The Lancet Diabetes & Endocrinology最新文献

{"title":"Automated insulin delivery postpartum: insights from the AiDAPT study extension","authors":"David N O'Neal, Glynis P Ross","doi":"10.1016/s2213-8587(24)00374-7","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00374-7","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"25 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated insulin delivery during the first 6 months postpartum (AiDAPT): a prespecified extension study","authors":"Tara T M Lee, Corinne Collett, Simon Bergford, Sara Hartnell, Eleanor M Scott, Robert S Lindsay, Katharine F Hunt, David R McCance, Rebecca M Reynolds, Malgorzata E Wilinska, Judy Sibayan, Craig Kollman, Roman Hovorka, Helen R Murphy","doi":"10.1016/s2213-8587(24)00340-1","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00340-1","url":null,"abstract":"<h3>Background</h3>Clinical guidelines in the UK and elsewhere do not specifically address hybrid closed loop (HCL) use in the postpartum period when the demands of caring for a newborn are paramount. Our aim was to evaluate the safety and efficacy of HCL use during the first 6 months postpartum compared with standard care.<h3>Methods</h3>In this prespecified extension to a multicentre, randomised controlled trial, pregnant women with type 1 diabetes at nine UK sites were followed up for 6 months postpartum. Eligible participants (AiDAPT participants recruited after the implementation of the postpartum protocol amendment approval, those still pregnant or within six months of delivery at the time of amendment implementation and still using HCL or continuous glucose monitoring [CGM] therapy) continued their randomly assigned treatment, either standard insulin therapy with CGM or HCL therapy (CamAPS FX system version 0.3.1, CamDiab, Cambridge, UK). Participants were randomised in a 1:1 ratio with stratification by clinical site using randomly permuted block sizes of 2 or 4. The primary outcome was the between-group difference in percentage time in range ([TIR] 3·9–10·0 mmol/L [70–180mg/dL]), measured during the periods of month 0 up to 3, months 3 to 6, and over 6 months postpartum. The study is registered at <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> (ISRCTN56898625) and is complete.<h3>Findings</h3>Of the 124 AiDAPT trial participants, 66 (53%) were ineligible for inclusion in the postpartum extension, and 57 participants consented to continue their treatment per original random allocation. The mean age was 31 years (SD 4), and all participants had early pregnancy HbA<sub>1c</sub> 59·4 mmol/mol (SD 10·5 [7·6% SD 1·0%]). In the 6 months postpartum, mean time with glucose levels within the target range was higher in the HCL group compared with the standard care group (72% [SD 12%] <em>vs</em> 54% [17%]), with an adjusted treatment difference of 15% (95% CI 7 to 22). Results for hyperglycaemia (>10·0 mmol/L) and mean CGM glucose also favoured HCL (–14% [95% CI –23% to –6%] and –1·3 mmol/L [–2·3 to –0·3], respectively). Hypoglycaemia rates were low, with no between-group differences (2·4% <em>vs</em> 2·6%). There were no treatment effect changes depending on postpartum period (0 up to 3 months <em>vs</em> 3 to 6 months) and no unanticipated safety problems.<h3>Interpretation</h3>Participants in the HCL group maintained 70% TIR during the first 6 months postpartum, supporting continued use of HCL rather than standard insulin therapy for people with diabetes once they have given birth.<h3>Funding</h3>National Institute for Health Research, Juvenile Diabetes Research Foundation, and Diabetes Research & Wellness Foundation. CGM devices were provided by","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"117 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143050776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating direct tissue effects versus weight loss effects of incretin-based drugs for obesity on various chronic conditions","authors":"Naveed Sattar, Matthew M Y Lee","doi":"10.1016/s2213-8587(24)00363-2","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00363-2","url":null,"abstract":"The extent to which newer, incretin-based drugs for obesity improve disease outcomes via weight loss versus the direct effects of these drugs is the subject of intense interest. Although reductions in major adverse cardiovascular events appear to be predominantly driven by the direct tissue effects of such drugs, the associated weight loss effects must be relevant to the benefits observed in other major outcomes, albeit to differing extents. In this Personal View, we draw on evidence to support that weight loss is at least partly responsible (albeit to differing extents) for the reported benefits of incretin-based drugs for obesity in people living with heart failure with preserved ejection fraction, hypertension, chronic kidney disease, and type 2 diabetes. Concurrently, we propose that drug-induced weight loss is largely responsible for the reported improvements in osteoarthritis, obstructive sleep apnoea, and metabolic dysfunction-associated steatohepatitis outcomes. However, more evidence is needed to solidify these observations, including, when possible, trials comparing the effects of incretin-based drugs for obesity with calorie-reduced diets on both outcomes and mechanistic pathways. Such evidence has implications for public health and the design of future trials of novel drugs for obesity.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"13 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lerodalcibep and evolocumab for the treatment of homozygous familial hypercholesterolaemia with PCSK9 inhibition (LIBerate-HoFH): a phase 3, randomised, open-label, crossover, non-inferiority trial","authors":"Frederick J Raal, Vimal Mehta, Meral Kayikcioglu, Dirk Blom, Preeti Gupta, Avishay Elis, Traci Turner, Chris Daniels, Jeffrey Vest, Tracy Mitchell, Kate Caldwell, El Mustapha Bahassi, David Kallend, Evan A Stein","doi":"10.1016/s2213-8587(24)00313-9","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00313-9","url":null,"abstract":"<h3>Background</h3>Lerodalcibep, a small binding anti-PCSK9 protein (adnectin), showed effective LDL cholesterol reduction in heterozygous familial hypercholesterolaemia. We aimed to assess the safety and efficacy of lerodalcibep and evolocumab in a globally diverse homozygous familial hypercholesterolaemia population.<h3>Methods</h3>This phase 3, randomised, open-label, crossover, non-inferiority study consisted of two 24-week treatment periods separated by an 8-week washout. The study was conducted in 12 lipid clinics in six countries (India, Israel, Norway, South Africa, Türkiye, and the USA). Patients aged 10 years or older with genetically confirmed homozygous familial hypercholesterolaemia were randomly assigned by computer-generated randomisation scheme performed centrally via interactive response technology to either monthly lerodalcibep 300 mg (1·2 mL subcutaneous injection) or monthly evolocumab 420 mg (subcutaneous 9 min infusion of 3·5 mL) for 24 weeks (period A) followed by an 8-week washout and then crossed over to the alternate therapy for the next 24 weeks (period B). The trial was open label, but all efficacy parameters were masked to patients, study staff, and the sponsor from randomisation. The primary efficacy endpoint was the percent change from baseline (day 1 of period A) in LDL cholesterol concentration to week 24 for period A and B. The intention-to-treat (ITT) population, defined as all randomly assigned patients, was used for the primary analysis. The safety population included all patients who received any study medication. The margin used to establish non-inferiority was 6%. The trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> (<span><span>NCT04034485</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>) and EudraCT (2019–003611–62), and has now finished.<h3>Findings</h3>Patients were enrolled from Nov 11, 2019, to July 2, 2021, and the final study visit took place on Aug 8, 2022. Of 82 patients screened, 66 entered period A (ITT population). The mean age was 28·7 years (SD 15·2); 20 (30%) of 66 were paediatric patients; 36 (55%) of 66 were female and 30 (45%) of 66 were male; and the mean baseline LDL cholesterol was 10·59 mmol/L (SD 4·37). Mean LDL cholesterol reduction by ITT analysis at week 24 was –4·9% (SE 3·5) on lerodalcibep compared with –10·3% (3·5) on evolocumab; the mean difference between treatments was 5·4% (95% CI –0·2 to 11·1), which did not show non-inferiority at the prespecified 6% margin. LDL cholesterol response varied considerably across the patient population but was generally similar in the same patients with both lerodalci","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"3 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the hypothalamic–pituitary–thyroid axis in thyroid cancer","authors":"Laura Abaandou, Raisa Ghosh, Joanna Klubo-Gwiezdzinska","doi":"10.1016/s2213-8587(24)00364-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00364-4","url":null,"abstract":"The hypothalamic–pituitary–thyroid axis plays a crucial role in the pathogenesis, diagnosis, risk stratification, effectiveness of radioiodine therapy, and treatment response evaluation in epithelial thyroid cancer. Supraphysiological doses of levothyroxine are used in patients with intermediate-risk and high-risk thyroid cancer to suppress thyroid-stimulating hormone (TSH) to prevent tumour progression. However, free thyroxine and tri-iodothyronine have also been found to promote tumour growth in thyroid cancer preclinical models. Moreover, current evidence remains inconclusive about the role of TSH suppression in improving survival outcomes and reveals an increased risk of cardiovascular and skeletal adverse events after long-term exposure to excess levothyroxine. Stimulation of the axis with either recombinant human TSH or thyroid hormone withdrawal has been proven equally effective for diagnostic purposes and for facilitating radioiodine uptake for thyroid remnant ablation, but evidence is insufficient for non-inferiority of recombinant human TSH-based <em>vs</em> thyroid hormone withdrawal-based stimulation before radioiodine therapy of distant metastases.","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"47 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protein-binding therapy: a new approach to lower cholesterol","authors":"Robert A Hegele","doi":"10.1016/s2213-8587(24)00347-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00347-4","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"113 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The STEP-HFpEF programme: advancing care at the intersections","authors":"John W Ostrominski, Vanita R Aroda","doi":"10.1016/s2213-8587(24)00335-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00335-8","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"74 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide in obesity-related heart failure with preserved ejection fraction and type 2 diabetes across baseline HbA1c levels (STEP-HFpEF DM): a prespecified analysis of heart failure and metabolic outcomes from a randomised, placebo-controlled trial","authors":"Melanie J Davies, Peter van der Meer, Subodh Verma, Shachi Patel, Khaja M Chinnakondepalli, Barry A Borlaug, Javed Butler, Dalane W Kitzman, Sanjiv J Shah, Signe Harring, Afshin Salsali, Søren Rasmussen, Dirk von Lewinski, Walter Abhayaratna, Mark C Petrie, Mikhail N Kosiborod","doi":"10.1016/s2213-8587(24)00304-8","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00304-8","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;About half of patients with heart failure with mildly reduced or preserved ejection fraction (HFpEF) have type 2 diabetes. In the STEP-HFpEF DM trial of adults with obesity-related HFpEF and type 2 diabetes, subcutaneous once weekly semaglutide 2·4 mg conferred improvements in heart failure-related symptoms and physical limitations, bodyweight, and other heart failure outcomes. We aimed to determine whether these effects of semaglutide differ according to baseline HbA&lt;sub&gt;1c&lt;/sub&gt;.&lt;h3&gt;Methods&lt;/h3&gt;STEP-HFpEF DM, a double-blind, randomised, placebo-controlled trial conducted at 108 clinical research sites across 16 countries in Asia, Europe, and North and South America, included individuals aged 18 years or older with documented HFpEF (left ventricular ejection fraction ≥45%), type 2 diabetes, and obesity (BMI ≥30 kg/m&lt;sup&gt;2&lt;/sup&gt;). Participants were randomly assigned (1:1), with a block size of four within each stratum using an interactive web response system, stratified by baseline BMI (&lt;35 kg/m&lt;sup&gt;2&lt;/sup&gt; &lt;em&gt;vs&lt;/em&gt; ≥35 kg/m&lt;sup&gt;2&lt;/sup&gt;), to receive either semaglutide 2·4 mg or placebo subcutaneously. The effects of semaglutide versus placebo on the efficacy endpoints were evaluated by HbA&lt;sub&gt;1c&lt;/sub&gt; categories at baseline: low (&lt;6·5%; &lt;48 mmol/mol), medium (6·5% to &lt;7·5%; 48 mmol/mol to &lt;58 mmol/mol), and high (≥7·5%; ≥58 mmol/mol). The dual primary endpoints were change in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) and bodyweight percentage from baseline to 52 weeks and were assessed in all randomly assigned participants by intention to treat. Hypoglycaemia events were also analysed to assess safety in all randomly assigned participants who received at least one dose of study drug. This trial is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT04916470&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;h3&gt;Findings&lt;/h3&gt;Between June 27, 2021 and Sept 2, 2022, 616 participants were enrolled and randomly assigned (mean age 68·4 years [SD 8·9]; 273 [44%] were female, 343 [56%] were male, and 519 [84%] were White). The low baseline HbA&lt;sub&gt;1c&lt;/sub&gt; group included 227 participants (112 assigned to semaglutide and 115 to placebo), the medium baseline HbA&lt;sub&gt;1c&lt;/sub&gt; group included 226 participants (124 assigned to semaglutide and 102 to placebo), and the high baseline HbA&lt;sub&gt;1c&lt;/sub&gt; group included 163 participants (74 assigned to semaglutide and 89 to placebo). The median duration of follow-up in the overall trial was 401 days (IQR 400–405). The change in KCCQ-CSS from baseline to 52 weeks was 1","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"30 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining obesity: advancing care for better lives","authors":"","doi":"10.1016/s2213-8587(25)00004-x","DOIUrl":"https://doi.org/10.1016/s2213-8587(25)00004-x","url":null,"abstract":"No Abstract","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"4 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definition and diagnostic criteria of clinical obesity","authors":"Francesco Rubino, David E Cummings, Robert H Eckel, Ricardo V Cohen, John P H Wilding, Wendy A Brown, Fatima Cody Stanford, Rachel L Batterham, I Sadaf Farooqi, Nathalie J Farpour-Lambert, Carel W le Roux, Naveed Sattar, Louise A Baur, Katherine M Morrison, Anoop Misra, Takashi Kadowaki, Kwang Wei Tham, Priya Sumithran, W Timothy Garvey, John P Kirwan, Geltrude Mingrone","doi":"10.1016/s2213-8587(24)00316-4","DOIUrl":"https://doi.org/10.1016/s2213-8587(24)00316-4","url":null,"abstract":"&lt;h2&gt;Section snippets&lt;/h2&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Executive summary&lt;/h2&gt;Current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about health at the individual level, which undermines medically-sound approaches to health care and policy. This Commission sought to define clinical obesity as a condition of illness that, akin to the notion of chronic disease in other medical specialties, directly results from the effect of excess adiposity on the function of organs and tissues. The specific aim of the&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Conception of the Commission&lt;/h2&gt;The idea and general plan to convene a global expert group for the definition of diagnostic criteria of chronic illness in obesity (clinical obesity) was conceived by FR, and discussed with editors of &lt;em&gt;The Lancet Diabetes &amp; Endocrinology&lt;/em&gt; journal for consideration as a &lt;em&gt;Lancet&lt;/em&gt; Commission. The Commission on clinical obesity was organised in partnership with the Institute of Diabetes, Endocrinology and Obesity at Kings Health Partners. Additional scientific input about the programme of the&lt;/section&gt;&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;General principles&lt;/h2&gt;Although the notion of disease might seem obvious, a clear definition of disease does not exist. One comprehensive approach to the definition of disease was proposed by Stanley Heshka and David Allison:&lt;sup&gt;27&lt;/sup&gt; (A) a condition of the body, its parts, organs, or systems, or an alteration thereof; (B) resulting from infection, parasites, nutritional, dietary, environmental, genetic, or other causes; (C) having a characteristic, identifiable, marked group of symptoms or signs; and (D) deviation from&lt;/section&gt;&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Commissioners' views on obesity as a disease&lt;/h2&gt;The idea of obesity as a disease was a controversial subject also within this Commission. Initial opinions diverged substantially, clearly indicating that a consensus would not be reached on a blanket definition of obesity as a disease, at least as currently defined. A specific pre-Delphi survey on the question of whether obesity is a disease showed that more than half of the commissioners rejected the all-or-nothing scenario implied in the question, but supported the view that obesity is a&lt;/section&gt;&lt;/section&gt;&lt;section&gt;&lt;section&gt;&lt;section&gt;&lt;h2&gt;Conceptual and practical issues in the current definition of obesity&lt;/h2&gt;Obesity is currently conceived and defined as a condition of excess adiposity that presents a “risk to health”.&lt;sup&gt;34&lt;/sup&gt; The current diagnosis of obesity worldwide is based on BMI, calculated as weight in kilograms divided by height in metres squared. According to WHO, an adult with a BMI of 30 kg/m&lt;sup&gt;2&lt;/sup&gt; or higher is considered to have obesity.This definition has been widely adopted and used in epidemiological studies, clinical practice, and public health policy.&lt;sup&gt;35&lt;/sup&gt; However, several studies have shown t","PeriodicalId":48790,"journal":{"name":"The Lancet Diabetes & Endocrinology","volume":"31 1","pages":""},"PeriodicalIF":44.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}