International Journal of Obesity最新文献

{"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":"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":"1523-1531"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396956/pdf/","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":"OA","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":"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":"1623-1631"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","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}

{"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":"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":"1654-1661"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","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":"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":"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":"1632-1641"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396966/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of other macronutrient composition within high-protein diet on body composition and cardiometabolic health: a systematic review, pairwise, and network meta-analysis of randomized controlled trials.","authors":"Yueying Yao, Shiqi Lin, Ziqi He, Jung Eun Kim","doi":"10.1038/s41366-025-01806-5","DOIUrl":"10.1038/s41366-025-01806-5","url":null,"abstract":"<p><strong>Background/obejctive: </strong>Although the high-protein diets (HPDs) on weight control and body composition management are well investigated, mix results have been reported across studies and this variability may be attributed to differences in the composition of other macronutrients within HPDs. The aim of this study was to evaluate the impacts of HPDs with varied macronutrient compositions on body composition and cardiometabolic health outcomes through a systematic review, pairwise, and network meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search of four databases (PubMed, Embase, CINAHL, and Web of Science) was conducted to identify relevant randomized controlled trials. A total of 83 articles were selected for systematic review and both meta-analyses.</p><p><strong>Results: </strong>Significant reduction in body mass (BM) (standardized mean difference [SMD] = -0.25; 95% CI: -0.40, -0.11), body mass index (BMI) (SMD = -0.26; 95% CI: -0.38, -0.15), waist circumference (WC) (SMD = -0.19; 95% CI: -0.33, -0.04), fat mass (FM) (mean difference [MD] = -0.64 kg; 95% CI: -0.98, -0.29), along with increase in lean body mass (LBM) (MD = 0.34 kg; 95% CI: 0.11, 0.57) were observed with HPDs regiments compared to normal-protein diets. Specifically, the high-protein, moderate-carbohydrate and high-fat diet ranked the best in reducing BM, BMI, WC, FM, systolic blood pressure, diastolic blood pressure and increasing LBM; while the high-protein, low-carbohydrate and high-fat diet obtained the highest score in reducing triglyceride and increasing high-density lipoprotein cholesterol.</p><p><strong>Conclusion: </strong>HPDs effectively reduce FM and increase LBM, and offers potential cardiometabolic benefits. Additionally, the manipulation of carbohydrate content in HPDs may further influence these outcomes.</p><p><strong>Registration: </strong>PROSPERO (CRD42023483907).</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":"1480-1489"},"PeriodicalIF":3.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995527","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":"Mechanisms of metabolic surgery effectiveness in obesity and type 2 diabetes: a puzzle with some known pieces.","authors":"Claudio Blasi","doi":"10.1038/s41366-025-01853-y","DOIUrl":"https://doi.org/10.1038/s41366-025-01853-y","url":null,"abstract":"<p><p>Metabolic surgery is currently the most effective available treatment for obesity and diabetes. However, it cannot be practiced widely, as some potential candidate patients do not have access to this procedure, primarily because it is expensive, necessitates experience on the part of operators, and requires adequate hospital facilities. Furthermore, side effects, although rare, remain a problem. Consequently, an ideal approach would be to reproduce the mechanisms of action of metabolic surgery through a noninvasive pharmacological treatment. To accomplish this, it is necessary to determine the exact mechanisms involved. Despite numerous studies in this field, a definitive conclusion has not yet been reached. Some of the known effects of metabolic surgery on organisms are described herein. Upon in-depth examination, all can be traced back to a functional modification of the autonomic GI-brain axis, mediated by afferent vagal fibers, establishing a constant relationship with brain centers to control food intake. These mechanisms act through the postsynaptic receptors of certain neurotransmitters. A viable path for implementing a pharmacological therapy for obesity may therefore be to identify drugs that act on these receptors to achieve adequate therapeutic responses. Possible candidates include substances that modulate various subtypes of NMDA glutamate receptors or gamma-aminobutyric acid (GABA) receptors. In conclusion, autonomic modifications which have so far been shown to be activated by metabolic surgery represent the pieces of a puzzle which, when put together, allow us to identify the functional modification of the GI-brain vagal axis as the primary cause of this treatment's positive effects. These findings suggest the plausibility of an alternative pharmacological mechanism.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760071","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":"The mixed-meal tolerance test as an appetite assay: methodological and practical considerations.","authors":"James A King, Alice E Thackray, Catherine Gibbons, Catia Martins, David R Broom, David J Stensel, Dimitris Papamargaritis, Frank Arsenyadis, Graham Finlayson, Gráinne Whelehan, Javier T Gonzalez, John Blundell, Kristine Beaulieu, Lewis James, Lore Metz, Mark Hopkins, Masashi Miyashita, Scott A Willis, Vicky Drapeau, David Thivel","doi":"10.1038/s41366-025-01866-7","DOIUrl":"https://doi.org/10.1038/s41366-025-01866-7","url":null,"abstract":"<p><p>Appetite control is a topic which attracts widespread interest given its importance to energy balance and obesity. In this research area, the mixed-meal tolerance test (MM-TT) has emerged as an 'appetite regulation assay', facilitating the dynamic assessment of appetite parameters (e.g. subjective appetite perceptions, appetite-related hormones, food reward) in response to an individual meal. The MM-TT is commonly employed in observational and experimental studies to examine population differences and intervention effects. Problematically, no practice standard exists for the MM-TT and protocols vary widely. This presents a challenge for researchers designing new MM-TTs and hampers the comparability of findings. Therefore, within this narrative review we sought to identify and discuss key methodological considerations inherent within a MM-TT. The scope of our review extends to evaluating participant familiarisation and methodological standardisation practices, test meal characteristics, appetite perception assessment, blood sampling techniques, measurement of appetite-related hormones and data handling/analysis. A checklist has been devised to summarise relevant methodological issues identified within this review. This checklist can be used as a tool by researchers to facilitate MM-TT design and promote greater standardisation/comparability between studies. This review highlights the need for broader standardisation of MM-TT procedures to support consistency across future research. Additional research is needed to strengthen the evidence base on which various recommendations are made, particularly relating to participant familiarisation and methodological standardisation practices. Additional scrutiny of less common outcomes employed in MM-TTs (not addressed here), such as diet-induced thermogenesis, gastric emptying and ad libitum energy intake, is also needed.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753332","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":"Agomelatine alleviates palmitic acid-induced mouse oocyte meiosis defects by restoring mitochondrial function.","authors":"Ruolin Zhao, Yujie Tang, Yingbing Zhang, Jinwang Liu, Changsheng Zhong, Bozhen Ji, Weijia Song, Chengtu Zhang, Jianmin Su","doi":"10.1038/s41366-025-01825-2","DOIUrl":"10.1038/s41366-025-01825-2","url":null,"abstract":"<p><strong>Background/objective: </strong>Palmitic acid (PA) is known to be elevated in the follicular fluid of women with obesity, negatively affecting female fertility. However, the mechanism by which PA exposure reduces female fertility is not fully understood, and how it can be treated requires further investigation.</p><p><strong>Methods: </strong>We first established in vivo and in vitro models of mouse oocyte maturation at high concentrations of PA and determined the effects of treatment with agomelatine (Ago) which is a melatonin receptor agonist with antioxidant properties. We assessed oocyte maturation rates, spindle morphology and chromosome morphology, oxidative stress and apoptosis levels. Lastly, we examined energy levels, mitochondrial function, and mitochondrial synthesis-related protein expression levels.</p><p><strong>Results: </strong>Our results showed that PA exposure disrupted spindle assembly and chromosome alignment, reduced microtubule stability, and impaired the meiotic maturation of oocytes. PA also disrupted mitochondrial function, leading to decreased ATP production, elevated Reactive Oxygen Species(ROS) levels, oxidative stress, and apoptosis. Remarkably, Ago supplementation promoted oocyte quality by restoring spindle/chromosome conformation, maintaining mitochondrial function, lowering ROS levels, and inhibiting apoptosis.</p><p><strong>Conclusions: </strong>This study establishes that Ago ameliorates metabolic stress-induced oocyte deterioration through mitochondrial functional restoration, providing mechanistic insights into obesity-associated infertility. Importantly, our study identifies a potentially favorable drug for combating obesity-induced female infertility.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730858","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":"Characterizing the effect of bariatric surgery on circulating S100A9.","authors":"Hamza Ahmed, Alondra Guzman, Ruina Zhang, Manish Parikh, Sean P Heffron","doi":"10.1038/s41366-025-01868-5","DOIUrl":"10.1038/s41366-025-01868-5","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery (BS) is associated with improved cardiovascular (CV) outcomes in individuals with obesity. One proposed mechanism is reduced inflammation. S100A9, a pro-inflammatory cytokine, is elevated in obesity. S100A9, particularly expression in platelets, has been associated with CV risk. The impact of BS on circulating and platelet S100A9 in obesity is unknown.</p><p><strong>Methods: </strong>We studied serum, plasma, and platelet supernatants from subjects with obesity pre- and post-BS (n = 23) and lean volunteers (n = 8). S100A9 levels were quantified using an S100A9 immunoassay. Wilcoxon, Mann-Whitney, and t-tests were performed to assess changes in S100A9 levels pre- and post-operatively and compare levels across sample and subject types. Spearman tests were used to assess correlations between S100A9 levels in different sample types and neutrophil/platelet counts.</p><p><strong>Results: </strong>Serum and plasma S100A9 concentrations were elevated in individuals with obesity relative to lean individuals. Levels decreased to lean subject levels at 1-year post-BS, despite subjects with obesity remaining overweight. Circulating neutrophil counts also decreased post-BS, and post-BS differences in serum S100A9 were eliminated when calculated per-neutrophil. Platelet supernatant S100A9 levels were lower than in serum and plasma and did not change post-BS. Platelet supernatant S100A9 correlated with plasma, but not serum, levels.</p><p><strong>Conclusion: </strong>We found that S100A9 concentrations differ substantially between blood components, are elevated in obesity, and normalize post-BS. Reductions in circulating S100A9 may contribute to reduced inflammation and be largely driven by resolution of obesity-associated neutrophilia. Our data suggest minimal platelet contribution to circulating (or systemic) S100A9, but a local level inflammatory impact cannot be excluded.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730859","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":"Mortality and complications in patients with obesity after open, robotic or laparoscopic pancreaticoduodenectomy: A systematic review and meta-analysis.","authors":"Juan Carlos Barrera Gutierrez, Elaina Vivian, Jimmy Shah, Alejandro Mejia","doi":"10.1038/s41366-025-01844-z","DOIUrl":"10.1038/s41366-025-01844-z","url":null,"abstract":"<p><strong>Objectives: </strong>This meta-analysis compares outcomes of pancreaticoduodenectomy (PD) using open (OPD), robotic (RPD), and laparoscopic (LPD) techniques in patients with and without obesity and resectable pancreatic cancer.</p><p><strong>Methods: </strong>Thirteen observational studies evaluating 30-day mortality and postoperative complications in patients that underwent PD were included. Outcomes included mortality, major complications (Clavien-Dindo classification), and specific surgical complications: postoperative pancreatic fistula (POPF), post-PD hemorrhage (PPH), delayed gastric emptying (DGE), and surgical site infections (SSI).</p><p><strong>Results: </strong>Patients with obesity had higher 30-day mortality rates (2.42% vs. 1.63%; OR: 1.68, 95% CI: 1.35-2.08, p < 0.00001, I² = 0%) and major complications (23.3% vs. 17.12%; OR: 1.77, 95% CI: 1.27-2.46, p = 0.0007, I² = 52%) than patients without obesity. Obesity also increased the risk of POPF (21.9% vs. 13.76%; OR: 2.04, 95% CI: 1.69-2.46, p < 0.00001, I² = 26%), PPH (7.31% vs. 6.26%; OR: 1.44, 95% CI: 1.07-1.94, p = 0.02, I² = 0%), and DGE (20.23% vs. 15.5%; OR: 1.98, 95% CI: 1.3-3.03, p < 0.00001, I² = 89%). SSI risk trended higher in patients with obesity but was not statistically significant (28.17% vs. 20.39%; OR: 1.80, 95% CI: 0.93-3.5, p = 0.08, I² = 90%). Among surgical techniques, patients with obesity who underwent OPD had higher risks of 30-day mortality (OR: 1.59, 95% CI: 1.26-2.00, p < .0001), major complications (OR 1.63, 95% CI 1.17-2.28, p = 0.004), and POPF (OR 1.98, 95% CI 1.59-2.47, p < 0.00001) than patients without obesity. In the RPD group, obesity increased the risk of 30-day mortality (OR: 2.68, 95% CI: 1.12-6.39, p = 0.03) and POPF (OR 3.32, 95% CI 1.68-6.57, p = 0.0006). In LPD, obesity was associated with a higher risk of POPF (OR 2.06, 95%CI 1.69-3.32, p = 0.003).</p><p><strong>Conclusions: </strong>Patients with obesity undergoing PD are at increased risk for 30-day mortality and major complications. OPD carries the highest overall risk, while RPD and LPD are linked to a greater POPF risk. These findings highlight the need for careful perioperative management in this high-risk population.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730860","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}