目的:了解成都市3~6岁学龄前儿童超重、单纯性肥胖发展趋势和干预效果,以寻求更有效的干预措施。方法:自2000~2007年对成都市五城区所有一类托幼园所3~6岁儿童进行调查,对其超重、肥胖发生、发展动态趋势进行分析研究,并设重点干预点进行连续干预监测。参照WHO标准,应用身高别体重法评价儿童超重和肥胖。结果:2000~2005年中,成都市学龄前儿童超重、单纯性肥胖发生率显著升高(2000年为6.50%、2.14%;2005年为9.57%,4.39%,Plt;0.001);通过对托幼园所实施肥胖干预后,2005~2007年儿童超重、单纯性肥胖检出率处于稳定控制状态(2007年为9.13%,4.17%,Pgt;0.05)。2005~2007年对本市15所托幼机构实施重点干预后,儿童超重、肥胖检出率为8.51%,3.26%,明显降低(Plt;0.05),而一般干预点,超重、肥胖发生率明显升高(10.42%,5.12%,Plt;0.05)。结论:学龄前儿童超重、单纯性肥胖呈上升趋势,有效的干预措施能控制超重和肥胖发生率。
Objectiveofthisstudyistoprognosethepossibilityofdevelopinggallstoneinsubjectswiththedyslipidemiaandobesity.Themultivariablelogisticregressionmodelwasusedtoevaluatetheoddsratio(OR)ofthedyslipidemiaandobesitytoinducetheformationofgallstone.ORgt;1indicatesdangerousfactor,ORlt;1protectivefactor,andOR=1nosignificance.Theresultsshowedthatiftriglyceride(TG)andverylowdensitylipoproteincholesterol(VLDLC)increasedanaveragelevelofnormalrespectively,andtherewouldbeORofTG2.43(Plt;0.05)andORofVLDLC6.09(Plt;0.05),thehighlevelsofTGandVLDLCwerethefactorsoflithogenesis.Highdensitylipoproteincholesterols(HDL1C,HDL2C,HDL3C),withORlessthanone,werethefactorsofprotectingagainsttheformationofgallstone.ORoflowdensitylipoproteincholesterol(LDLC)andORoftotalcholesterol(TC)werealsolessthanone,butpresentresearchindicatedthattheymaybeawayoflipidmetabolismnottobeaprotectivefactor.ORofBMIinmalesubjectswas1.16(Pgt;0.05),andinfemale1.38(Plt;0.05).Thesesuggestthatbothcorrectionofthemetabolismofdyslipidemiaandreductionofbodyweightareimportanttodecreasethemorbidityofcholecystolithiasis.
A lot of evidence-based medical evidence has shown that laparoscopic Roux-en-Y gastric bypass (LRYGB) is a durable and effective method for obesity and diabetes, and can significantly improve a series of obesity-related metabolic complications. This guideline provides a detailed description of the main operating steps and technical points of the symmetric three-port LRYGB, including posture layout, trocar position selection, liver suspension, gauze exposure, production of small gastric sacs, gastrojejunal anastomosis and production of biliary pancreatic branches, entero-enteric side to side anastomosis, closure of gastrointestinal anastomosis and mesenteric hiatus, greater omentum coverage, and closure of incisions. The purpose is to standardize the operating process of the symmetrical three hole method of LRYGB, providing standardized surgical operation references for clinical doctors in the field of obesity metabolic surgery.
ObjectiveTo systematically review the effectiveness of breastfeeding duration and intensity in reducing the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia. MethodsThe PubMed, EMbase, Web of Science, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect observational studies on the associations of breastfeeding with the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia from inception to September 25th, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Stata 16.0 software was used for the meta-analysis. ResultsA total of 12 657 participants from 13 observational studies were included. The results of meta-analysis showed that breastfeeding could reduce the risk of overweight or obesity among offspring exposed to intrauterine hyperglycemia (OR=0.67, 95%CI 0.53 to 0.84, P=0.001). Subgroup analysis revealed a protective effect of breastfeeding for both 1-6 months (OR=0.53, 95%CI 0.37 to 0.75, P<0.001) and ≥6 months (OR=0.56, 95%CI 0.46 to 0.69, P<0.001); however, breastfeeding shorter than one month was suggested to increase the risk of overweight or obesity (OR=2.15, 95%CI 1.41 to 3.27, P<0.001). ConclusionAvailable evidence suggests that breastfeeding for more than one month is effective in reducing the risk of overweight or obesity in offspring exposed to intrauterine hyperglycemia, and women with hyperglycemia should be encouraged to breastfeed their offspring for at least 1 month to achieve the effect. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
目的:探讨老年2型糖尿病患者体重指数(BMI)与胰岛β功能状态及胰岛素抵抗(RI)的关系。方法:调查对象为2006年4月~2008年7月入我接受健康体检的成都地区离退休干部。采用1999年WHO糖尿病诊断标准,以129例已确诊T2DM患者为观察对象,根据体重指数(BMI)分为两组:肥胖组(含超重)(BMI≥25)66例,均为男性;非肥胖组(BMIlt;25)63例,其中3例为女性(无统计学意义),并与19例正常对照组进行对比研究。以氧化酶法测定空腹血葡萄糖(FBG),酶联免疫法测胰岛素(INS)及C肽(CP)水平等参数。用HOMA公式计算胰岛素抵抗(IR)和β细胞功能指数(BCI)。采用SPSS软件进行方差分析(ANOVA),分析3组间各指标的差异显著性x-±S表示。结果:三组经HOMA 公式计算的IR值为对照组(3.0±1.3)、非肥胖组(4.6±4.0)、肥胖组(5.2±6.2)依次递增,但各组间无显著性差异。HOMAβ细胞功能指数为非肥胖组(82.06±84.1)、肥胖组(138.4±179.6)、对照组(226.5±236.8)依次递增,各组间均有显著性差异(Plt;0.01～0.05)。 结论:老年2型糖尿病患者普遍存在β细胞功能减退,尤其是非肥胖组;同时也具有胰岛素抵抗,主要是肥胖组。表明BMI对老年糖尿病患者胰岛β细胞功能有影响,肥胖患者β细胞分泌能力加强,负担加重,功能受损,胰岛素抵抗明显。
Obesity is closely related to thyroid function. The concentration of thyroid stimulating hormone (TSH) in obese patients is higher than that in the general population, and TSH will decrease accordingly after weight loss. Leptin is a bridge linking obesity and thyroid hormones, which can affect the release of TSH. There are many kinds of weight-reducing drugs that target the thyroid gland. Among them, thyroid hormone receptor-specific agonists may be potential drugs for future obesity treatment, but further studies are still needed.
ObjectiveTo evaluate the superiority of nasopharyngeal airway on obesity patients during general anesthesia induction period. MethodForty-two trachea cannula and general anesthesia obesity patients treated from June to November in 2013 were chosen and divided equally into two groups:nasopharyngeal airway group (group A) and control group (group B). Mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), arterial blood partial pressure of carbon dioxide (PaCO2) were recorded when the patients entered the operation room, three minutes after man-made positive pressure ventilating and five minutes after intubation. Peak voltage (Ppeak) of man-made positive pressure ventilation for three minutes was also observed, and intubation frequency and time, mouth mucosa bleeding, and sore throat examples were compared between the two groups. ResultsCompared with group B, MAP, HR, PaCO2 and Ppeak three minutes after man-made positive pressure ventilating were lower (P<0.05), but SpO2 was higher in group A (P<0.05). Intubation frequency and time, mouth mucosa bleeding, and sore throat examples of group A were less than those in group B (P<0.05). ConclusionsNasopharyngeal airway is better for obesity patients during general anesthesia induction period, which also improves anesthesia safety level.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.