International Journal of Obesity最新文献

{"title":"Adiposity trajectory as a predictor of chronic and multisite pain in the transition from childhood to adolescence: A prospective study of a large birth cohort.","authors":"Francisco Fernandes, Rita Pereira, Raquel Lucas, Milton Severo, Carla Lopes, Makram Talih","doi":"10.1038/s41366-026-02227-8","DOIUrl":"https://doi.org/10.1038/s41366-026-02227-8","url":null,"abstract":"<p><strong>Background/objectives: </strong>The association between obesity and pain may have relevant population health implications starting in young ages. We aimed to quantify associations between adiposity and pain in the general population, from 4 to 13 years of age, using complementary longitudinal approaches.</p><p><strong>Methods: </strong>Participants were from Generation XXI, a population-based cohort assembled at birth in Porto, Portugal, and re-evaluated at 4, 7, 10, and 13 years of age (n = 4563). Pain was assessed using the Luebeck Pain Questionnaire and classified as chronic (above three months) or multisite (two or more sites). Adiposity parameters included fat mass percentage and age- and sex-standardized body mass index scores (BMI z-scores). Associations between individual adiposity trajectories from ages 4 to 13, extracted from mixed-effects polynomial trend models, and pain measures at age 13 were tested using logistic regression adjusted for pubertal development and practice of programmed physical activity. Bidirectionality was assessed using cross-lagged analysis.</p><p><strong>Results: </strong>Among girls, quadratic fat mass (FM) trajectories, characterized by accelerated fat mass gain, were associated with increased odds of chronic pain (quadratic coefficient odds ratio [ <math> <msub><mrow><mi>OR</mi></mrow> <mrow><mi>F</mi> <msup><mrow><mi>M</mi></mrow> <mrow><mn>2</mn></mrow> </msup> </mrow> </msub> </math> ] = 1.37, 95% confidence interval [CI]: 1.12, 1.69) and multisite pain ( <math> <msub><mrow><mi>OR</mi></mrow> <mrow><mi>F</mi> <msup><mrow><mi>M</mi></mrow> <mrow><mn>2</mn></mrow> </msup> </mrow> </msub> </math>  = 1.27, 95% CI: 1.05, 1.53) at age 13. Consistently, results from the cross-lagged analysis in girls suggest associations between adiposity at age 10 and pain reports at age 13. Among boys, only suggestive associations emerged, particularly for the quadratic BMI z-score trajectories with chronic pain ( <math> <msub><mrow><mi>OR</mi></mrow> <mrow><mi>B</mi> <mi>M</mi> <mi>I</mi> <msup><mrow><mi>z</mi></mrow> <mrow><mn>2</mn></mrow> </msup> </mrow> </msub> </math> :1.34, 95% CI: 0.96, 1.86).</p><p><strong>Conclusion: </strong>Higher adiposity during childhood and early adolescence was a predictor of chronic and multisite pain reports at age 13 among girls.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024809","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":"Autophagy in hypothalamic POMC and AgRP neurons: mechanisms and therapeutic implications for obesity.","authors":"Dike Jing, Rao Dai, Shuwei Peng, Lishen Zeng, Jinyan Cai","doi":"10.1038/s41366-026-02223-y","DOIUrl":"https://doi.org/10.1038/s41366-026-02223-y","url":null,"abstract":"<p><p>Obesity is increasingly recognized as a disorder involving impaired central endocrine regulation in which hypothalamic nutrient sensing, leptin responsiveness, and intracellular quality control are closely intertwined. Within the arcuate nucleus, autophagy exerts divergent metabolic effects in the two principal appetite-regulating neuronal populations. In pro-opiomelanocortin (POMC) neurons, autophagy supports metabolic homeostasis by promoting alpha-melanocyte-stimulating hormone (α-MSH) production, preserving leptin and insulin sensitivity, and activating peripheral lipophagy; its disruption predisposes to hyperphagia, leptin resistance, and obesity-related metabolic dysfunction. In contrast, autophagy in agouti-related peptide (AgRP) neurons promotes feeding and energy conservation by maintaining AgRP expression, integrating ghrelin signals, and sensing peripheral fatty acids; its inhibition alleviates diet-induced obesity in mice. This review critically evaluates discrepancies among models based on the deletion of autophagy-related gene 5,7, and 12 (Atg5, Atg7, and Atg12), as well as differences arising from developmental versus adult manipulations, dietary paradigms, and the reliance of static autophagy markers. We further discuss how POMC and AgRP neuron autophagy may interact with broader hypothalamic and extra-hypothalamic networks, including basonuclin 2 (BNC2), steroidogenic factor 1 (SF1) neurons in the ventromedial hypothalamus (VMH), and paraventricular hypothalamic nucleus (PVH) pathways, as well as extra-hypothalamic components involving the brainstem, glial and tanycytic cells, and neurovascular interaction. Chaperone-mediated autophagy (CMA) has emerged as a potential pathway potentially linking saturated fatty acid exposure, LAMP2A-dependent proteostasis, and insulin responsiveness in hypothalamic neurons, although direct evidence remains limited. Because direct demonstration of altered autophagic flux in human POMC or AgRP neurons remains lacking, hypothalamic autophagy should currently be viewed as a mechanistic and translational research framework rather than a validated clinical target. Future therapies will likely require pathway-biased, neuron-type-specific, and circuit-aware modulation rather than global activation or inhibition of autophagy.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016344","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":"ADRB3, LEPR, FTO and PPARG variants contribute to obesity-related metabolic syndrome in Brazilian adults: a polygenic risk score approach.","authors":"Tamiris Invencioni Moraes Stefani, Thiago Dominguez Crespo Hirata, Alvaro Cerda, Raquel de Oliveira, Marina Aparecida Dos Santos, Cristina Moreno Fajardo, Egídio Lima Dorea, Márcia Martins Silveira Bernik, Mario Hiroyuki Hirata, Rosario Dominguez Crespo Hirata","doi":"10.1038/s41366-026-02218-9","DOIUrl":"https://doi.org/10.1038/s41366-026-02218-9","url":null,"abstract":"<p><strong>Objective: </strong>Polymorphisms in genes involved in obesity-related metabolic pathways are associated with metabolic syndrome (MetS). We hypothesized that variants in FTO, LEP, LEPR, ADRB3, ADIPOQ, TCF7L2, ENPP1, APOA5, PPARG, and CYP11B2 are associated with MetS and obesity-related traits.</p><p><strong>Methods: </strong>A group of 420 subjects (179 with MetS and 241 without MetS) was selected from a Brazilian adult cohort. Clinical, anthropometric, metabolic and inflammatory data were assessed. Genetic variants were analyzed by qPCR and their association with non-genetic variables were explored using multivariate logistic and linear regression analyses. Using logistic regression results weighted by clinically relevant variants, we evaluated the prognostic capability of a polygenic risk score (PRS) model for MetS risk.</p><p><strong>Results: </strong>ADRB3 rs4994A>G (OR:3.71, 95%CI:1.71-8.03, p = 0.001) and LEPR rs1137100A>G (OR: 2.52, 95%CI: 1.33-4.79, p = 0.005) were associated with high risk of MetS. ADRB3 rs4994A>G, LEPR rs1137100A>G, FTO rs17817449T>G and PPARG rs1801282C>G predicted anthropometric, metabolic and inflammatory alterations related to MetS (p < 0.05). Normalized values of PRS (nPRS) were higher in subjects with MetS, although ROC analysis demonstrated to discriminate MetS with limited sensitivity (AUC-ROC = 0.616, p < 0.001), increasing values of nPRS were associated with higher number of MetS components (p < 0.001).</p><p><strong>Conclusion: </strong>Variants in ADRB3, LEPR, FTO and PPARG play an important role in adiposity related to MetS, contributing to metabolic disturbances and pro-inflammatory state that increase cardiovascular risk in adult subjects. The integration of these variants into a polygenic risk score highlights a cumulative genetic susceptibility, as reflected by higher scores in MetS and a clear gradient across the number of MetS components.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016806","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":"Deep learning-derived abdominal adiposity phenotypes and 28-day mortality in sepsis.","authors":"Hye Ju Yeo, Ha Lim Kim, Kipoong Kim, Jin Ho Jang, Eunjeong Choi, Hee Yun Seol, Seung Eun Lee, Woo Hyun Cho","doi":"10.1038/s41366-026-02220-1","DOIUrl":"https://doi.org/10.1038/s41366-026-02220-1","url":null,"abstract":"<p><strong>Background: </strong>Body mass index does not distinguish visceral from subcutaneous adiposity, which may have different prognostic implications during sepsis. We used automated computed tomography (CT) analysis to evaluate the associations of abdominal adipose tissue distribution with 28-day mortality.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study of 1107 adults with sepsis, abdominal CT scans were analyzed using a pretrained nnU-Net-based segmentation pipeline. Subcutaneous adipose tissue cross-sectional area (SAT CSA), visceral adipose tissue (VAT) CSA, the VAT/SAT ratio, adipose tissue attenuation, and psoas muscle measures were quantified at L3-L4. Cox proportional hazards models estimated hazard ratios (HRs) per 1-standard deviation (SD) increase using clinically selected covariate adjustment. Exploratory BMI-stratified models included formal interaction testing.</p><p><strong>Results: </strong>Among 1107 patients, 300 (27.1%) died within 28 days during the index hospitalization. Obesity (BMI ≥ 25 kg/m²) was associated with lower mortality (adjusted HR 0.62; 95% CI, 0.41-0.94, P = 0.023), as was greater SAT CSA (adjusted HR 0.83; 95% CI, 0.69-1.00, P = 0.048). A higher VAT/SAT ratio was associated with higher mortality (adjusted HR 1.14; 95% CI, 1.01-1.28, P = 0.031). In exploratory BMI-stratified analyses, greater SAT CSA was associated with lower mortality among underweight patients (adjusted HR 0.37; 95% CI, 0.16-0.83), and a higher VAT/SAT ratio was associated with higher mortality among patients with obesity (adjusted HR 1.48; 95% CI, 1.18-1.85); however, interactions with BMI category were not significant (P for interaction = 0.145 and 0.127, respectively). Among psoas muscle measures, only a higher low-attenuation muscle proportion remained associated with mortality after adjustment (adjusted HR 1.14; 95% CI, 1.01-1.28, P = 0.033).</p><p><strong>Conclusions: </strong>Greater SAT CSA and a higher VAT/SAT ratio showed opposing adjusted associations with 28-day mortality. Automated CT-derived body composition may complement BMI-based risk characterization in sepsis, although the subgroup and skeletal muscle findings require external validation.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008433","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":"Effects of nocturnal intermittent hypoxia on metabolic syndrome in Japanese adults without abdominal obesity.","authors":"Yuko Kato, Ai Ikeda, Hadrien Charvat, Kiyohide Tomooka, Koutatsu Maruyama, Isao Saito, Takeshi Tanigawa","doi":"10.1038/s41366-026-02228-7","DOIUrl":"https://doi.org/10.1038/s41366-026-02228-7","url":null,"abstract":"<p><strong>Objectives: </strong>The association between nocturnal intermittent hypoxia and metabolic syndrome (MetS) in individuals without abdominal obesity has not yet been fully explored. We conducted a longitudinal study to investigate the association between nocturnal intermittent hypoxia and the incidence of MetS and its components in Japanese individuals without abdominal obesity.</p><p><strong>Methods: </strong>This prospective cohort study included 647 participants without baseline MetS and abdominal obesity, defined as a waist circumference of <90 cm in men and <80 cm in women. Nocturnal intermittent hypoxia was assessed using 3% oxygen desaturation index (ODI). MetS was diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel III criteria. Incident MetS and its components were assessed at the five-year follow-up survey. The median follow-up period was 5.0 years (IQR, 4.8-5.1). The association between nocturnal intermittent hypoxia and the incidence of MetS and its components was evaluated using a modified Poisson regression analysis. The analysis was stratified by age group (<65 years vs. ≥65 years).</p><p><strong>Results: </strong>In the younger age group, 3% ODI ≥ 5 was associated with a significantly higher risk ratio (RR) for MetS incidence (RR 2.10, 95% confidence interval [CI]: 1.18-3.76). Participants with 3% ODI ≥ 5 in the younger age group also had significantly higher RRs for abdominal obesity (RR 2.17, 95% CI: 1.42-3.33), low high-density lipoprotein cholesterol (RR 2.01, 95% CI: 1.02-3.96), and hypertriglyceridemia (RR 2.41, 95% CI: 1.35-4.30). In the older age group, 3% ODI ≥ 5 was not significantly associated with increased RRs for MetS or its components.</p><p><strong>Conclusions: </strong>Nocturnal intermittent hypoxia was associated with an increased risk of developing MetS and some of its components in younger individuals without abdominal obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008436","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":"Levothyroxine therapy for euthyroidism restoration results in clinically insignificant weight and anthropometric changes: a systematic review and meta-analysis.","authors":"Sium Wolde Sellasie, Nicola Ossola, Tommaso Piticchio, Luigi Uccioli, Pierpaolo Trimboli","doi":"10.1038/s41366-026-02224-x","DOIUrl":"https://doi.org/10.1038/s41366-026-02224-x","url":null,"abstract":"<p><strong>Background: </strong>Weight gain is commonly regarded as a hallmark of hypothyroidism,although supporting evidence is limited. Consequently, restoration of euthyroidism with levothyroxine is often expected to induce clinically meaningful weight loss or return to premorbid body weight. These expectations may affect patient counseling, treatment satisfaction, and interpretation of persistent symptoms after biochemical correction. This systematic review and metanalysis aimed to synthesize available evidence on changes in body weight(BW) and anthropometric parameters, including body mass index(BMI), waist circumference(WC), fat mass(FM), and lean body mass(LBM), after levothyroxine treatment in hypothyroid adults achieving euthyroidism.</p><p><strong>Methods: </strong>A comprehensive search of PubMed and Google Scholar was conducted up to April 1, 2026, to identify original English-language studies reporting anthropometric outcomes before levothyroxine initiation and after achievement of euthyroidism. For each outcome, effect size was calculated as mean change from baseline to post-treatment. When appropriate, heterogeneity was explored through subgroup analyses or meta-regression.</p><p><strong>Results: </strong>Twenty-three studies including 763 patients were analyzed.Levothyroxine treatment was associated with significant reductions in BW (-1.39 kg; 95% CI: -2.56 to -0.23),BMI (-0.39 kg/m²; 95% CI: -0.68 to -0.11), FM (-0.75 kg; 95% CI: -1.47 to -0.02), and LBM (-0.95 kg; 95% CI: -1.47 to -0.43). Subgroup analyses showed significant reductions in BW and BMI in overt hypothyroidism, but not in subclinical hypothyroidism. Conversely, LBM decreased significantly only in subclinical hypothyroidism. Baseline TSH and study duration were not associated with changes in anthropometric outcomes.</p><p><strong>Discussion: </strong>Achieving euthyroidism with levothyroxine produces modest reductions in BW, BMI, FM, and LBM. Effects appear partly influenced by disease severity, with more consistent BW and BMI reductions in overt hypothyroidism. These findings support realistic counseling and discourage levothyroxine use solely for weight loss.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001903","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 trimester-specific gestational weight gain with child BMI by maternal BMI categories in community-based healthcare organizations.","authors":"Erin S LeBlanc, Rachel Springer, Anna Booman, Natalie A Rosenquist, Kimberly K Vesco, Evelyn Sun, Byron A Foster, Janne Boone-Heinonen","doi":"10.1038/s41366-026-02210-3","DOIUrl":"10.1038/s41366-026-02210-3","url":null,"abstract":"<p><strong>Background/objectives: </strong>Information is lacking about how trimester-specific gestational weight gain (GWG) is associated with childhood body mass index (BMI) across maternal BMI categories.</p><p><strong>Subjects/methods: </strong>We examined the association between GWG and child BMI in patients receiving care from a national network of community health care organizations. We stratified by pre-pregnancy BMI (n = 5721 normal weight; 5667 overweight; 3213 obesity class I; 1344 class II; 692 class III). Child BMI z-score and overweight and obesity status at age 5 were modeled as a function of total GWG and GWG rate in each trimester, controlling for GWG rate in previous trimester(s) and maternal characteristics, using linear or modified Poisson regression.</p><p><strong>Results: </strong>Higher total GWG during pregnancy was positively associated with child BMI at 5 years of age in a linear, dose-dependent manner. When stratified by BMI, each 1 kg/week greater weight gain in the first trimester was associated with a 0.25-0.45 increase in child BMI z-score, depending on BMI class. Each 1 kg/week weight gain in the 2^nd trimester was associated with a 0.28 to 0.52 increase in child BMI z-score, although the associations were not significant in class III obesity. Associations between GWG in the third trimester and child BMI z-score were weak (-0.07 to 0.21 increase in BMI z-score per kg/week increase in maternal weight) and generally not significant.</p><p><strong>Conclusion: </strong>Among a diverse and systemically underserved pregnant population, GWG in the 1^st and 2^nd trimesters are most strongly associated with child BMI at age 5. Early pregnancy and mid-pregnancy may be key times to intervene to prevent overweight and obesity in offspring.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989861","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":"Changes in plasma levels of a selected panel of miRNAs do not explain the shift from cholesterol-synthesizer to cholesterol-absorber phenotype in men with abdominal obesity after diet-induced weight loss.","authors":"Maurice C J M Konings, Ronald P Mensink, Peter J Joris, Mark V Boekschoten, Casper G Schalkwijk, Alfons J H M Houben, Jogchum Plat","doi":"10.1038/s41366-026-02217-w","DOIUrl":"https://doi.org/10.1038/s41366-026-02217-w","url":null,"abstract":"<p><strong>Background: </strong>Individuals with overweight or obesity exhibit a cholesterol-synthesizer phenotype (high plasma lathosterol/campesterol ratio). Previously, we have reported that weight loss in men with abdominal obesity shifted this phenotype towards a cholesterol-absorber (low plasma ratio) profile. Given the role of microRNAs (miRNA) in cholesterol metabolism, we hypothesized that this shift is mediated by changes in regulatory miRNAs.</p><p><strong>Objective: </strong>To assess whether a panel of pre-selected plasma miRNAs mediates the phenotype switch from cholesterol-synthesizer to cholesterol-absorber following weight loss.</p><p><strong>Methods: </strong>An untargeted serum miRNA screening approach was performed. From an existing database (N = 367), samples from participants with the highest (N = 8) and the lowest (N = 8) plasma lathosterol/campesterol ratios were selected. Three microRNAs associated with cholesterol-synthesizers and three miRNAs associated with cholesterol-absorbers were identified. Changes in these miRNAs were then evaluated in a well-controlled weight-loss study. For this, men with abdominal obesity were randomized into a no-weight-loss control group (N = 26) and a weight-loss group (N = 23) that lost 10.3 kg body weight. Pre- and post-intervention, plasma microRNA levels were measured.</p><p><strong>Results: </strong>The screening identified miR-486-5p, miR-320b-3p and miR-185-5p as associated with the cholesterol-synthesizer phenotype, and miR-4529-3p, miR-3613-5p and miR-6776-5p with the cholesterol-absorber phenotype. One miRNA assay (miR-4529-3p) was unreliable and excluded from further analysis. Although the expected phenotype shift after weight loss was observed, changes in plasma miRNA levels were not significantly different between the two groups.</p><p><strong>Conclusion: </strong>In men with abdominal obesity, these five plasma miRNAs did not contribute to the observed phenotype switch from cholesterol-synthesizer towards cholesterol-absorber following weight loss.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976694","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":"Body mass index and regional brain N-acetylaspartate: a systematic review and meta-analysis of ¹H-MRS studies.","authors":"Cameron MacGillivray, Linzhi Wu, Julia Fraiha-Pegado, Sean McWhinney, Tomas Hajek","doi":"10.1038/s41366-026-02214-z","DOIUrl":"https://doi.org/10.1038/s41366-026-02214-z","url":null,"abstract":"<p><strong>Background/objectives: </strong>Obesity has increasingly been associated with structural brain alterations and cognitive dysfunction; however, the neurometabolic correlates of these findings remain unclear. Proton magnetic resonance spectroscopy (¹H-MRS) provides a non-invasive method for examining neurometabolites in vivo, including N-acetylaspartate (NAA), a marker commonly associated with neuronal integrity and mitochondrial metabolism. The present study systematically reviewed and quantitatively synthesized existing ¹H-MRS literature examining the relationship between body mass index (BMI) and regional brain NAA concentrations.</p><p><strong>Subjects/methods: </strong>Following PRISMA guidelines, systematic searches of PubMed, Scopus, and Embase identified 23 eligible studies. Separate regional random-effects meta-analyses were conducted for categorical comparisons between groups with normal weight and groups with overweight or obesity, and for continuous associations between BMI and NAA. Supplementary pooled analyses were conducted across brain regions to quantify an overall brain-wide assessment.</p><p><strong>Results: </strong>Higher BMI was associated with lower NAA concentrations within the frontal region across both categorical (Hedges' g = -0.48, 95% CI [-0.93, -0.03], p = 0.035) and continuous analyses (r = -0.218, 95% CI [-0.323, -0.108], p < 0.001). Additional significant associations were observed in the right hippocampal region in the categorical analysis (Hedges' g = -0.51, 95% CI [-0.84, -0.19], p = 0.002) and the parietal region in the continuous analysis (r = -0.256, 95% CI [-0.463, -0.022], p = 0.032). Pooling results across all regions demonstrated consistently significant negative BMI-NAA associations across continuous analyses of both the lower-bound (most negative) and upper-bound (least negative/most positive) models, while categorical pooled analyses retained significance only within the lower-bound model.</p><p><strong>Conclusions: </strong>In this meta-analysis, higher BMI was associated with lower neural NAA, most consistently in the frontal regions, but with pooled analyses suggesting more widespread NAA-obesity associations. Findings support the utility of ¹H-MRS as a complementary neuroimaging modality within obesity-related brain research.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976655","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":"Response to the comments by noor un nisa and colleagues.","authors":"Jing Wu, Feihong Luo","doi":"10.1038/s41366-026-02205-0","DOIUrl":"https://doi.org/10.1038/s41366-026-02205-0","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944775","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}