International Journal of Obesity最新文献

{"title":"Exposure to gestational diabetes mellitus in utero impacts hippocampal functional connectivity in response to food cues in children","authors":"Sixiu Zhao, Lorenzo Semeia, Ralf Veit, Shan Luo, Brendan C. Angelo, Ting Chow, Andreas L. Birkenfeld, Hubert Preissl, Anny H. Xiang, Kathleen A. Page, Stephanie Kullmann","doi":"10.1038/s41366-024-01608-1","DOIUrl":"10.1038/s41366-024-01608-1","url":null,"abstract":"Intrauterine exposure to gestational diabetes mellitus (GDM) increases the risk of obesity in the offspring, but little is known about the underlying neural mechanisms. The hippocampus is crucial for food intake regulation and is vulnerable to the effects of obesity. The purpose of the study was to investigate whether GDM exposure affects hippocampal functional connectivity during exposure to food cues using functional magnetic resonance imaging (fMRI). Participants were 90 children age 7–11 years (53 females) who underwent an fMRI-based visual food cue task in the fasted state. Hippocampal functional connectivity (FC) was examined using generalized psychophysiological interaction in response to food versus non-food cues. Hippocampal FC was compared between children with and without GDM exposure, while controlling for possible confounding effects of age, sex and waist-to-hip ratio. In addition, the influence of childhood and maternal obesity were investigated using multiple regression models. While viewing high caloric food cues compared to non-food cure, children with GDM exposure exhibited higher hippocampal FC to the insula and striatum (i.e., putamen, pallidum and nucleus accumbens) compared to unexposed children. With increasing BMI, children with GDM exposure had lower hippocampal FC to the somatosensory cortex (i.e., postcentral gyrus). Intrauterine exposure to GDM was associated with higher food-cue induced hippocampal FC especially to reward processing regions. Future studies with longitudinal measurements are needed to clarify whether altered hippocampal FC may raise the risk of the development of metabolic diseases later in life.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1-7"},"PeriodicalIF":4.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01608-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093145","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":"Does menu calorie labelling cause or exacerbate eating disorders?","authors":"Jane Brealey, Rebecca Evans, Amy Finlay, Thomas Gough, Megan Polden, I. Gusti Ngurah Edi Putra, Loukia Tzavella, Rozemarijn Witkam, Eric Robinson","doi":"10.1038/s41366-024-01622-3","DOIUrl":"10.1038/s41366-024-01622-3","url":null,"abstract":"ER and JB were responsible for conceptualisation and study design. JB screened prospective eligible studies, conducted the literature review and wrote the first draft of the manuscript. RE, AF, TG, MP, IP, LT and RW reviewed the literature and contributed to writing. All authors contributed to the manuscript writing, revision, editing, and approved the submitted version.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1679-1683"},"PeriodicalIF":4.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01622-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093144","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":"Randomized non-inferiority trial comparing an asynchronous remotely-delivered versus clinic-delivered lifestyle intervention.","authors":"Sherry L Pagoto, Jared M Goetz, Ran Xu, Monica L Wang, Lindsay Palmer, Stephenie C Lemon","doi":"10.1038/s41366-024-01617-0","DOIUrl":"https://doi.org/10.1038/s41366-024-01617-0","url":null,"abstract":"<p><strong>Objective: </strong>Lifestyle interventions are effective, but those delivered via in-person group meetings have poor scalability and reach. Research is needed to establish if remotely delivered lifestyle interventions are non-inferior to in-person delivered lifestyle interventions.</p><p><strong>Methods: </strong>We conducted a randomized non-inferiority trial (N = 329) to compare a lifestyle intervention delivered remotely and asynchronously via an online social network (Get Social condition) to one delivered via in-person groups (Traditional condition). We hypothesized that the Get Social condition would result in a mean percent weight loss at 12 months that was not inferior to the Traditional condition. Additional outcomes included intervention delivery costs per pound lost and acceptability (e.g., convenience, support, modality preferences).</p><p><strong>Results: </strong>At 12 months, no significant difference in percent weight change was observed between the Get Social and Traditional conditions (2.7% vs. 3.7%, p = 0.17) however, criteria for non-inferiority were not met. The Get Social condition costs $21.45 per pound lost versus $26.24 for the Traditional condition. A greater percentage of Get Social condition participants rated participation as convenient (65% vs 44%; p = 0.001).</p><p><strong>Conclusions: </strong>Results revealed a remotely-delivered asynchronous lifestyle intervention resulted in slightly less weight loss than an in-person version but may be more economical and convenient.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618 .</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080275","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":"Prolonged latency of the gustatory evoked potentials for sucrose solution in subjects living with obesity compared with normal-weight subjects","authors":"Thomas Mouillot,&nbsp;Marie-Claude Brindisi,&nbsp;Cyril Gauthier,&nbsp;Sophie Barthet,&nbsp;Clémence Quere,&nbsp;Djihed Litime,&nbsp;Manon Perrignon-Sommet,&nbsp;Sylvie Grall,&nbsp;Fabienne Lienard,&nbsp;Claire Fenech,&nbsp;Hervé Devilliers,&nbsp;Alexia Rouland,&nbsp;Marjolaine Georges,&nbsp;Luc Penicaud,&nbsp;Laurent Brondel,&nbsp;Corinne Leloup,&nbsp;Agnès Jacquin-Piques","doi":"10.1038/s41366-024-01607-2","DOIUrl":"10.1038/s41366-024-01607-2","url":null,"abstract":"A difference in cortical treatment of taste information could alter food intake promoting the development of obesity. The main purpose was to compare, in subjects living with obesity (OB) and normal-weight subjects (NW), the characteristics of gustatory evoked potentials (GEP) for sucrose solution (10 g.100 mL−1) before and after a standard lunch. The secondary objective was to evaluate the correlations between GEP and the plasmatic levels of acylated ghrelin, leptin, insulin and serotonin. Each subject had 2 randomized sessions spaced by an interval of 2 days. During one session, subjects were fasting and during the other, subjects took a lunch low in sugar. In each session, subjects had a blood test before a first GEP recording followed by a second GEP recording either after a lunch (feeding session) or no lunch (fasting session). Twenty-eight OB (BMI: 38.6 ± 9.0 kg.m−2) were matched to 22 NW (BMI: 22.3 ± 2.2 kg.m−2). GEP latencies were prolonged in OB regardless the sessions and the time before and after lunch, compared with NW (in Cz at the morning: 170 ± 33 ms vs 138 ± 25 ms respectively; p &lt; 0.001). The increase in latency observed in NW after lunch was not observed in OB. Negative or positive correlations were noted in all participants between GEP latencies and ghrelin, leptin, insulin plasmatic levels (P1Cz, r = −0.38, r = 0.33, r = 0.37 respectively, p &lt; 0.0001). This study highlights a slower activation in the taste cortex in OB compared with NW.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1-8"},"PeriodicalIF":4.2,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055523","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":"Effect of Helicobacter pylori on sleeve gastrectomy and gastric microbiome differences in patients with obesity and diabetes","authors":"Young Suk Park,&nbsp;Kung Ahn,&nbsp;Kyeongeui Yun,&nbsp;Jinuk Jeong,&nbsp;Kyung-Wan Baek,&nbsp;Do Joong Park,&nbsp;Kyudong Han,&nbsp;Yong Ju Ahn","doi":"10.1038/s41366-024-01611-6","DOIUrl":"10.1038/s41366-024-01611-6","url":null,"abstract":"Obesity and diabetes mellitus (DM) have become public health concerns worldwide. Both conditions have severe consequences and are associated with significant medical costs and productivity loss. Additionally, Helicobacter pylori infection may be a risk factor for the development of these conditions. However, whether eradicating H. pylori infection directly causes weight loss or improves insulin sensitivity is unknown. In this study, we confirmed the effect of sleeve gastrectomy according to the state of the gastric microbiota in 40 patients with obesity, DM, and H. pylori infection. Patients with obesity were divided into four groups: non-DM without H. pylori infection (ND), non-DM with H. pylori infection (ND-HP), DM, and DM with H. pylori infection (DM-HP) using 16S V3–V4 sequencing. In the DM group, ALT, hemoglobin, HbA1c, blood glucose, and HSI significantly decreased, whereas high-density lipoprotein significantly increased. However, in the H. pylori-positive group, no significant difference was observed. The diversity of gastric microbiota decreased in the order of the ND &gt; DM &gt; ND-HP &gt; DM-HP groups. We also conducted a correlation analysis between the preoperative microbes and clinical data. In the ND-HP group, most of the top 20 gastric microbiota were negatively correlated with glucose metabolism. However, H. pylori infection was positively correlated with pre-insulin levels. Therefore, these findings indicate that patients with obesity and diabetes clearly benefit from surgery, but H. pylori infection may also affect clinical improvement.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 11","pages":"1664-1672"},"PeriodicalIF":4.2,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046608","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":"Accurate prediction of three-dimensional humanoid avatars for anthropometric modeling","authors":"Cassidy McCarthy,&nbsp;Michael C. Wong,&nbsp;Jasmine Brown,&nbsp;Sophia Ramirez,&nbsp;Shengping Yang,&nbsp;Jonathan P. Bennett,&nbsp;John A. Shepherd,&nbsp;Steven B. Heymsfield","doi":"10.1038/s41366-024-01614-3","DOIUrl":"10.1038/s41366-024-01614-3","url":null,"abstract":"To evaluate the hypothesis that anthropometric dimensions derived from a person’s manifold-regression predicted three-dimensional (3D) humanoid avatar are accurate when compared to their actual circumference, volume, and surface area measurements acquired with a ground-truth 3D optical imaging method. Avatars predicted using this approach, if accurate with respect to anthropometric dimensions, can serve multiple purposes including patient body composition analysis and metabolic disease risk stratification in clinical settings. Manifold regression 3D avatar prediction equations were developed on a sample of 570 adults who completed 3D optical scans, dual-energy X-ray absorptiometry (DXA), and bioimpedance analysis (BIA) evaluations. A new prospective sample of 84 adults had ground-truth measurements of 6 body circumferences, 7 volumes, and 7 surface areas with a 20-camera 3D reference scanner. 3D humanoid avatars were generated on these participants with manifold regression including age, weight, height, DXA %fat, and BIA impedances as potential predictor variables. Ground-truth and predicted avatar anthropometric dimensions were quantified with the same software. Following exploratory studies, one manifold prediction model was moved forward for presentation that included age, weight, height, and %fat as covariates. Predicted and ground-truth avatars had similar visual appearances; correlations between predicted and ground-truth anthropometric estimates were all high (R2s, 0.75–0.99; all p &lt; 0.001) with non-significant mean differences except for arm circumferences (%Δ ~ 5%; p &lt; 0.05). Concordance correlation coefficients ranged from 0.80–0.99 and small but significant bias (p &lt; 0.05–0.01) was present with Bland-Altman plots in 13 of 20 total anthropometric measurements. The mean waist to hip circumference ratio predicted by manifold regression was non-significantly different from ground-truth scanner measurements. 3D avatars predicted from demographic, physical, and other accessible characteristics can produce body representations with accurate anthropometric dimensions without a 3D scanner. Combining manifold regression algorithms into established body composition methods such as DXA, BIA, and other accessible methods provides new research and clinical opportunities.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1-7"},"PeriodicalIF":4.2,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01614-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055522","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":"Likely causal effects of insulin resistance and IGF-1 bioaction on childhood and adult adiposity: a Mendelian randomization study","authors":"Duaa I. Olwi,&nbsp;Lena R. Kaisinger,&nbsp;Katherine A. Kentistou,&nbsp;Marc Vaudel,&nbsp;Stasa Stankovic,&nbsp;Pål R. Njølstad,&nbsp;Stefan Johansson,&nbsp;John R. B. Perry,&nbsp;Felix R. Day,&nbsp;Ken K. Ong","doi":"10.1038/s41366-024-01605-4","DOIUrl":"10.1038/s41366-024-01605-4","url":null,"abstract":"Circulating insulin and insulin-like growth factor-1 (IGF-1) concentrations are positively correlated with adiposity. However, the causal effects of insulin and IGF-1 on adiposity are unclear. We performed two-sample Mendelian randomization analyses to estimate the likely causal effects of fasting insulin and IGF-1 on relative childhood adiposity and adult body mass index (BMI). To improve accuracy and biological interpretation, we applied Steiger filtering (to avoid reverse causality) and ‘biological effect’ filtering of fasting insulin and IGF-1 associated variants. Fasting insulin-increasing alleles (35 variants also associated with higher fasting glucose, indicative of insulin resistance) were associated with lower relative childhood adiposity (P = 3.8 × 10−3) and lower adult BMI (P = 1.4 × 10−5). IGF-1-increasing alleles also associated with taller childhood height (351 variants indicative of greater IGF-1 bioaction) showed no association with relative childhood adiposity (P = 0.077) or adult BMI (P = 0.562). Conversely, IGF-1-increasing alleles also associated with shorter childhood height (306 variants indicative of IGF-1 resistance) were associated with lower relative childhood adiposity (P = 6.7 × 10−3), but effects on adult BMI were inconclusive. Genetic causal modelling indicates negative effects of insulin resistance on childhood and adult adiposity, and negative effects of IGF-1 resistance on childhood adiposity. Our findings demonstrate the need to distinguish between bioaction and resistance when modelling variants associated with biomarker concentrations.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 11","pages":"1650-1655"},"PeriodicalIF":4.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035829","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":"Prioritising patients for publicly funded bariatric surgery in Queensland, Australia","authors":"Paul Scuffham,&nbsp;Megan Cross,&nbsp;Srinivas Teppala,&nbsp;George Hopkins,&nbsp;Viral Chikani,&nbsp;Katie Wykes,&nbsp;Jody Paxton","doi":"10.1038/s41366-024-01615-2","DOIUrl":"10.1038/s41366-024-01615-2","url":null,"abstract":"This study reports the development and pilot application of the Bariatric Surgery Assessment and Prioritisation Tool (BAPT) for use in a public health system. The BAPT was designed as a patient prioritisation instrument to assess patients with excessive weight and type 2 diabetes suitable for bariatric surgery. We assessed whether the instrument successfully identified those who gained the greatest benefits including weight loss, diabetes remission, reduction in comorbidities, and health-related quality of life (HR-QoL). The BAPT instrument was applied to score 292 patients referred for bariatric surgery in Queensland between 2017 and 2020 based on their, body mass index, diabetes status, surgical risk (e.g. pulmonary embolism) and comorbidities (e.g. non-alcoholic steatohepatitis). These data were collected at referral and at 12-months post-surgery for 130 patients and stratified by BAPT scores. Outcomes included clinical and HR-QoL. Patients’ BAPT scores ranged from 12 to 78 (possible range 2–98). Those with higher scores tended to be younger (p &lt; 0.001), have higher BMI (p &lt; 0.001) or require insulin to manage diabetes (p &lt; 0.01). All patients lost similar percentages of body weight (20–25%, p = 0.73) but higher-scoring patients were more likely to discontinue oral diabetes medications (p &lt; 0.001) and the improvement in glycated haemoglobin was four times greater in patients scoring 70–79 points compared to those scoring 20–29 (p &lt; 0.05). Those who scored ≥ 50 on the BAPT were substantially more likely to obtain diabetes remission (57% vs 31%). BAPT scores of 40 and above tended to have greater improvement in HR-QoL. The BAPT prioritised younger patients with higher BMIs who realised greater improvements in their diabetes after bariatric surgery. Higher-scoring BAPT patients should be prioritised for bariatric surgery as they have a greater likelihood of attaining diabetes remission.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1-10"},"PeriodicalIF":4.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01615-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035830","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":"Effect of physical activity intervention on weight change in rural older Chinese: a cluster randomized controlled trial","authors":"Qian Deng,&nbsp;Nanyan Li,&nbsp;Shiyi Li,&nbsp;Jie Peng,&nbsp;Na Ji,&nbsp;Yufei Wang,&nbsp;Julinling Hu,&nbsp;Xing Zhao,&nbsp;Junmin Zhou","doi":"10.1038/s41366-024-01616-1","DOIUrl":"10.1038/s41366-024-01616-1","url":null,"abstract":"Current randomized trial evidence for the effects of physical activity intervention on weight change in adults was mainly from western countries, with little reliable evidence from low- and middle-income countries, such as China, where lifestyle factors and obesity patterns differ substantially from those in western countries. We examined the effects of physical activity intervention on weight change using cluster randomized trial data among Chinese older adults. The cluster randomized controlled trial included an 8-week physical activity intervention period and was followed up to 24 months. Eight villages were randomly assigned to the intervention group (4 villages, n = 240) or the control group (4 villages, n = 268). The intervention group received physical activity intervention based on the socio-ecological model, while the control group did not. The intervention involved three levels: individual, interpersonal, and community levels, which aimed to promote leisure-time physical activity of participants. The primary outcome of the present study was the difference in percentage weight change at 24 months from baseline. We used Tanita BC-601 analyzer scales to measure weight and recorded it to the nearest 0.1 kg. Among the 508 participants, the mean age was 70.93 (SD, 5.69) years, and 55.5% were female. There were significant differences in percentage weight change between the intervention group and the control group with a mean change of −1.78% (95% CI, −2.67% to −0.90%; p &lt; 0.001) in the total sample, −1.94% (95% CI, −3.14% to −0.73%; p = 0.002) in participants with overweight/obesity, and −1.45% (95% CI, −2.73% to −0.18%; p = 0.027) among participants with underweight/healthy weight in favor of the intervention group at 24 months. Physical activity intervention resulted in weight loss in rural older sample at 24 months. This suggested that physical activity interventions are feasible for weight loss among older adults, especially for those with overweight/obesity or aged under 80. The study has been registered on the Chinese Clinical Trial Registry on April 20, 2021 (ChiCTR2100045653), https://www.chictr.org.cn/showproj.html?proj=123704 .","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1-9"},"PeriodicalIF":4.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008778","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":"Hidden barriers: obesity bias in hypertension treatment","authors":"Guilherme Heiden Telo,&nbsp;Lucas Strassburger Matzenbacher,&nbsp;Lucas Friedrich Fontoura,&nbsp;Georgia Oliveira Avila,&nbsp;Vicenzo Gheno,&nbsp;Maria Antônia Bertuzzo Brum,&nbsp;Julia Belato Teixeira,&nbsp;Isadora Nunes Erthal,&nbsp;Josiane Schneiders,&nbsp;Beatriz D. Schaan,&nbsp;Janine Alessi,&nbsp;Gabriela Heiden Telo","doi":"10.1038/s41366-024-01613-4","DOIUrl":"10.1038/s41366-024-01613-4","url":null,"abstract":"Individuals with obesity often face obesity bias, which may influence the delivery of appropriate medical care. Our aim is to evaluate the adequacy of therapeutic decisions regarding the pharmacological treatment for hypertension in patients with diabetes, both with and without obesity. This is a multicentric cross-sectional study of patients with type 2 diabetes and arterial hypertension who received outpatient care in Southern Brazil. Participants were stratified into two groups according to their body mass index (BMI): lower weight (BMI &lt; 25.0 kg/m2) and with obesity (BMI ≥ 30.0 kg/m2). The primary outcome evaluated was the difference in pharmacological treatment decisions for hypertension between groups, considering individualized hypertension targets from American Diabetes Association (ADA), European Society of Hypertension (ESH), and European Society of Cardiology (ESC) guidelines. Data were analyzed as a binary endpoint (failure to receive treatment intensification vs. receiving treatment intensification when necessary) and groups were compared using multivariable logistic regression. This study included 204 participants, of which 53 were at a lower weight and 151 had obesity. Patients with obesity more frequently failed to receive appropriate treatment intensification when compared to individuals with lower weight. The differences between the study groups were observed when considering the blood pressure target of three societies: ESH (adjusted OR 2.28 [95% CI 1.12–4.63], p = 0.022), ESC (adjusted OR 2.13 [95% CI 1.05–4.31], p = 0.035), and ADA (adjusted OR 2.33 [95% CI 1.13–4.77], p = 0.021). These findings suggest that patients with obesity may face potential disparities in hypertension management, and obesity status may be related to therapeutic inertia in the management of arterial hypertension in this group.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 10","pages":"1506-1512"},"PeriodicalIF":4.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004199","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}