, the adjusted odds ratios (95% confidence intervals) of children with MHO were 4.78 (3.44-6.64) for left ventricular hypertrophy, 1.81 (1.33-2.47) for high relative wall thickness, 1.45 (1.01-2.08) for concentric remodeling, 4.37 (3.01-6.33) for eccentric hypertrophy, and 7.50 (3.77-14.91) for concentric hypertrophy. In contrast, children with metabolically unhealthy normal WHtR did not exhibit increased odds of any type of LVG remodeling. Similar results were observed when defining abdominal obesity based on waist circumference.</p><p><strong>Conclusions: </strong>MHO is associated with a higher likelihood of LVG remodeling, suggesting that this phenotype may not be benign for the heart in children. Due to its simplicity and practicality, WHtR may be a preferable tool for the rapid screening of children with abdominal obesity and associated cardiac risk.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}