International Journal of Obesity最新文献

{"title":"Are low carbohydrate diet interventions beneficial for metabolic syndrome and its components? A systematic review and meta-analysis of randomized controlled trials.","authors":"Qi Zheng, Xin Gao, Xiang Ruan, Siju Chen, Xingchen Pan, Ruotong Wang, Lanjian Zhao, Zhouchen Yu, Die Li, Jinxia Zhai","doi":"10.1038/s41366-025-01822-5","DOIUrl":"10.1038/s41366-025-01822-5","url":null,"abstract":"<p><strong>Background: </strong>Diet plays a crucial role in metabolic syndrome (MetS) which might develop into diabetes mellitus and cardiovascular disease.</p><p><strong>Objective: </strong>We aimed to evaluate the effects of low-carbohydrate diet (LCD) interventions on MetS and its components.</p><p><strong>Methods: </strong>Four electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, and Medline were selected from database inception until March 2024. Randomized clinical trials in adults with MetS evaluated LCD interventions (50-130 g of carbohydrates/day or 10-40% of total dietary energy at 2000 kcal/day) and a control intervention for at least 12 weeks. Four reviewers independently extracted data and assessed risk of bias using Cochrane tool. Meta-analyses used a random-effects model to calculate mean differences (MD) and 95% confidence intervals (CI) and analyzed heterogeneity, sensitivity, and publication bias.</p><p><strong>Results: </strong>A total of 41 articles satisfied the study's inclusion criteria. Thirty articles were incorporated in the meta-analysis, of which 25 were high-quality studies and 5 were of moderate quality. In total, 3806 adults were assessed. Pooled analysis of mean differences (MD) indicated that compared to the control dietary intervention, the LCD intervention reduced BMI (MD -0.43 kg/m², 95% CI -0.75, -0.11), waist circumference (MD -0.77 cm, 95% CI -1.43, -0.12), systolic blood pressure (MD -1.19 mmHg, 95% CI -2.36, -0.02), diastolic blood pressure (MD -1.49 mmHg, 95% CI -2.36, -0.02), HbA1c (MD -0.62%, 95% CI -0.91, -0.32) and triglycerides (MD -0.24 mmol/L, 95% CI -0.42, -0.05), and increased high-density lipoprotein cholesterol (MD 0.06 mmol/l, 95% CI 0.03, 0.09). The subgroup analysis results indicated that the source of high heterogeneity might come from the dosage of intervention.</p><p><strong>Conclusion: </strong>In summary, LCD interventions improved MetS-related biomarkers in adults with MetS. Moreover, further research is needed to determine the optimal intervention period of LCD on MetS.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1252-1263"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511930","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":"Cross-cultural differences in weight loss maintenance: a comparison between North America and Europe.","authors":"Suzanne Phelan, Michelle I Cardel, Alexandra M Lee, Noemi Alarcon, Nicholas A Elich, Mark Hiroshi Sugita Troftgruben, Gary D Foster","doi":"10.1038/s41366-025-01770-0","DOIUrl":"10.1038/s41366-025-01770-0","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare behavioral, psychosocial, and neighborhood environmental factors of long-term weight loss maintainers in North America and Europe.</p><p><strong>Methods: </strong>Participants were weight loss maintainers in WeightWatchers in North America (n = 3656) and Europe (n = 624) who had maintained a ≥ 9.1 kg (21.7 kg on average) weight loss for ≥1 year (5.3 years on average) and had a current mean BMI of 29.9 kg/m². Validated surveys assessed behavioral (e.g., self-weighing, dietary strategies, restaurant eating, physical activity, sedentary time) psychological (e.g., habit strength, future focus, diet consistency, motivation, quality of life, body image, internalized weight bias), and neighborhood environment factors.</p><p><strong>Results: </strong>Weight loss maintainers in North America vs. Europe had higher odds of weekly self-weighing (95% vs. 91%; OR = 1.7 [95% CI: 1.1, 2.5]), eating at fast food restaurants ≥weekly (11.6% vs. 2.6%; 7.7 [3.9, 14.3]; p < 0.001]), and other restaurants (29.7% vs 17.3%; OR = 1.47 [1.2, 2.1]; p < 0.001), more positive scores for body image (21.4 vs.20.7; η_p² = 0.253; p < 0.001) and body satisfaction (28.7 vs 22.8; η_p² = 0.248; p < 0.001), less weight bias internalization (3.0 vs 3.1; η_p² = 0.320; p < 0.001), shape concerns (2.3 vs 2.4; η_p² = 0.181; p < 0.001) and weight concerns (2.6 vs2.7; η_p² = 0.176; p < 0.001), and higher quality of life (75.0 vs. 73.4; η_p² = 0.154; p < 0.001), including general health perception (72.3 vs 68.1; η_p² = 0.187; p < 0.00), and physical functioning (81.3 vs 79.2; η_p² = 0.252; p < 0.001). In a multivariable regression, the variables that most strongly differentiated weight loss maintainers in North America and Europe were fast food consumption (OR = 10.8 [4.6, 25.5] p < 0.001) and self-weighing (OR = 1.9 [1.2,3.0]; p < 0.01).</p><p><strong>Conclusions: </strong>Weight loss maintainers in North America and Europe differed in restaurant eating and self-weighing practices but otherwise reported similar behavioral, psychological, and environmental strategies.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1297-1306"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994455","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":"Higher-weight social identity as a risk and protective factor in the negative health consequences of weight stigma: a systematic review.","authors":"Alice Hudson, Luisa Batalha, Joseph Ciarrochi","doi":"10.1038/s41366-025-01755-z","DOIUrl":"10.1038/s41366-025-01755-z","url":null,"abstract":"<p><strong>Background: </strong>Weight stigma causes significant physical and psychological harm to its targets.</p><p><strong>Objective: </strong>This review aims to determine when identifying as a member of the higher-weight group exacerbates versus mitigates the adverse effects of weight stigma.</p><p><strong>Methods: </strong>Searches were conducted on 10 January, 2025, using PsycInfo, Medline, Scopus, Web of Science, Embase, and CINAHL. Evidence was synthesised in terms of exacerbating versus protective effects of higher-weight social identity (as moderator/mediator) in the relationship between weight stigma and 18 distinct health outcomes. This review is registered on PROSPERO (ID: CRD42023415639).</p><p><strong>Results: </strong>Fourteen studies met the inclusion criteria. Studies employing weight status measures to assess higher-weight social identity identified actual and self-perceived higher-weight as risk factors for anticipated rejection, dietary control challenges, increased physiological stress and greater functional disability following stigmatisation. Conversely, studies measuring individual connection with the higher-weight group revealed that stronger identification had protective effects on self-esteem and distress, but only for specific individuals (e.g., those with low internalised weight bias).</p><p><strong>Limitations: </strong>Grey literature and unpublished studies were not reviewed.</p><p><strong>Conclusions: </strong>Initial evidence suggests that higher-weight social identity functions as both risk and protective factor in the relationship between weight stigma and well-being.</p><p><strong>Implications: </strong>Future research should explore the emotional and evaluative components of higher-weight social identity to enhance understanding of how and when group membership influences the adverse effects of weight stigma. This knowledge can inform targeted interventions designed to improve the well-being of higher-weight individuals.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1209-1228"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003406","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":"Ultraviolet exposure of mice fed a high fat diet reduces weight gain and markers of liver disease progression.","authors":"Gareth Hazell, Marina Khazova, Hannah Mancey, Raymond Shek, Paul O'Mahoney","doi":"10.1038/s41366-025-01779-5","DOIUrl":"10.1038/s41366-025-01779-5","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that ultraviolet (UV) exposure of mice placed on a high fat diet can reduce incidence of metabolic disease. However, current research had primarily focused on male mice with UV outside level of terrestrial sunlight.</p><p><strong>Objectives: </strong>Here we attempt to address this imbalance, with a pilot study presented wherein female mice C57Bl6 mice are included, with UV exposure at level comparable to low dose (non-burning) sunlight exposure.</p><p><strong>Methods: </strong>2% UV-B and 98% UV-At a dose of 1.83 J/cm² with UV-A and 0.04 J/ cm² UV-B were delivered over a 10-min timeframe twice weekly. Mice were placed on a low-fat diet or high fat diet, with the high fat diet cohort either exposed twice weekly to UV light or sham exposed.</p><p><strong>Results: </strong>Non-significant trends are observed for weight amelioration in UV exposed mice across both sexes at study endpoint, whereas in the liver, a reduction of lipid droplet size due to UV exposure is observed. Assessment of vitamin D status at study endpoint shows that the high fat diet increases 25(OH)D level in both sexes, more so in female mice, with further non-significant rises due to UV exposure.</p><p><strong>Conclusions: </strong>This study supports previous evidence that non-vitamin D mediated pathways may be responsible for the outcomes reported in this study. The UV exposures used in this study also resulted in minimal damage to ex vivo skin or in vitro cells, as assessed by cyclobutene-pyrimidine dimers (CPD's) (characteristic signature mutations induced by UV), and double stranded breaks, further demonstrating the potential benefit of such exposures. This study supports and builds on current evidence that non-vitamin D pathways mediated through UV exposure may be beneficial in slowing weight gain and liver disease progression.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1373-1381"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980450","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":"Personality, eating behaviour, and body weight: results from the population study of women in Gothenburg 2016/17.","authors":"Lena Farhan, Dominique Hange, Tore Hällström, Cecilia Björkelund, Lauren Lissner, Lisbeth Stahre, Kirsten Mehlig","doi":"10.1038/s41366-025-01764-y","DOIUrl":"10.1038/s41366-025-01764-y","url":null,"abstract":"<p><strong>Aims: </strong>The aim was to investigate the cross-sectional associations between personality traits, psychogenic needs and eating behaviour, and to describe the extent to which personality influences the association between eating behaviour and weight status.</p><p><strong>Methods: </strong>In 2016/17, a population-based sample of 573 women in Gothenburg, Sweden aged either 38 or 50 participated in a health examination. They completed the Three-Factor Eating Questionnaire, measuring uncontrolled eating, emotional eating and cognitive restraint on a scale of zero to 100. Scores higher than 50 defined excessive eating behaviour. The Cesarec-Marke Personality Schedule was used to measure psychogenic needs, characterised by pursuits and objectives that define personality and influence actions. Extraversion and neuroticism were assessed using the Eysenck-Personality Inventory. Regression models for excessive eating behaviour and for logarithmic body mass index (BMI) as a function of standardised personality scores were adjusted for sociodemographic, lifestyle and health factors.</p><p><strong>Results: </strong>A higher need to defend one's status (DST) was positively associated with excessive uncontrolled eating, odds ratio (OR) = 1.44, 95% confidence interval = (1.11, 1.86) per standard deviation (SD) of DST. The need to defend one's status was more strongly associated with excessive emotional eating, OR = 1.61 (1.18, 2.20) than neuroticism, OR = 1.45 (1.06, 1.97), in a mutually adjusted model. Needs for achievement and autonomy were associated with excessive cognitive restraint, OR = 1.39 (1.09, 1.76) and 0.78 (0.62, 0.97), respectively. Excessive emotional eating was associated with 5.3 (1.1, 9.6) % higher values of BMI when adjusted for the need of DST, which was associated with -2.7 (-4.1, -1.3) % lower BMI per SD.</p><p><strong>Conclusions: </strong>Psychogenic needs were more closely associated with eating behaviour than personality traits. A lower need to defend one's status and excessive emotional eating were independently associated with higher BMI, suggesting different pathways to obesity and treatment strategies.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1272-1279"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788352","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":"Serum secreted EMC10 (scEMC10) levels are inversely associated with metabolically active brown adipose tissue in humans.","authors":"Qing Miao, Yahao Wang, Qiongyue Zhang, Wei Wu, Yifei Yu, Fangfang Zeng, Yehong Yang, Chuantao Zuo, Yihui Guan, Chong Wee Liew, Matthias Blüher, Yiming Li, Xuanchun Wang","doi":"10.1038/s41366-025-01744-2","DOIUrl":"10.1038/s41366-025-01744-2","url":null,"abstract":"<p><strong>Background/objectives: </strong>Secreted endoplasmic reticulum membrane complex subunit 10 (scEMC10) has been implicated in obesity in mice and humans. In this study, the associations of serum scEMC10 levels with thermoneutrality-modulated brown adipose tissue (BAT) activity and thyroid hormone (TH)-dependent thermogenesis were investigated in humans.</p><p><strong>Subjects/methods: </strong>Serum scEMC10 levels were measured in participants from multiple cohorts using enzyme-linked immunosorbent assay, including participants with or without active BAT determined by PET-CT scanning, participants with positive BAT before and after thermoneutrality, and patients with hyperthyroidism before and after anti-thyroid drug (ATD) treatment. The difference in serum scEMC10 between participants with positive or negative BAT, and the changes of serum scEMC10 in participants with positive BAT before and after thermoneutrality and in patients with Grave's disease-caused hyperthyroidism before and after ATD treatment were determined.</p><p><strong>Results: </strong>PET-CT scan with ¹⁸F-FDG indicated participants with positive BAT were significantly younger and leaner than ones with negative BAT. There was, however, no significant difference in serum scEMC10 between the two groups. Serum scEMC10 levels in participants with positive BAT were significantly elevated by 2-h thermoneutrality (p = 0.0017), concomitant with disappearance of active BAT. No significant association of serum scEMC10 with serum levels of either TSH, FT3, or FT4 was observed in participants from both Chinese and White cohorts. ATD treatment normalized thyroid function and reduced the uptake of ¹⁸F-FDG into skeletal muscle of patients with hyperthyroidism. Serum scEMC10 concentration, however, remained unchanged in these patients before and after ATD treatment.</p><p><strong>Conclusions: </strong>Serum scEMC10 levels are inversely associated with BAT activity in humans.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1264-1271"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656969","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":"Associations of smoking status and leisure-time physical activity with waist circumference change-10-year follow-up among twin adults.","authors":"Maarit Piirtola, Eeva-Liisa Filippone, Anu Ranjit, Taru Kinnunen, Jaakko Kaprio, Tellervo Korhonen","doi":"10.1038/s41366-025-01820-7","DOIUrl":"https://doi.org/10.1038/s41366-025-01820-7","url":null,"abstract":"<p><strong>Background: </strong>This cohort study investigated the associations of smoking status and leisure-time physical activity (LTPA) with weight circumference (WC) change.</p><p><strong>Methods: </strong>In the FinnTwin16 cohort, 3322 twins (46% men) reported smoking status, LTPA, and WC in early adulthood and 10 years later providing information on essential covariates at baseline. The effects of smoking status and LTPA (metabolic equivalent tasks [MET]-h/week) on WC change (cm) were estimated by modeling WC value at the end of follow-up and adjusted for baseline WC in linear regression models. Within-pair associations were analyzed using linear fixed-effect regressions among 660 dizygotic and 390 monozygotic twin pairs.</p><p><strong>Results: </strong>During the 10-year follow-up, 36.4% (n = 273) of baseline daily smokers quit smoking. Among those who quit daily smoking, the mean WC increase was 8.4 cm (SD 8.1). Quitters who smoked daily at baseline increased WC by about 2 cm more than continuing smokers (adjusted β 2.04; 95% CI 0.94, 3.14). This association was not robust after shared familial influences were controlled for. In general, the participants decreased LTPA during follow-up, except the quitters with the mean LTPA increase of 5.0 MET-h/week (SD 35.0). Independently of smoking status, each additional MET-h/week was associated with 0.06 cm less WC increase (adjusted β -0.06; 95% CI -0.07, -0.05). This association was replicated in the within-pair analyses.</p><p><strong>Conclusions: </strong>Smoking cessation seems to be associated with WC increase, but familial confounding may be involved in this process. LTPA appears to mitigate increase in WC independently of smoking status and familial influences.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527873","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":"Prevalence and changes of childhood overweight across China and its provinces from 2000 to 2030.","authors":"Xiaoling Wang, Jing Nie, Chao Niu, Yuan Qiu, Zeru Xu, Hong Zhu, Jian Wang, Zimiao Chen, Xiaokun Li, Xiong Chen","doi":"10.1038/s41366-025-01813-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01813-6","url":null,"abstract":"<p><strong>Objectives: </strong>Childhood obesity has emerged as a significant public health challenge and there is an urgent need to improve the effectiveness of local government governance to curb its growth. We aimed to estimate the prevalence and changes of childhood overweight (including obesity) across China and its provinces from 2000 to 2019 and to project the prevalence by 2030, stratified by sex.</p><p><strong>Methods: </strong>This study utilized data from the Institute for Health Metrics and Evaluation (IHME), which generated local-, administrative-, and national-level estimates of overweight prevalence among children under 5 years of age at a 5 × 5 km resolution for several low- and middle-income countries (LMICs) between 2000 and 2019 using a model-based geostatistical approach. Temporal trends were analyzed by sex and region using Joinpoint Regression, while overweight prevalence in China and its provinces was projected up to 2030 using polynomial regression models.</p><p><strong>Results: </strong>Overweight prevalence among children under five years of age increased from 17.9% (95% CI: 14.9 to 21.3) in 2000 to 22.1% (95% CI: 14.9 to 30.9) in 2019, which was higher among boys than girls. Extrapolating from current growth trends, the forecast results showed approximately 25.1% (95% CI: 23.2 to 27.0) of children in China would be overweight by 2030. Only two of the 31 provinces (Shanxi and Inner Mongolia) were on track to meet China's obesity prevention and control targets by 2030. The overweight burden from 2000 to 2019 was assessed across 33 provincial-level administrative units, with the greatest burdens concentrated in northeastern China and the provinces of Hunan, Hong Kong, and Macao.</p><p><strong>Conclusions: </strong>Childhood obesity in China has become a major public health problem with a steadily rising prevalence. This study underscores the urgent need for evidence-based policy and clinical interventions to stem the tide of obesity in Chinese preschool children.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511931","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":"Enhancing obesity management in primary care: the role of registered dietitian nutritionists.","authors":"Brian Burroughs, Michaeleen Burroughs, Tamim Rajjo","doi":"10.1038/s41366-025-01786-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01786-6","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484331","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":"Do lower antenatal blood pressure cut-offs in pregnant women with obesity identify those at greater risk of adverse maternal and perinatal outcomes? A secondary analysis of data from the UK Pregnancies Better Eating and Activity Trial (UPBEAT).","authors":"L Slade, N Syeda, H D Mistry, J N Bone, M Wilson, M Blackman, L Poston, K M Godfrey, P von Dadelszen, L A Magee","doi":"10.1038/s41366-025-01803-8","DOIUrl":"https://doi.org/10.1038/s41366-025-01803-8","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major risk-factor for adverse pregnancy outcomes. While the 2017 American College of Cardiology/American Heart Association (ACC/AHA) classification of normal and abnormal blood pressure (BP) outside pregnancy has been suggested for use in pregnancy, the impact on adverse outcomes has not been examined specifically in women with obesity.</p><p><strong>Methods: </strong>The UK Pregnancies Better Eating and Activity Trial (UPBEAT) enroled women with a body mass index (BMI) ≥ 30 kg/m². In secondary analyses, maximal antenatal BP was categorised by 2017 ACC/AHA criteria: 'Normal' BP (systolic [sBP] <120 mmHg and diastolic [dBP] <80 mmHg), 'Elevated' BP (sBP 120-129 mmHg and dBP <80 mmHg), 'Stage 1 hypertension' (sBP 130-139 mmHg and/or dBP 80-89 mmHg), and 'Stage 2 hypertension' (sBP ≥140 mmHg and/or dBP ≥90 mmHg, non-severe [sBP 140-159 mmHg and/or dBP 90-109 mmHg] and severe (sBP ≥160 mmHg and/or dBP ≥110 mmHg). Main outcomes were preterm birth, postpartum haemorrhage (PPH), birthweight <10th centile (small-for-gestational age, SGA), and neonatal intensive care unit (NICU) admission. Associations with adverse outcomes were adjusted for UPBEAT intervention, maternal age, booking BMI, ethnicity, parity, smoking, alcohol, and previous pre-eclampsia or gestational diabetes. Diagnostic test properties (positive and negative likelihood ratios, -LR and +LR) were assessed as individual categories (vs. 'Normal' BP), and as threshold values.</p><p><strong>Results: </strong>Severe 'Stage 2 hypertension' (vs. BP < 160/110 mmHg) was associated with PPH (RR 2.57 (1.35, 4.86)) and SGA (RR 2.52 (1.05, 6.07)) only in unadjusted analyses. No outcomes were associated with 'Stage 1 hypertension' or 'Elevated BP'. All +LR were <5.0 and -LR ≥ 0.20, indicating that no BP threshold was useful as a diagnostic test to detect preterm birth, PPH, SGA, or NICU admission.</p><p><strong>Conclusions: </strong>Among pregnant women with obesity, we found no evidence that lowering the antenatal BP considered to be abnormal (from 140/90 mmHg) would assist in identifying women and babies at risk.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309849","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}