Objective To explore the correlation between overweight, obesity and incidence of type 2 diabetes mellitus (T2DM). Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CNKI, VIP, CBM and WanFang Data were searched from inception to May, 2012 to collect the cohort studies on the correlation between overweight, obesity and incidence of T2DM. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, the quality was evaluated, the data were extracted, and then meta-analysis was performed using RevMan 5.1 and Stata 11.0 software. Results A total of 8 studies involving 101 864 participants were included. The results of meta-analysis showed that, compared with the normal weight population, the onset risk of T2DM was obviously higher in the overweight (RR=2.59, 95%CI 2.11 to 3.19, Plt;0.000 01), and obese (RR=6.28, 95%CI 4.99 to 7.91, Plt;0.000 01) populations. In the subgroup analysis, the onset risk of T2DM was higher in the western obese population (RR=6.91, 95%CI 5.59 to 8.56) than the eastern obese population (RR=4.19, 95%CI 2.93 to 5.99). Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE), the quality of the included studies on T2DM developed by overweight and obesity was low and medium respectively. Conclusion Overweight and obesity can increase the onset risk of T2DM which is higher in the female and western obese populations than the male and eastern obese populations respectively.
Objective To understand the prevalence of overweight and obesity and its influence factors in Zhuhai inhabitants. Methods Applying multi-stage cluster random sampling in the three administrative areas of Zhuhai including Xiangzhou, Doumen and Jinwan, A questionnaire-based survey was performed in conjunction of the measurement of height and weight among 961 inhabitants aged 15-69 years. In addition, a multivariate unconditional logistic regression model was employed to analyze the influence factors of overweight and obesity. Results The prevalence and standardized rates of overweight and obesity in the study population were 18.1%, 17.6%, 6.6%, 6.5%, respectively. The standardized rates of overweight and obesity in male and female were 18.4%, 5.8%, 16.5%, 7.2%, respectively. Age, drinking, smoking and regional difference were identified as the 4 risk factors of overweight and obesity, their OR values being 1.028, 1.683, 0.677, 1.404, Plt;0.05, respectively. Conclusion The prevalence of overweight and obesity in Zhuhai’s inhabitants was over the average level of Chinese residents, and overweight and obesity has become a major risk factor influencing the health of Zhuhai’s inhabitants. In view of the influence factors of overweight and obesity, timely and effective prevention and control measures should be taken.
目的 比较无创双水平正压通气（BiPAP）平均容积保证压力支持（AVAPS）模式与同步/时间控制（S/T）模式在肥胖的慢性阻塞性肺疾病（COPD）患者并发急性Ⅱ型呼吸衰竭中的治疗作用。 方法 选取2012年3月－2013年6月入院治疗且体质量指数（BMI）＞25 kg/m2的COPD发生急性Ⅱ型呼吸衰竭患者36例，按数字随机表法分为AVAPS组与S/T组。两组的基础治疗相同，AVAPS组采用飞利浦伟康V60呼吸机BiPAP AVAPS模式进行无创通气治疗，S/T组采用相同机型BiPAP S/T模式治疗。分别比较两组患者治疗1、6、24、72 h的格拉斯高昏迷（GCS）评分变化、血气分析结果、呼吸机监测数据。 结果 AVAPS组患者在最初治疗的6 h内GCS评分高于S/T组[1 h：（13.2 ± 0.6）、（11.9 ± 0.6） 分，P＜0.05；6 h：（13.8 ± 0.5）、（12.1 ± 0.6）分，P＜0.05]；24 h内的动脉血气酸碱度pH值改善[1 h：7.31 ± 0.03、7.26 ± 0.02，P＜0.05；6 h：7.37 ± 0.05、7.31 ± 0.04，P＜0.05]；24 h：7.40 ± 0.04、7.33 ± 0.03，P＜0.05]及二氧化碳分压下降[1 h：（65.2 ± 5.1）、（69.5 ± 4.1）mm Hg（1 mm Hg=0.133 kPa），P＜0.05；6 h：（61.4 ± 4.2）、（66.7 ± 4.3） mm Hg，P＜0.05；24 h：（58.2 ± 4.5）、（64.3 ± 5.4） mm Hg，P＜0.05）]优于S/T组，24 h内浅快呼吸指数低于S/T组[1 h：（35.2 ± 8.1）、（62.8 ± 13.2）次/（min·L），P＜0.05]；6 h（33.4 ± 7.8） 、（54.8 ± 11.6）次/（min·L），P＜0.05]，同时，减少了额外的人工参数调整次数[3.4 ± 1.1、1.2 ± 0.6），P＜0.05] 结论 对超重的COPD合并急性Ⅱ型呼吸衰竭患者采用AVAPS模式进行无创通气治疗，较S/T模式能更快地恢复意识水平，更快地降低血二氧化碳分压、改善pH值，同时减少了呼吸治疗师的人工操作次数。
【摘要】 目的 探讨内江市企事业及机关单位从业人员20~60岁人群中超重、肥胖者及其相关因素。 方法 2009年6月－2010年9月采用整体随机分层方法，对内江市企事业及机关单位从业人员共5 832例进行调查。用问卷了解吸烟、饮酒、运动、家族史、文化程度，并测定身高、体重、空腹血糖、甘油三酯、胆固醇等。采用SPSS 17.0软件进行统计学分析，以双侧Plt;0.05为有统计学的意义。与肥胖有关的危险因素采用多因素logistic回归分析。 结果 超重及肥胖者比例为27.16%，其中超重者1 377例，占23.6%，肥胖者207例，占3.55%；肥胖较超重者空腹血糖、甘油三酯、血压更高；多因素logistic回归分析提示:超重及肥胖与年龄、吸烟、性别、运动、家族史、文化程度有关，与饮酒无关。 结论 内江市企事业及机关单位从业人员20~60岁人群中超重、肥胖者比例为27.16%；肥胖较超重者更易发生高血糖、高血压、高血脂、高尿酸血症；超重及肥胖与年龄、吸烟、性别、运动、家族史、文化程度均有关。【Abstract】 Objective To investigate the prevalence and the risk factors of overweight and obesity among employees aged 20 to 60 years old in enterprises and government institutions in Neijiang city. Methods From June 2009 to September 2010, 5 832 employees in government departments, enterprises and institutions in Neijiang were surveyed using stratified random sampling method. Items like physical exercise, smoking, drinking, educational level, and family history were collected through face-to-face questionnaire, and their height, weight, fasting plasma glucose, triglyceride, cholesterol were measured. SPSS 17.0 was used for statistical analysis, and the relationship of each index was analyzed by Pearson correlative analysis. Bilateral Plt;0.05 was considered to be statistically significant. Risk factors associated with obesity were analyzed by Logistic regression analysis. Results The overweight and obesity morbidity rate was 27.16%, including 1377 cases of overweight (23.6%) and 207 cases of obesity (3.55%). Fasting plasma glucose, triglyceride, and blood pressure of obesity patients were higher than those of the overweight patients. Correlation analysis showed that overweight and obesity were positively correlated with fasting plasma glucose (r=0.116,Plt;0.01), triglyceride(r=0.319,Plt;0.01), uric acid (r=0.373,Plt;0.01), diastolic blood pressure (r=0.198,Plt;0.01), and systolic blood pressure (r=0.212,Plt;0.01), but not correlated with cholesterol. Logistic regression multivariate analysis showed that overweight and obesity were related with age, smoking, sex, sports, the educational level and family history, but not related with drinking. Conclusions The prevalence of overweight and obesity among employees aged 20 to 60 years old in enterprises and government institutions in Neijiang city is 27.16%. People with overweight and obesity are more susceptible to hyperglycemia, hypertension, hyperlipemia, and hyperuricemia. Overweight and obesity were closely related with age, smoking, gender, sports activities, family history, and educational level.
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。
目的:了解四川省直机关省厅级公务员超重、肥胖的现状,探讨体重指数、腰围与血脂的关系。方法:2008年对四川省直机关省厅级公务员取样调查1260人测身高,体重,腰围(WC),血脂,计算体重指数(BMI),并对男女各组间胆固醇、甘油三酯进行统计学分析。结果:四川省直机关省厅级公务员的男女肥胖率分别为9.1%、7.7%,超重率分别为45.3%、27.8%,肥胖组及超重组甘油三酯明显高于正常组,多元回归分析结果显示男女性甘油三酯与BMI、WC均有明显相关性(Plt;0.01)。结论:防治高血脂,控制肥胖及腹型肥胖甚为重要,体重指数、腰围的控制也为防治高血脂的基本措施之一。
ObjectiveTo determine the influence of high BMI on postoperative complications in a cohort of squamous esophageal cancer patients. MethodsWe retrospectively analyzed the clinical data of 450 consecutive esophageal cancer patients who underwent esophagectomy in our hospital from September 2010 through November 2012 year. The patients were divided into three groups. Forty-five patients were classified as a low BMI group (BMI < 18.5 kg/m2), 304 patients were classified as a normal BMI group (18.5≤BMI < 25.0 kg/m2), and 101 patients as a high BMI group (BMI≥25.0 kg/m2). Patients' demographics, tumor characteristics, and postoperative complications were compared among the three groups. ResultsThe comorbidity of diabetes was higher in the high BMI group compared with the other two groups (P=0.025). Longer operative time, wound infection or delayed healing were more frequent in the high BMI group (P=0.010 and P=0.039, respectively). Pneumonia and length of hospital stay had a tendency to increase in the high BMI group (P=0.052 and P=0.081, respectively). However, the differences did not reach statistical significance. There was no statistical difference in pulmonary embolism, respiratory failure, anastomotic leakage, vocal code paresis, chylothorax, other organ damage, reoperation, arrhythmia, or in-hospital mortality among the three groups. ConclusionsHigh BMI has a negative impact on postoperative morbidity after esophagectomy. However, overweight is not a postoperative complications which should always be paid attention to.
Orlistat, which has a new mechanism of action, is currently the only approved weight-loss drug in China. In addition to controlling body weight, orlistat can significantly improve blood glucose, blood pressure, dyslipidemia, adiponectin, insulin concentration and other obesity-related biochemical indicators in patients with overweight/obese. Recently, orlistat was approved for weight management in patients with polycystic ovary syndrome. Although there are clinical trials supporting the good weight loss efficacy of orlistat, its long-term safety and effectiveness in obesity-related diseases still need to be further determined. This article provides a brief review of the new progress in the clinical efficacy and safety of orlistat, aiming to provide a reference for the more rational drug application.
Objective To systematically review the efficacy and safety of a very low-calorie ketogenic diet (VLCKD) in patients who were overweight or obese. Methods From inception to August 2021, the electronic databases PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM were searched for randomized controlled trials (RCTs) of VLCKD in patients with overweight or obesity. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Then, meta-analysis was performed using Stata 16.0 software. Results A total of 5 RCTs involving 245 patients were included. Among patients with baseline body mass index (BMI) ≥30 kg/m2, the meta-analysis showed that compared with the control group, VLCKD could significantly reduce the BMI (MD=−0.24, 95%CI −0.39 to −0.08, P<0.05), weight (MD=−7.00, 95%CI −10.48 to −3.53, P<0.05) and waist circumference (MD=−7.40, 95%CI −12.68 to −2.12, P<0.05) . The subgroup analysis results showed that compared with the control diet, VLCKD could significantly reduce the glucose (MD=−9.60, 95%CI −17.52 to −1.69, P<0.05), glycated hemoglobin (MD=−0.24, 95%CI −0.39 to −0.08, P<0.05), insulin resistance index (MD=−0.90, 95%CI −1.08 to −0.73, P<0.05) and triglycerides (MD=−41.42, 95%CI −53.78, −29.06, P<0.05) in patients with type 2 diabetes and with obesity or overweight. In patients with obesity or overweight, VLCKD could increase high-density lipoprotein cholesterol (MD=8.60, 95%CI 0.17 to 17.03, P<0.05) when the intervention lasted longer than 12 months. In patients with obesity or overweight, VLCKD had no effect on insulin, total cholesterol, low-density lipoprotein, urea, creatinine, or uric acid. Patients with VLCKD had a higher rate of adverse events than those in the control groups; however, there was no significant difference in the rate when the intervention lasted longer than 4 months. Conclusion The current evidence shows that VLCKD can reduce BMI, weight, and waist circumference and reduce fasting glucose, HbA1c, insulin resistance index, and triglycerides among patients with type 2 diabetes and with obesity or overweight. However, VLCKD has no effect on insulin, total cholesterol, low-density lipoprotein, urea, creatinine, or uric acid. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
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.