Diabetes, Obesity & Metabolism最新文献

{"title":"Associations of intra-pancreatic fat deposition with triglyceride-rich lipoproteins and lipoprotein lipase.","authors":"Yutong Liu, Loren Skudder-Hill, Wandia Kimita, Xiatiguli Shamaitijiang, Ivana R Sequeira-Bisson, Maxim S Petrov","doi":"10.1111/dom.16338","DOIUrl":"https://doi.org/10.1111/dom.16338","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the associations of intra-pancreatic fat deposition (IPFD) with very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL) and lipoprotein lipase.</p><p><strong>Materials and methods: </strong>A total of 174 participants underwent magnetic resonance imaging on a 3.0 Tesla scanner for the quantification of IPFD. Blood samples were collected following an 8-h fasting period. Triglyceride-rich lipoproteins were measured using the Lipoprint® system and classed as VLDL, IDL-C, IDL-B and IDL-A subfractions. Lipoprotein lipase was measured using ELISA. Univariable and multivariable linear regression analyses were conducted.</p><p><strong>Results: </strong>Both IPFD and lipoprotein lipase were significantly associated with the levels of IDL-B in the most adjusted model. Specifically, each unit increase in IPFD was associated with a 0.12-unit increase in IDL-B (p = 0.047) whereas each unit increase in lipoprotein lipase was associated with a 0.22-unit increase in IDL-B (p = 0.015). Neither IPFD nor lipoprotein lipase was associated with VLDL.</p><p><strong>Conclusions: </strong>The relationship of IPFD with triglyceride-rich lipoproteins differs depending on the nature of the lipoproteins. High IPFD is significantly associated with increased levels of IDL (specifically, its most representative subfraction-IDL-B), but not VLDL. Fatty pancreas disease may contribute to increasing the risk of atherosclerotic CVD through IDL.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622937","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":"Is serum 25-hydroxyvitamin D deficiency a risk factor for the incidence of slow gait speed in older individuals? Evidence from the English longitudinal study of ageing.","authors":"Mariane Marques Luiz, Roberta de Oliveira Máximo, Aline Fernanda de Souza, Thales Batista de Souza, Sara Souza Lima, Leticia Coelho Silveira, Thaís Barros Pereira da Silva, Andrew Steptoe, Cesar de Oliveira, Tiago da Silva Alexandre","doi":"10.1111/dom.16317","DOIUrl":"https://doi.org/10.1111/dom.16317","url":null,"abstract":"<p><strong>Aims: </strong>Cross-sectional studies demonstrate an association between low serum levels of vitamin D and slower gait speed in older individuals. However, longitudinal studies remain inconclusive. This study investigates whether vitamin D deficiency and insufficiency are risk factors for the incidence of slowness.</p><p><strong>Materials and methods: </strong>A total of 2815 participants from the English Longitudinal Study of Ageing (ELSA), aged ≥60 years and with a baseline gait speed >0.8 m/s, were followed for six years. Baseline serum levels of vitamin D [25(OH)D] were categorized as \"sufficiency\" (>50 nmol/L), \"insufficiency\" (>30 and ≤50 nmol/L) or \"deficiency\" (≤30 nmol/L). Gait speed was reassessed at four and six years of follow-up to identify incident cases of slowness (walking speed ≤0.8 m/s). A Poisson regression model, adjusted for sociodemographic, behavioural and clinical characteristics at baseline, was conducted to determine the association between serum 25(OH)D levels and the risk of slowness.</p><p><strong>Results: </strong>The incidence densities of slowness per 1000 person-years were 67.4 (95% CI: 60.93-74.64) for sufficiency, 76.7 (95% CI: 68.30-86.22) for insufficiency and 90.7 (95% CI: 78.46-104.92) for deficiency. Serum 25(OH)D deficiency was associated with a 22% increase in the risk of slowness (IRR: 1.22; 95% CI: 1.01-1.49) compared with serum 25(OH)D sufficiency. No significant association was observed for serum 25(OH)D insufficiency.</p><p><strong>Conclusions: </strong>Serum 25(OH)D deficiency is a risk factor for the incidence of slowness in older individuals, suggesting that maintaining sufficient 25(OH)D levels could be a strategic approach to minimise long-term mobility impairment.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622958","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":"Correction to “The effect of HbA1c variability on the efficacy of intensive blood pressure control in patients with type 2 diabetes”","authors":"","doi":"10.1111/dom.16323","DOIUrl":"10.1111/dom.16323","url":null,"abstract":"<p>Wang X, Pei J, Zheng K, Liu M, Hu X. The effect of HbA1c variability on the efficacy of intensive blood pressure control in patients with type 2 diabetes. <i>Diabetes Obes Metab</i>. 2025;27(3):1208-1216. doi:10.1111/dom.16112\u0000 </p><p>We failed to include the following important affiliation for the first author ‘Xiaopu Wang’:</p><p>1. Department of Cardiovascular Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.</p><p>The author affiliations should read as:</p><p>Xiaopu Wang MD^1,2 | Junyu Pei MD¹ | Keyang Zheng MD³ | Maojun Liu MD¹ | Xinqun Hu MD¹</p><p>1. Department of Cardiovascular Medicine, Second Xiangya Hospital, Central South University, Changsha, Hunan, China</p><p>2. Libin Cardiovascular Institute of Alberta, University of Calgary, Health Sciences Centre, Calgary, Alberta, Canada</p><p>3. Department of Cardiovascular Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China</p><p>We apologize for this error.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2906"},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622940","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":"Time spent in glycaemic control with sustained body weight reduction with tirzepatide: A post hoc analysis of the SURPASS clinical trial programme.","authors":"Brandon K Bergman, Julio Rosenstock, W Timothy Garvey, Rachel L Batterham, Yanyun Chen, Minzhi Liu, Palash Sharma, Chrisanthi A Karanikas, Vivian T Thieu","doi":"10.1111/dom.16337","DOIUrl":"https://doi.org/10.1111/dom.16337","url":null,"abstract":"<p><strong>Aims: </strong>This participant-level exploratory analysis assessed the continuous time spent in glycaemic control and/or with sustained weight reductions with tirzepatide treatment in participants with type 2 diabetes (T2D) from the SURPASS programme.</p><p><strong>Materials and methods: </strong>Participants (N = 6246) from SURPASS 1-5 were randomized to once weekly tirzepatide (5, 10 or 15 mg) or comparator (once weekly placebo, once weekly semaglutide 1 mg, insulin degludec or insulin glargine). Continuous time spent with HbA1c < 7.0% (53 mmol/mol), ≤6.5% (48 mmol/mol) and ≥5% body weight reduction and combined HbA1c ≤ 6.5% (48 mmol/mol) with a ≥5% body weight reduction were assessed through 40 weeks (SURPASS-1, -2, and -5) or 52 weeks (SURPASS-3 and -4). The non-parametric Wilcoxon rank sum test was used to compare the median duration of continuous time spent in control, and logistic regression was used to analyse the proportion of participants achieving glycaemic control and body weight reduction at any time points or at the end of the primary study period.</p><p><strong>Results: </strong>Median time spent with HbA1c < 7.0% (53 mmol/mol) was 80% (tirzepatide) versus 70% (semaglutide) and 0% (placebo) of the treatment duration in 40-week studies, and 77%-85% (tirzepatide) versus 62% (insulin degludec) and 23% (insulin glargine) of the treatment duration in 52-week studies (p < 0.001). Time spent with HbA1c < 7.0% (53 mmol/mol) was generally similar across all tirzepatide doses in each study. Dose-dependent increases in time spent with ≥5% body weight reduction were observed with tirzepatide (median time spent: 20%-77% with tirzepatide versus 25% with semaglutide 1 mg) (p < 0.001). Tirzepatide-treated participants experienced longer time spent with HbA1c ≤ 6.5% (48 mmol/mol) and ≥5% body weight reduction versus semaglutide (median: 35%-60% vs. 7%) (p < 0.001).</p><p><strong>Conclusions: </strong>In this post hoc analysis, people with T2D experienced substantially longer continuous time in glycaemic control and more sustained body weight reductions with tirzepatide versus placebo and active comparators.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623025","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 dapagliflozin on blood and breath ketones during supervised insulin withdrawal in adults with type 1 diabetes: A randomized crossover trial.","authors":"Max C Petersen, Kai E Jones, Alexander M Markov, Maamoun Salam, Petra Krutilova, Alexis M McKee, Kathryn L Bohnert, Samantha E Adamson, Janet B McGill","doi":"10.1111/dom.16324","DOIUrl":"10.1111/dom.16324","url":null,"abstract":"<p><strong>Aims: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors increase ketoacidosis risk, limiting their use in type 1 diabetes. To better understand the pathophysiology of SGLT2 inhibitor-mediated ketoacidosis, we measured blood glucose, capillary blood and plasma β-hydroxybutyrate (BOHB) and breath acetone (BrACE) during supervised insulin withdrawal in adults with type 1 diabetes with and without dapagliflozin treatment.</p><p><strong>Materials and methods: </strong>Twenty adults with type 1 diabetes underwent supervised insulin withdrawal twice in a randomized crossover design: during usual care and after treatment with dapagliflozin (10 mg daily for 2 weeks plus the test day). After insulin withdrawal, capillary blood glucose, BOHB and BrACE measurements were obtained at least hourly until stopping rules were met (>8 h elapsed, symptoms of ketosis, glucose >400 mg/dL, BOHB >4 mmol/L or participant request).</p><p><strong>Results: </strong>The peak BOHB and BrACE values achieved during supervised insulin withdrawal were both greater with dapagliflozin than with usual care. Throughout the insulin withdrawal study, dapagliflozin treatment was associated with significantly greater BOHB and BrACE concentrations. The proportions of participants reaching BOHB >1.5 mmol/L and >2.5 mmol/L during supervised insulin withdrawal were greater in the dapagliflozin arm. Blood glucose reached a lower peak in the dapagliflozin arm.</p><p><strong>Conclusions: </strong>In adults with type 1 diabetes undergoing supervised insulin withdrawal, dapagliflozin treatment compared to usual care was associated with greater blood and breath ketone concentrations in the absence of significant hyperglycaemia.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622943","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":"Hepatocyte-specific RAP1B deficiency ameliorates high-fat diet-induced obesity and liver inflammation in mice.","authors":"Yinxu Fu, Pingyi Hu, Yanyang Hu, Yu Fang, Yaping Zhou, Yu Shi, Kaiqiang Yang, Ting Fu, Weijia Li, Evgeniy Rostislavovich Gritskevitch, Liqin Jin, Jianxin Lyu, Qiongya Zhao","doi":"10.1111/dom.16309","DOIUrl":"https://doi.org/10.1111/dom.16309","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated the role of RAP1B in hepatic lipid metabolism and its implications in obesity and associated metabolic disorders, focusing on the molecular mechanisms through which RAP1B influences lipid accumulation, inflammation and oxidative stress in liver tissues and hepatocyte cell lines.</p><p><strong>Materials and methods: </strong>Liver-specific RAP1B-knockout (LKO) and overexpression (OE) mice were generated and fed a high-fat diet for 18 weeks to evaluate systemic and hepatic metabolic changes. Comprehensive metabolic phenotyping included measurements of body weight, body fat content, activity levels, energy expenditure (EE), respiratory exchange ratio (RER), glucose tolerance test and insulin tolerance test. RAP1B-knockdown AML12 hepatocytes were used for in vitro studies. Comprehensive transcriptome and metabolome analyses identified differentially expressed genes and key metabolic shifts. Biochemical and histological analyses were performed to assess lipid accumulation, oxidative stress and inflammatory markers.</p><p><strong>Results: </strong>We found that LKO mice exhibited significant reductions in body weight, fat pad size and liver mass, along with decreased hepatic lipid accumulation due to enhanced lipid breakdown. These mice demonstrated improved glucose tolerance and insulin sensitivity without changes in food intake. Liver histology showed reduced F4/80-positive macrophage infiltration, indicating decreased inflammatory cell recruitment. Additionally, markers of oxidative stress were significantly lower, and molecular analysis revealed downregulation of the MAPK(p38) and NF-κB signaling pathways, further supporting an anti-inflammatory hepatic environment. In contrast, OE mice showed increased liver weight, aggravated hepatic lipid accumulation driven by enhanced lipogenesis, worsened insulin resistance and elevated inflammation.</p><p><strong>Conclusions: </strong>This study highlights RAP1B's pivotal role in hepatic metabolism and positions it as a potential therapeutic target for obesity and related metabolic disorders.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622945","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":"Metabolic dysfunction-associated steatotic liver disease, insulin sensitivity and continuous glucose monitoring metrics in patients with type 1 diabetes: A multi-centre cross-sectional study.","authors":"Michela Vergani, Nicolò Diego Borella, Mariangela Rizzo, Matteo Conti, Silvia Perra, Eleonora Bianconi, Elena Sani, Alessandro Csermely, Elisabetta Grespan, Giovanni Targher, Gianluca Perseghin, Alessandro Mantovani, Stefano Ciardullo","doi":"10.1111/dom.16333","DOIUrl":"https://doi.org/10.1111/dom.16333","url":null,"abstract":"<p><strong>Background and aim: </strong>We assessed the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and significant liver fibrosis in adults with type 1 diabetes mellitus (T1DM) and the association of MASLD with insulin sensitivity and continuous glucose monitoring metrics.</p><p><strong>Methods: </strong>We consecutively enrolled 198 adults with T1DM undergoing vibration-controlled transient elastography with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). All participants had a continuous glucose monitoring (CGM) device. Insulin sensitivity was evaluated by estimated glucose disposal rate (eGDR). MASLD was defined as CAP ≥ 248 db/m and the presence of at least one cardiometabolic risk factor. Significant liver fibrosis was defined as LSM ≥ 7 kPa.</p><p><strong>Results: </strong>Patients had a mean age of 56 years, mean BMI of 26.0 ± 5.9 kg/m², and mean eGDR of 7.1 ± 2.3 mg/kg/min. 73 (37%) patients had MASLD (using a CAP threshold of 274 dB/m), 16 (8.1%) of whom had significant liver fibrosis. MASLD was associated with a significantly lower eGDR (beta coefficient = -0.367, 95% confidence interval -0.472 to -0.261; p < 0.001). This association remained significant, even after adjustment for age, sex, body mass index, plasma triglycerides, diabetes duration, daily insulin dose, time above the range of glucose levels, LSM and chronic kidney disease. No association was observed between MASLD and CGM-derived metrics. These results were not different when we used a CAP threshold of 274 dB/m for diagnosing MASLD.</p><p><strong>Conclusion: </strong>In T1DM, MASLD was inversely associated with eGDR and biomarkers of insulin resistance but not with CGM-derived metrics.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622995","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":"Efficacy and safety of once-weekly semaglutide 2.4 mg for weight management in participants from China: A prespecified analysis of the STEP 7 randomized clinical trial","authors":"Weijun Gu MD,&nbsp;Yibing Lu PhD,&nbsp;Xinhua Ye MD,&nbsp;Guoyue Yuan MD,&nbsp;Dongmei Liu MD,&nbsp;Zewei Shen MD,&nbsp;Ning Zu MD,&nbsp;Yiming Mu MD","doi":"10.1111/dom.16253","DOIUrl":"10.1111/dom.16253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of semaglutide 2.4 mg versus placebo for weight management in a population of Chinese adults with overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In STEP 7 (NCT04251156), a double-blind, phase 3a trial, adults from a predominantly East Asian population with overweight or obesity, with or without type 2 diabetes, were randomized 2:1 to once-weekly subcutaneous semaglutide 2.4 mg or placebo for 44 weeks as an adjunct to a reduced-calorie diet and increased physical activity. This prespecified analysis evaluated Chinese participants in STEP 7. The primary endpoints were percentage change in body weight from baseline to Week 44 and the proportion of participants who achieved ≥5% reduction in body weight from baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 195 Chinese participants were randomized to semaglutide 2.4 mg and 105 to placebo. Estimated change in mean body weight from baseline to Week 44 was −11.8% with semaglutide 2.4 mg versus −3.5% with placebo (estimated treatment difference −8.3%; 95% confidence interval [CI] –10.2, −6.4; <i>p</i> &lt; 0.0001). At Week 44, a greater proportion of participants treated with semaglutide 2.4 mg achieved ≥5% body weight loss versus placebo (85.4% vs. 26.8%): odds ratio 16.1; 95% CI 8.4, 30.9; <i>p</i> &lt; 0.0001. Adverse events were reported by 92.3% of semaglutide-treated participants and 82.9% of placebo-treated participants, the most common of which were gastrointestinal disorders (126/195, 64.6% vs. 35/105, 33.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These data demonstrate beneficial effects of semaglutide 2.4 mg versus placebo, supporting its use in an adult Chinese population with overweight or obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 5","pages":"2540-2551"},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603152","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":"An overview of obesity-related complications: The epidemiological evidence linking body weight and other markers of obesity to adverse health outcomes","authors":"Matthias Blüher MD","doi":"10.1111/dom.16263","DOIUrl":"10.1111/dom.16263","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;p&gt;Obesity is a highly prevalent chronic multisystem disease associated with shortened life expectancy due to a number of adverse health outcomes. Epidemiological data link body weight and parameters of central fat distribution to an increasing risk for type 2 diabetes, hypertension, fatty liver diseases, cardiovascular diseases including myocardial infarction, heart failure, atrial fibrillation, stroke, obstructive sleep apnoea, osteoarthritis, mental disorders and some types of cancer. However, the individual risk to develop cardiometabolic and other obesity-related diseases cannot entirely be explained by increased fat mass. Rather than excess fat accumulation, dysfunction of adipose tissue may represent the mechanistic link between obesity and adverse health outcomes. There are people living with obesity who seem to be protected against the premature development of cardiometabolic diseases. On the other hand, people with normal weight may develop typical obesity diseases upon dysfunction of adipose tissue and predominantly visceral fat distribution. The mechanisms linking impaired function of adipose tissue in people with obesity include adipocyte hypertrophy, altered cellular composition, limited expandability of safe subcutaneous fat stores, ectopic fat deposition in visceral depots, the liver and other organs, hypoxia, a variety of stresses, inflammatory processes, and the release of pro-inflammatory, diabetogenic and atherogenic signals. Genetic and environmental factors might contribute either alone or via interaction with intrinsic biological factors to variation in adipose tissue function. There are still many open questions regarding the mechanisms of how increased body weight causes obesity-related disorders and whether these pathologies could be reversed. Evidence-based weight loss interventions using behaviour change, pharmacological or surgical approaches have clarified the beneficial effects of realistic and sustained weight loss on obesity-related complications as hard outcomes. This review focusses on recent advances in understanding epidemiological trends and mechanisms of obesity-related diseases.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Plain Language Summary&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Obesity is a chronic complex and progressive disease characterized by excessive fat deposition that may impair health and quality of life. Worldwide, the number of adults living with obesity has more than doubled since 1990. Obesity may lead to reduced life expectancy, because it increases the risk for type 2 diabetes, cardiovascular diseases (e.g., myocardial infarction, high blood pressure, stroke), fatty liver diseases, musculoskeletal diseases, chronic respiratory diseases, depression and certain types of cancer. However, not every person with obesity develops these diseases. For bette","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 S2","pages":"3-19"},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603150","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":"Identifying individuals at risk for weight gain using machine learning in electronic medical records from the United States.","authors":"Casey Choong, Neena Xavier, Beverly Falcon, Hong Kan, Ilya Lipkovich, Callie Nowak, Margaret Hoyt, Christy Houle, Scott Kahan","doi":"10.1111/dom.16311","DOIUrl":"https://doi.org/10.1111/dom.16311","url":null,"abstract":"<p><strong>Aims: </strong>Numerous risk factors for the development of obesity have been identified, yet the aetiology is not well understood. Traditional statistical methods for analysing observational data are limited by the volume and characteristics of large datasets. Machine learning (ML) methods can analyse large datasets to extract novel insights on risk factors for obesity. This study predicted adults at risk of a ≥10% increase in index body mass index (BMI) within 12 months using ML and a large electronic medical records (EMR) database.</p><p><strong>Materials and methods: </strong>ML algorithms were used with EMR from Optum's de-identified Market Clarity Data, a US database. Models included extreme gradient boosting (XGBoost), random forest, simple logistic regression (no feature selection procedure) and two penalised logistic models (Elastic Net and Least Absolute Shrinkage and Selection Operator [LASSO]). Performance metrics included the area under the curve (AUC) of the receiver operating characteristic curve (used to determine the best-performing model), average precision, Brier score, accuracy, recall, positive predictive value, Youden index, F1 score, negative predictive value and specificity.</p><p><strong>Results: </strong>The XGBoost model performed best 12 months post-index, with an AUC of 0.75. Lower baseline BMI, having any emergency room visit during the study period, no diabetes mellitus, no lipid disorders and younger age were among the top predictors for ≥10% increase in index BMI.</p><p><strong>Conclusion: </strong>The current study demonstrates an ML approach applied to EMR to identify those at risk for weight gain over 12 months. Providers may use this risk stratification to prioritise prevention strategies or earlier obesity intervention.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603153","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}