International Journal of Obesity最新文献

{"title":"Metabolically healthy obesity is independently associated with 20-year incidence of cardiovascular disease: findings from the ATTICA cohort study (2002-2022).","authors":"Theodosios D Filippatos, Panagiotis Katrapas, Thomas Tsiampalis, Christina Chrysohoou, Fotios Barkas, Evangelos Liberopoulos, Petros P Sfikakis, Costas Tsioufis, Christos Pitsavos, Demosthenes Panagiotakos","doi":"10.1038/s41366-026-02056-9","DOIUrl":"https://doi.org/10.1038/s41366-026-02056-9","url":null,"abstract":"<p><strong>Background: </strong>Individuals with excess body weight do not share the same risk for cardiovascular disease (CVD). The phenotype of metabolically healthy obesity (MHO) has drawn the attention of the scientific community due to a potentially reduced CVD risk compared with the phenotype of metabolically unhealthy obesity (MUO).</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving 3042 participants from the Attica region in Greece. Baseline demographic, clinical, and lifestyle characteristics were assessed, with participants categorized by their obesity and metabolic health status. Cox proportional hazards models were used to analyze the association between obesity/metabolic health status and 20-year CVD incidence, adjusting for relevant covariates.</p><p><strong>Results: </strong>The sample at baseline comprised 38% individuals who were metabolically healthy without obesity (MHWO), 44% individuals who were metabolically unhealthy without obesity (MUWO), 6% individuals with MHO, and 12% individuals with MUO. Over the 20-year follow-up, 718 participants experienced a CVD event; participants with MUO demonstrated the highest incidence rate (61.1%). Cox regression analyses revealed that individuals with MUO had an 85% higher risk of developing CVD compared with individuals having the MHWO phenotype (HR = 1.85, 95% CI = 1.02-3.58). Individuals with MHO had a 39% elevated risk compared with individuals having the MHWO phenotype (HR = 1.39, 95% CI = 1.06-3.42). Groups with MHO and MUO had independently increased CVD risk, even after multivariable adjustment.</p><p><strong>Conclusions: </strong>Individuals with MUO exhibit the highest risk, but individuals with MHO also have an independently increased CVD risk, emphasizing the significant impact of both obesity and metabolic health status on long-term CVD incidence.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716673","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":"Childhood adversity and gestational diabetes: examining the mediating effect of BMI and depression through interventional mediation analysis.","authors":"Megan Davies, Bianca De Stavola, Karoline Kragelund Nielsen, Peter Damm, Naja H Rod","doi":"10.1038/s41366-026-02080-9","DOIUrl":"https://doi.org/10.1038/s41366-026-02080-9","url":null,"abstract":"<p><strong>Background: </strong>Childhood adversity has been shown to increase the risk of gestational diabetes mellitus (GDM), though the mechanisms through which the risk is increased have yet to be examined.</p><p><strong>Methods: </strong>We used register data on all women born in Denmark and giving birth for the first time between 2004 and 2018, totalling 207,659 women. Interventional mediation analysis was used to estimate how two mechanistic pathways, depression and pre-pregnancy BMI, mediate the relationship between childhood adversity and GDM across five previously identified adversity trajectory groups.</p><p><strong>Results: </strong>4779 women were diagnosed with GDM between 2004 and 2018, corresponding to a 2.3% absolute risk of GDM. Compared to those who experienced low adversity in childhood, we estimated that those who experienced early material deprivation could have a 0.12% [95% CI 0.10, 0.14] reduction in absolute GDM risk by intervening on BMI and equalising its distribution to that of mothers in the low adversity group. We found no evidence of a reduction in risk if depression were similarly intervened on. For those in the high levels of adversity group no evidence of mediation was found.</p><p><strong>Conclusions: </strong>Intervening on pre-pregnancy BMI might potentially reduce the risk of GDM for mothers in some of the adversity groups, whereas intervening on depression seems to have little impact. The findings suggest that high adversity likely increases the risk of GDM through alternative mechanisms than BMI or depression.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698712","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":"Association of cord blood mitochondrial DNA heteroplasmy and copy number with childhood overweight or obesity.","authors":"Xueqi Qu, Guoying Wang, Xiumei Hong, Jessica An, Hilary J Vernon, Xiaobin Wang","doi":"10.1038/s41366-026-02086-3","DOIUrl":"10.1038/s41366-026-02086-3","url":null,"abstract":"<p><strong>Background: </strong>Mitochondria, the cell's powerhouse, play a central role in energy homeostasis and may influence obesity risk. Variations in mitochondrial DNA (mtDNA) have been hypothesized to influence early-life metabolic programming; however, prospective evidence remains limited, and no study has jointly examined multiple mtDNA biomarkers. We aimed to investigate the individual and combined associations of cord blood mtDNA heteroplasmy and copy number with the risk of childhood overweight or obesity (OWO).</p><p><strong>Methods: </strong>Data were obtained from 952 children enrolled at birth and followed longitudinally in the Boston Birth Cohort. Body mass index (BMI) z scores were calculated using U.S. reference data, and OWO was defined as BMI ≥85th percentile for age and sex. Cord blood mtDNA heteroplasmy and copy number were assessed by targeted sequencing, with functional region heteroplasmy defined as heteroplasmic variants in coding regions and classified as inherited or de novo. Mixed-effects models were used to evaluate associations between mtDNA measures and repeated measures of child BMI and OWO.</p><p><strong>Results: </strong>In sex-specific analyses, de novo functional region heteroplasmy was associated with higher BMI z score (β = 0.29, 95% CI: 0.01, 0.57) and increased risk of OWO (RR = 1.46, 95% CI: 1.07, 2.00) among girls, whereas no associations were observed overall. BMI associations were more evident in adolescent girls (aged 10-18 years). MtDNA copy number z score was negatively associated with BMI in children with overall or de novo functional region heteroplasmy but showed modest positive associations in those without specific heteroplasmy (p for interaction < 0.05).</p><p><strong>Conclusions: </strong>Cord blood mtDNA heteroplasmy and copy number interactively influence the risk of childhood OWO, with associations varying by sex and age. This is the first prospective study to jointly evaluate these mtDNA biomarkers, offering new insight into mitochondrial contributions to the developmental origins of OWO and a potential framework for early-life risk assessment.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689465","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":"The association of prenatal adiposity characteristics with early childhood overweight and obesity: findings from a large and diverse mother-child cohort.","authors":"Hua Min, Michael S Bloom, Grace N Lawrence, Alma Fuller, Kathi C Huddleston","doi":"10.1038/s41366-026-02082-7","DOIUrl":"https://doi.org/10.1038/s41366-026-02082-7","url":null,"abstract":"<p><strong>Background: </strong>Maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) are risk factors for overweight and obesity (OWO) in childhood. However, a better understanding of the magnitude, timing, and mediating mechanisms of these associations can inform interventions to improve maternal and child health.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of 2899 mother-child dyads in northern Virginia (2012-2019). Maternal ppBMI was self-reported and GWG was calculated and categorized as excess (EGWG) using 2009 Institute of Medicine guidelines. Child weight was reported by parents every six months from birth to 24 months, and annually thereafter. Childhood OWO was defined as >85th percentile of WHO growth charts at 36 months. Generalized linear and mixed models estimated maternal OWO status and GWG as predictors of children's body weight Z-score and growth velocity, adjusted for covariate. Causal mediation analysis was used to quantify birth weight and early growth velocity as intervening factors.</p><p><strong>Results: </strong>Mothers self-reported Hispanic (32.08%) and non-Hispanic (51.98%) ethnicity (15.94% missing). Mean ± SD ppBMI was 25.5 ± 5.4 kg/m² (35.46% with obesity) and GWG was 14.2 ± 6.8 kg (40.8% EGWG). At 36 months, 25.4% of children had overweight and 10.5% had obesity. Higher ppBMI (RR = 1.04 per 1.00 kg/m²; 95% CI: 1.03-1.06) and GWG was associated with childhood risk of OWO among non-Hispanic but not Hispanic mothers (interaction P = 0.02). Similarly, maternal obesity status (RR = 1.64; 95% CI: 1.26-2.13) and EGWG (RR = 1.38; 95% CI: 1.09-1.74) were associated with childhood OWO risk. Approximately 26.8% (95% CI: 14.9%-55.9%) of the ppBMI-OWO association could be attributed to birth weight.</p><p><strong>Conclusions: </strong>Maternal ppBMI and GWG were independently associated with risk of OWO in early childhood OWO, with variations by child age and ethnicity, highlighting the potential of pre- and perinatal interventions to reduce childhood obesity risk.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689456","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":"Real-world outcomes of hybrid obesity care using digital coaching and GLP-1 therapy in a multi-ethnic Asian setting.","authors":"Shahmir H Ali, Michelle H Lee, Kyle Xin Quan Tan, Chu Jing Wong, Faidon Magkos, Ian Yi Han Ang, Sue-Anne Toh","doi":"10.1038/s41366-026-02062-x","DOIUrl":"https://doi.org/10.1038/s41366-026-02062-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity remains a major health challenge globally and in Asia, driving cardio-metabolic disease risks. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and mobile health (mHealth) coaching each demonstrate weight loss efficacy, but real-world evidence for hybrid models combining these treatments remains limited, especially in multi-ethnic Asian settings.</p><p><strong>Methods: </strong>We evaluated real-world outcomes among 708 adults enrolled in NOVI Optimum Plus, a physician-led obesity program in Singapore that integrates GLP-1 RA pharmacotherapy with app-based lifestyle coaching. Data on weight, metabolic indicators, and engagement were extracted from clinical records and the mHealth platform. Linear mixed models estimated changes over 6-18 months, stratified by engagement, metabolic status, and ethnicity.</p><p><strong>Results: </strong>Participants (mean age 42.1 years; 64.1% female) were primarily East Asian (45.5%), European (26.8%), South Asian (13.3%), and Southeast Asian (10.3%). Most received semaglutide (86% oral 14 mg). At 12 months, mean weight loss was 12.7% (95% CI: -14.0, -11.3) and BMI dropped by 4.1 points, with further weight loss reaching 14.7% at 18 months. Systolic blood pressure decreased by 11.5 mmHg, body fat percentage by 8.8%, waist-to-hip ratio improved from 0.83 to 0.80, and HbA1c declined by 0.6%. Greater app engagement was linked to 2.0-2.2% additional weight loss, 0.72 kg/m² more BMI reduction, and up to 2.9 mmHg greater systolic BP drop. More frequent health coach contact contributed modest added improvements for weight and BMI. Weight loss was significantly lower among East Asians and those with hyperglycemia.</p><p><strong>Conclusion: </strong>In this real-world Asian setting, hybrid obesity care combining GLP-1 RAs with digital coaching produced clinically meaningful, sustained weight and metabolic improvements. Higher engagement consistently enhanced outcomes, supporting scalable integrated models tailored for diverse populations.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645228","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 effectiveness of healthy weight interventions in the early years of childhood: a systematic review and meta-analysis of evidence from high-income countries.","authors":"Disha Dhar, Lucy Karwatowska, Maria Sifaki, Semina Michalopoulou, Claire Stansfield, Jessica Packer, Simon J Russell","doi":"10.1038/s41366-026-02073-8","DOIUrl":"https://doi.org/10.1038/s41366-026-02073-8","url":null,"abstract":"<p><strong>Background: </strong>Early childhood represents an important opportunity for establishing lifelong health behaviours, including the maintenance of a healthy weight. Given that weight patterns established in early life often persist into adolescence and adulthood, there is an urgent need to understand whether universal interventions in early childhood are effective in preventing excess weight gain. We aimed to systematically synthesise the effects of universal healthy weight interventions for pre-school children on anthropometric outcomes.</p><p><strong>Methods: </strong>We searched nine academic databases and included studies published from 2011 with pre-post implementation assessments of anthropometric outcomes amongst preschool children aged 5 years and under. Eligible studies included interventions that incorporated diet, physical activity, and/or behavioural change components. All studies were included in a narrative synthesis and, where possible, three-level random-effects meta-analyses were conducted to pool standardised mean differences.</p><p><strong>Results: </strong>A total of 40 studies (n = 26,977 participants) met the inclusion criteria. The most commonly reported outcomes were BMI z-score (zBMI; k [number of studies] = 27), weight status categories (k = 19), BMI (k = 14), BMI percentiles (k = 11), body weight (k = 8), waist circumference (k = 8), skinfolds (k = 6), percentage body fat (k = 3), fat-free mass index (k = 3), and fat mass index (k = 2). The findings from the meta-analyses suggested that children receiving interventions had significantly lower zBMI (SMD [standardised mean difference] = -0.085, 95% CI -0.140, -0.029), lower waist circumference (SMD = -0.186, 95% CI -0.361, -0.011), percentage body fat (SMD = -0.159, 95% CI -0.290, -0.028) and higher fat-free mass index (SMD = 0.170, 95% CI 0.012, 0.328) compared to controls. No significant differences were found for BMI percentile. Narrative synthesis indicated limited evidence of effectiveness.</p><p><strong>Conclusions: </strong>Universal multicomponent healthy weight interventions for preschool children in high-income countries were associated with modest but meaningful improvements in zBMI, waist circumference, percentage body fat, and fat-free mass index. These findings suggest that early childhood interventions can be effective if delivered at scale and may serve as a key element in broader childhood obesity prevention strategies.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645255","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":"Reproductive hormone stability with prolonged intranasal oxytocin in adults with obesity.","authors":"Francesca Galbiati, Sarah Hiranandani, Marie-Louis Wronski, Franziska Plessow, Katherine Holman, Elisa Asanza, Sarah E Smith, Maged Muhammed, Emily R Golden, Natalia Hadaway, Ethiopia Getachew, Madhusmita Misra, Anna Aulinas, Elizabeth A Lawson","doi":"10.1038/s41366-026-02074-7","DOIUrl":"10.1038/s41366-026-02074-7","url":null,"abstract":"<p><strong>Context: </strong>Oxytocin, a posterior pituitary hormone known for its role in parturition and lactation, is also implicated in many physiologic functions. Intranasal oxytocin is under investigation for obesity treatment, among other indications. The interplay of anterior and posterior pituitary hormones is currently not well understood. Given the well-established role of oxytocin in reproduction, it is important to examine intranasal oxytocin effects on prolactin and the hypothalamic-pituitary-gonadal (HPG) axis. Preclinical studies indicate that regulation of oxytocin, prolactin, and sex steroids in both sexes are intertwined; however, data in humans are limited, and no studies have reported the effects of prolonged oxytocin administration on prolactin or the HPG axis OBJECTIVE: To elucidate physiology and generate preliminary data regarding reproductive safety of prolonged intranasal oxytocin, we leveraged a completed trial to investigate oxytocin effects on circulating prolactin and sex steroid levels in adults with obesity.</p><p><strong>Methods: </strong>Sixty-one adults with obesity (52% females) participated in a longitudinal randomized clinical trial data and received eight-weeks intranasal oxytocin (24 IU) four times daily or placebo. Main outcome measures were pre- and post-treatment fasting estradiol, testosterone, and prolactin; exploratory outcome measure was on-treatment menstrual cycle length.</p><p><strong>Results: </strong>Oxytocin vs. placebo groups did not differ for effects on prolactin or sex steroid levels (p's ≥ 0.140). On-treatment mean menstrual cycle length did not differ across groups (p = 0.234).</p><p><strong>Conclusion: </strong>In our study, eight-weeks of intranasal oxytocin administration did not impact prolactin or sex steroid levels, or menstrual cycle length, providing preliminary support for reproductive safety of oxytocin-based therapeutics in adults with obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638692","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":"Racial and ethnic variations of metabolic indicators associated with childhood obesity: a comparative cross-sectional study.","authors":"Jing Wu, Zhenran Xu, Li Xi, Miaoying Zhang, Xiaojing Li, Feihong Luo","doi":"10.1038/s41366-026-02078-3","DOIUrl":"https://doi.org/10.1038/s41366-026-02078-3","url":null,"abstract":"<p><strong>Background: </strong>Susceptibility to adult metabolic diseases varies significantly across ethnicities. Asian adults exhibit elevated risks associated with obesity at lower body mass index (BMI) levels; whether similar patterns occur in pediatric populations remains unclear. This study aimed to evaluate how metabolic indicators associated with childhood obesity vary across diverse racial/ethnic groups.</p><p><strong>Methods: </strong>Age-matched adolescents (12-18 years) from diverse regions across China-along with adolescents from Hispanic, Mexican American (MA), Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Other ethnic groups from the National Health and Nutrition Examination Survey (NHANES)-were enrolled. Comprehensive demographic, anthropometric and metabolic data-including glycemic parameters, lipid profiles, and insulin resistance indices-were analyzed. Cross-sectional mediation analysis was conducted to explore the potential biological pathways underlying the relationship between obesity (BMI standard deviation score [SDS] as the exposure) and metabolic dysfunction (metabolic indicators as the outcomes), testing cortisol and adrenocorticotropic hormone (ACTH) as potential mediators. Average direct and causal mediation effects were evaluated, with results interpreted as statistical associations consistent with the mediation framework.</p><p><strong>Results: </strong>The study included 632 adolescents (55.22% male, mean age 14.51 ± 1.87 years, median BMI 31.55 kg/m²). Compared to Chinese adolescents, NHB had higher HbA1c, NHW had lower HbA1c; both showed lower HOMA-β. All groups had higher HDL-C, lower total cholesterol and LDL-C levels than Chinese adolescents. HbA1c correlated positively with BMI SDS in Chinese and MA adolescents. Fasting insulin and HOMA-IR correlated positively with BMI SDS in all groups except Hispanic adolescents, while HOMA-β correlated positively in all groups except Hispanic and NHW adolescents. In Chinese adolescents, ACTH mediated the associations of BMI SDS with fasting insulin and HOMA-IR (P = 0.014 and 0.020 for mediation effects, respectively).</p><p><strong>Conclusions: </strong>This first multiethnic pediatric metabolic comparison reveals distinct racial/ethnic patterns, with ACTH emerging as a novel mediator in Chinese adolescents. Findings underscore the need for ethnicity-tailored prevention strategies.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645280","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":"Racial and ethnic disparities in type 2 diabetes: does visceral fat play a role? Evidence from the MESA study.","authors":"Tong Xia, Roch A Nianogo, QingZhao Yu, Tamara Horwich, Preethi Srikanthan, Kosuke Inoue, Matthew Allison, Zuo-Feng Zhang, Moyses Szklo, Karol E Watson, Liwei Chen","doi":"10.1038/s41366-026-02079-2","DOIUrl":"https://doi.org/10.1038/s41366-026-02079-2","url":null,"abstract":"<p><strong>Objective: </strong>In the United States, racial and ethnic minorities have higher risk of developing type 2 diabetes (T2D) than Whites. One hypothesis is that some minorities (e.g., Hispanics, Asians) have more visceral fat than Whites in a sex-specific manner. We aimed to test this hypothesis by examining to what degree racial differences in T2D were explained by visceral fat in males and females.</p><p><strong>Methods: </strong>This prospective cohort included 1457 participants (51.2% females) from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort who had visceral fat measured by computed tomography and followed for incident T2D from 2002-2005 to 2020. We assessed associations of race and T2D risk using Cox proportional hazards regressions and estimated associations explained by visceral fat using natural mediation effects, stratified by sex.</p><p><strong>Results: </strong>Controlling for confounders, compared with White participants, T2D risk was higher in Hispanic females (HR 1.77, 95% CI 1.17-2.69), Chinese females (1.91, 1.15-3.15), Black females (1.59, 1.02-2.49), and Hispanic males (1.82, 1.20-2.76). Estimates for Black males (1.48, 0.92-2.38) and Chinese males (0.86, 0.48-1.55) were not statistically significant. By sex, Hispanic females [mean difference (SE): 22.72 (5.68)] had higher visceral fat (cm²) than White females, while Chinese [-77.56 (8.47)] and Black [-57.57 (8.11)] males had lower visceral fat (cm²) than White males. Visceral fat explained 23.1% of T2D risk between Hispanic and White females, but not for other racial and sex subgroups.</p><p><strong>Conclusion: </strong>Visceral fat explained one-fifth of racial and ethnic differences in T2D comparing Hispanic females to White females and may contribute to Hispanic females' higher T2D risk.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638763","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":"Non-invasive islet β-cell markers track with weight-loss interventions for type 2 diabetes: a prospective cohort study.","authors":"Hongyan Sun, Yun Shen, Susan J Burke, Phillip Brantley, Ricky Brock, Dachuan Zhang, Shengping Yang, Gang Hu, J Jason Collier","doi":"10.1038/s41366-026-02070-x","DOIUrl":"10.1038/s41366-026-02070-x","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the longitudinal impact of intensive medical intervention (IMI) and bariatric surgery procedures on indirect measures of pancreatic β-cell death and function.</p><p><strong>Methods: </strong>Eighty-four participants (28 non-type 2 diabetes [T2D], 56 T2D) from the HEADS UP study were assessed at baseline and 1-year post-intervention. Circulating unmethylated and methylated insulin gene [INS] DNA were quantified from blood samples via droplet digital polymerase chain reaction (PCR). Metabolic biomarkers, including fasting plasma glucose, HbA1c, proinsulin-to-insulin ratio, insulin, and C-peptide, were analyzed.</p><p><strong>Results: </strong>At baseline, participants with T2D had significantly higher levels of unmethylated INS DNA and higher unmethylated-to-methylated INS DNA ratios than individuals without T2D. After 1-year, significant reductions in these biomarkers were observed primarily in the T2D group. Bariatric surgeries yielded greater improvements in metabolic profiles and reductions in unmethylated INS DNA than IMI. Despite substantial metabolic improvement, participants with T2D maintained elevated proinsulin-to-insulin ratios, indicating alterations to β-cell function.</p><p><strong>Conclusions: </strong>Circulating unmethylated INS DNA is a non-invasive index of β-cell death and responds to weight-loss interventions. Metabolic surgeries are more effective than IMI in preserving β-cell mass and function, highlighting their potential in diabetes management. Long-term studies are necessary to confirm these initial findings.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638480","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}