Obesity最新文献

{"title":"DXA-Measured Visceral Adipose Tissue and Accelerated Biological Aging in Middle-Aged Adults","authors":"Riorden O'Shea,&nbsp;Jennie Hui,&nbsp;Chrianna Bharat,&nbsp;Kevin Murray,&nbsp;Gillian Arscott,&nbsp;Michael Hunter,&nbsp;John Walsh,&nbsp;Kun Zhu","doi":"10.1002/oby.70239","DOIUrl":"10.1002/oby.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Obesity, particularly excess visceral adipose tissue (VAT), may accelerate biological aging; however, few studies have examined this in middle-aged adults. We investigated associations between dual-energy X-ray absorptiometry (DXA)-derived VAT and two biomarkers of biological aging—phenotypic age acceleration (PhenoAgeAccel) and leukocyte telomere length (LTL)—in 4799 participants (2614 females, aged 45–69 years) from the Busselton Healthy Ageing Study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Whole-body DXA (GE Lunar) quantified VAT mass. Phenotypic age was estimated from chronological age and nine biomarkers. In a subsample of 1221 participants, LTL was measured as the telomeric DNA to single-copy gene (<i>T</i>/<i>S</i>) ratio. Sex-stratified linear regressions assessed associations, adjusting for chronological age and lifestyle factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean ± SD VAT mass was 1677 ± 873 g in males and 882 ± 598 g in females. Higher VAT was associated with greater PhenoAgeAccel in both sexes; each 1-SD increase in VAT corresponds to 1.397 (95% CI 1.197, 1.596) and 1.919 (1.738, 2.099) years higher PhenoAgeAccel in males and females, respectively. In females only, higher VAT was associated with shorter LTL (−0.041 [−0.069, −0.013] per 1 SD). Associations mostly remained significant after adjustment for anthropometric and other DXA-derived adiposity measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VAT may represent a specific marker of accelerated biological aging, independent of lifestyle and adiposity measures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1613-1622"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348075","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 Sex-Stratified Effects of RSPO3 Expression on Body Fat and Blood Lipids: An Omics Mendelian Randomization Study","authors":"Yihua Guo,&nbsp;Zhihe Chen,&nbsp;Lanhui Huang,&nbsp;Zhongyun Zhang,&nbsp;Yujia Gong,&nbsp;Qian Yang,&nbsp;Jiqiu Wang,&nbsp;Jie Zheng","doi":"10.1002/oby.70252","DOIUrl":"10.1002/oby.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examined sex-stratified effects of R-spondin 3 (RSPO3) expression levels on body fat and blood lipids and their potential mediation effects through sex hormones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a sex-stratified genome-wide association study (GWAS) of RSPO3 protein (<i>N</i> = 18,529 men and 21,323 women). We used two-sample Mendelian randomization (MR) to examine associations of RSPO3 expression with the outcomes. Sex-stratified MR estimates were compared using the pairwise <i>z</i> score test and Cochran's <i>Q</i> test. We conducted two-step MR analyses to explore mediation effects through sex hormones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sex-stratified GWAS identified nine loci associated with RSPO3 protein levels, including three novel signals and four female-stratified loci. In women, RSPO3 protein levels were associated with visceral adipose tissue (β = 0.22, 95% CI = 0.10 to 0.34), waist circumference (0.10, 0.05 to 0.15), hip circumference (0.10, 0.05 to 0.15), triglycerides (0.22, 0.18 to 0.26), high-density lipoprotein cholesterol (−0.17, −0.21 to −0.13), and apolipoprotein A (−0.11, −0.15 to −0.06). We also observed sex differences in these associations. Two-step MR showed that RSPO3 protein levels affected six outcomes via sex hormone-binding globulin in women, with little evidence in men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings indicated that <i>RSPO3</i> could be a drug target for regulating body fat distribution and blood lipids in women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1623-1634"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414467","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":"Congener-Specific Associations of Per- and Polyfluoroalkyl Substances With Obesity-Metabolic Phenotypes: A Multimodel Analysis","authors":"Liyun Sun,&nbsp;Mi Zhang,&nbsp;Bingrui Gao,&nbsp;Mingyue Wang,&nbsp;Zhiyi Guan,&nbsp;Ziwei Kang,&nbsp;Zhongyan Shan,&nbsp;Weiping Teng,&nbsp;Jing Li","doi":"10.1002/oby.70259","DOIUrl":"10.1002/oby.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the associations between per- and polyfluoroalkyl substances (PFAS) and distinct obesity-metabolic phenotypes and explore underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 8692 adults from NHANES 2003–2018 were classified into four phenotypes as follows: metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), metabolically healthy non-obesity (MHNO), and metabolically unhealthy non-obesity (MUNO). Multiple statistical models were used to evaluate the associations between PFAS exposure and distinct phenotypes. Network toxicology and molecular docking were employed for mechanistic exploration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Logistic regression analyses showed congener-specific associations of PFAS with MHO, MUO, and MUNO. PFUA was inversely associated with all three phenotypes (OR = 0.60, 0.55, and 0.79, respectively; <i>p</i> &lt; 0.05). Weighted quantile sum (WQS), quantile g-computation (Qgcomp), and Bayesian kernel machine regression (BKMR) analyses consistently indicated the negative associations of PFAS mixture exposure with MHO (OR_WQS = 0.67, log[OR]_Qgcomp = −0.48; <i>p</i> &lt; 0.001) and MUO (OR_WQS = 0.81, log[OR]_Qgcomp = −0.24; <i>p &lt;</i> 0.001). Stratified BKMR suggested the inverse PFAS-BMI relationship was independent of metabolic status. The peroxisome proliferator-activated receptor signaling pathway was predicted to link PFAS and obesity-metabolic phenotypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although PFAS mixture exposure may not increase the risks of obesity and metabolic abnormalities, congener-specific effects on distinct phenotypes indicate the necessity of analyzing specific compositional profiles of PFAS exposure when evaluating endocrine toxicity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1655-1668"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427896","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 Surgery in the GLP-1 Era: Upfront Toll, Long-Term Dividend","authors":"Antonio Iannelli,&nbsp;Sergio Carandina,&nbsp;Luigi Angrisani","doi":"10.1002/oby.70237","DOIUrl":"10.1002/oby.70237","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1531-1534"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240852","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":"How Low Could Semaglutide Prices Fall? An Analysis of Production Cost and Implications for Global Access","authors":"Jacob Levi,&nbsp;Samuel Cross,&nbsp;Nydile Ramesh,&nbsp;Francois Venter,&nbsp;Andrew Hill","doi":"10.1002/oby.70241","DOIUrl":"10.1002/oby.70241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to estimate potential launch prices of generic semaglutide following patent expiry in 2026 and to quantify the global obesity and type 2 diabetes (T2DM) burden in countries where generic access may become possible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used World Bank population data and World Obesity and Diabetes Atlas prevalence estimates to calculate obesity and T2DM burden. Patent status was identified using MedsPaL and cross-checked with regional databases. We applied updated cost-plus pricing methods using 2024–2025 Indian active pharmaceutical ingredient shipment data to estimate production costs for oral and injectable semaglutide, incorporating formulation, packaging, taxation, and profit assumptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve countries with 2026 patent expiry account for 47% of obesity and 49% of T2DM globally. No patent filings were identified in 150 additional countries. By the end of 2026, generic injectable semaglutide could be available in 162 countries representing 69% of global T2DM and 84% of clinical obesity. Estimated generic injectable costs ranged from $28 to $140 per person-year; oral formulations ranged from $186 to $380 per person-year. Injection devices contributed disproportionately to total cost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patent expiry may substantially expand access at lower prices, but device costs, secondary patents, and health system constraints could limit equitable uptake without coordinated policy action.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1545-1550"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Ultra-Processed Food Intake During a Single-Arm Behavioral Weight Management Intervention: A Secondary Analysis","authors":"Kate E. Worwag,&nbsp;Armaan Shetty,&nbsp;Meena N. Shankar,&nbsp;Kathryn M. Ross","doi":"10.1002/oby.70251","DOIUrl":"10.1002/oby.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Increasing evidence links ultra-processed food (UPF) intake to obesity and related diseases; however, little is known about the role of UPF in behavioral weight-loss interventions (BWLIs). Thus, the current study investigated whether UPF intake changes during a BWLI and whether these changes are associated with weight-loss outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 449 adults with obesity (mean ± SD age = 49.5 ± 11.4 years, BMI = 35.7 ± 4.0 kg/m², 83.5% female, 23.4% Black/African American, 9.8% Hispanic) completed a 16-week BWLI. Using dietary intake data collected via the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24), we examined (1) changes in caloric intake and the proportion of calories from UPFs from baseline to post-intervention and (2) associations between these changes and weight loss, overall and adjusting for caloric intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants demonstrated reductions in calorie intake (−461 ± 931 kcal/day), UPF intake (−3.0% ± 2.8% of total energy), and body weight (−7.2 ± 7.6 kg) over the BWLI, <i>p</i>s &lt; 0.001. Greater reductions in UPFs were associated with greater decreases in caloric intake (<i>r</i> = 0.10) and greater weight loss (<i>r</i> = 0.08, <i>p</i>s &lt; 0.001), even after adjusting for changes in caloric intake (<i>p</i> = 0.005); however, effect sizes were small.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UPF intake decreased during the BWLI, and greater reductions were associated with greater weight loss, independent of caloric changes, though small effect sizes warrant cautious interpretation. Future research should examine whether targeting UPF reduction in a BWLI enhances weight outcomes.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> ClinicalTrials.gov Identifier: NCT04116853.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1592-1599"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439861","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":"Use of Glucagon-Like Peptide-1 Receptor Agonists in Danish Adolescents and Young Adults 2018–2025","authors":"Helene Kildegaard,&nbsp;Jacob Harbo Andersen,&nbsp;Rebecca Kofod Vinding,&nbsp;Julie Tonsgaard Kloppenborg,&nbsp;Anton Pottegård","doi":"10.1002/oby.70234","DOIUrl":"10.1002/oby.70234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has increased rapidly following approval for obesity treatment, but data on their use in younger populations remain limited. We examined trends in GLP-1RA use among 12– to 24-year-olds in Denmark during 2018–2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using nationwide prescription, hospital, and laboratory registries, we conducted a drug utilization study including all 12– to 24-year-olds who filled a GLP-1RA prescription between January 2018 and December 2025. We described incidence of use, baseline characteristics, prescribing patterns, and treatment persistence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GLP-1RA use rose more than 50-fold across the study period, reaching 418 new users per 100,000 by 2025, driven by semaglutide for weight management. Uptake was steepest among individuals aged 18–24 years (from 13 to 686 per 100,000) and more modest among adolescents aged 12–17 years (from 1.7 to 72 per 100,000). Most users were female, few had diabetes, and 33% had psychiatric comorbidity, particularly emotional and neurodevelopmental disorders. By 2025, 78% of new treatments were initiated in general practice. Only 38% were covered by a prescription after 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings demonstrate rapid uptake of GLP-1RAs in youth and the need for specialist involvement, long-term safety data, and careful evaluation of mental health in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1551-1557"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201790","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":"Revisiting Motivation in Pediatric Weight Management: A Self-Determination Perspective on the STARKIDS Cohort Findings","authors":"Oscar Fidel Antunez Martinez,&nbsp;Kai-Wei Katherine Wang","doi":"10.1002/oby.70244","DOIUrl":"10.1002/oby.70244","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1527-1528"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213944","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":"Dietary Protein Reduction During Isocaloric Conditions Reduces Body Weight in Men With Overweight or Obesity","authors":"Aslak E. Lyster,&nbsp;Amalie S. Frederiksen,&nbsp;Jacob K. Jensen,&nbsp;Annemarie Lundsgaard,&nbsp;Nicoline R. Andersen,&nbsp;Kasper S. Jørgensen,&nbsp;Daniela Weber,&nbsp;Lukas Nachtigall,&nbsp;Erik A. Richter,&nbsp;Andreas M. Fritzen,&nbsp;Bente Kiens","doi":"10.1002/oby.70248","DOIUrl":"10.1002/oby.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Dietary protein reduction increases plasma fibroblast growth factor 21 (FGF21) and energy requirements in lean men under eucaloric conditions. Whether these metabolic effects translate to weight loss during isocaloric conditions in men with overweight or obesity remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventeen men with overweight or obesity were randomly allocated to two different highly controlled, isocaloric diets for 5 weeks, receiving either a protein-reduced diet (0.9 g kg⁻¹ BW day⁻¹) substituted with increased carbohydrates or a habitual diet (1.8 g kg⁻¹ BW day⁻¹).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Protein reduction induced a 2.0 ± 0.6 kg weight loss and increased plasma FGF21 concentration compared with higher protein intake, without caloric restriction. Changes in plasma FGF21 concentration were inversely associated with changes in body weight (<i>r</i> = −0.59, <i>p</i> = 0.02). Expression of key components in the FGF21 receptor complex, FGFR1 and β-klotho, and downstream targets in subcutaneous adipose tissue remained unchanged. Markers of skeletal muscle mitochondrial oxidative phosphorylation were also unaltered. Fat mass decreased significantly, whereas this level of protein reduction only tended to lower lean body mass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that reducing protein intake (0.9 g kg⁻¹ BW day⁻¹), substituted with increased carbohydrates, compared with a habitual protein intake (1.8 g kg⁻¹ BW day⁻¹), can induce weight loss without restricting total energy intake in men with overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>\u0000 ClinicalTrials.gov identifier: NCT06263725</p>\u0000 \u0000 <div>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1569-1582"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261106","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":"The Clinical Outcomes of Preclinical and Clinical Obesity Across Multiple Cohorts","authors":"Sitong Li,&nbsp;Qi Huang,&nbsp;Yingning Liu,&nbsp;Song Wang,&nbsp;Yingying Luo,&nbsp;Xueyao Han,&nbsp;Linong Ji,&nbsp;Xiantong Zou","doi":"10.1002/oby.70260","DOIUrl":"10.1002/oby.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The <i>Lancet Diabetes &amp; Endocrinology</i> Commission proposed a new definition for clinical obesity. However, its prognostic value remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical obesity was defined using the Commission's criteria in the China Health and Retirement Longitudinal Study (CHARLS), the English Longitudinal Study of Aging (ELSA), and the National Health and Nutrition Examination Survey (NHANES). Prevalence estimation was conducted across four categories based on obesity and organ dysfunction status. Cox proportional hazards models were used to assess associations with clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of clinical obesity was 2.50% (CHARLS), 6.18% (ELSA), and 9.08% (NHANES), respectively. Overall, older adults and men had lower prevalence, while older men in NHANES showed higher prevalence. Compared with non-obesity without dysfunctions, clinical obesity and non-obesity with dysfunctions showed higher risks of cardiovascular outcomes. Compared with preclinical obesity, clinical obesity elevated cardiovascular risk in CHARLS (HR = 2.49, 95% CI: 1.32–4.70) and ELSA (HR = 1.80, 95% CI: 1.02–3.17) and increased all-cause (HR = 1.88, 95% CI: 1.23–2.87) and cardiovascular (HR = 3.11, 95% CI: 1.49–6.50) mortality risk in NHANES.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of clinical obesity varied by age, sex, and country. Overall, the prevalence was lower among older adults and men. Clinical obesity was associated with increased cardiovascular event risk across cohorts and increased all-cause mortality risk in NHANES, highlighting its value for risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1669-1676"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427852","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}