Objective To systematically review the efficacy of different exercises on inflammatory cytokines in individuals with overweight or obesity. Methods The CNKI, WanFang Data, VIP, PubMed, EBSCO, Cochrane Library, Web of Science and Embase databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise on inflammatory cytokines in individuals with overweight or obesity from January, 2000 to April, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The network meta-analysis was then performed using Stata 16.0 software. Results A total of 63 RCTs were included, 49 of which reported the changes in IL-6, 47 of which reported the changes in TNF-α, and 16 of which reported the changes in IL-10. The results of the network meta-analysis found that compared with those in the control group, aerobic exercise (AE) (SMD=−0.9, 95%CI −1.4 to −0.5, P<0.01) and high-intensity interval training (HIIT) (SMD=−1.3, 95%CI −2.3 to −0.3, P=0.011) significantly reduced IL-6. AE (SMD=−1.3, 95%CI −1.7 to −0.9, P<0.01), combined exercise (COM) (SMD=−0.7, 95%CI −1.3 to −0.1, P=0.02), and HIIT (SMD=−1.8, 95%CI −2.6 to −0.9, P<0.01) significantly reduced TNF-α; AE (SMD=0.8, 95%CI 0.1 to 1.5, P=0.03) significantly increased IL-10. The cumulative probability ranking results showed that HIIT was the most effective in reducing IL-6 and TNF-α and increasing IL-10, followed by AE and COM, and resistance training (RT) was the least effective. Conclusion Different exercise types have different effects on improving inflammation in individuals with overweight or obesity. HIIT can be suggested as the best exercise program to improve chronic inflammation in individuals with overweight or obesity. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
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.
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 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。
ObjectiveTo systematically review the intervention effects of high-intensity interval training (HIIT) on weight loss and blood lipid metabolism in overweight/obese populations. MethodsThe computer conducted searches in the PubMed, Embase, Cochrane Library, Web of Science, CNKI, and WanFang Data database to collect randomized controlled trials (RCTs) related to HIIT and weight loss, fat reduction, and blood lipid metabolism in overweight/obese populations. The search was conducted from the inception of the databases to March 31, 2023. Two researchers independently conducted literature screening and data extraction. After evaluating the risk of bias of the included studies, a meta-analysis was performed using RevMan 5.4 software. ResultsA total of 19 RCTs, involving 595 overweight/obese participants, were included. The meta-analysis results showed that compared wtih the control group, HIIT interventions effectively reduced body weight (MD=−2.63, 95%CI −4.04 to −1.23, P<0.05), BMI (MD=−1.21, 95%CI −1.95 to −0.48, P<0.05), Fat% (MD=−1.66, 95%CI −2.28 to −1.04, P<0.05), TG (MD=−0.13, 95%CI −0.25 to −0.01, P=0.04), HDL (MD=0.14, 95%CI 0.05 to 0.23, P<0.05), and LDL (MD=−0.26, 95%CI −0.39 to −0.13, P<0.05) levels but did not improve TC (MD=−0.15, 95%CI −0.36 to 0.06, P=0.15) levels. ConclusionHIIT intervention can effectively improve body weight, BMI, Fat%, TG, HDL, and LDL levels in overweight/obese populations, particularly showing a more pronounced improvement in lipid profiles among overweight/obese adolescents, but it does not reduce TC levels. This study demonstrates that HIIT may be an effective strategy to assist in weight loss and prevent cardiovascular diseases in overweight/obese populations, with potential for broader application.
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: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。
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.
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.
Objective To systematically review the efficacy of eight time-restricted eating strategies on overweight/obese adults using network meta-analysis. MethodsThe Scopus, MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on the intervention effects of eight time-restricted eating strategies on overweight/obese adults from inception to September 18, 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was performed using ADDIS 1.16.8 and Stata 18.0 software. ResultsA total of 23 RCTs involving 1 306 overweight/obese adults were included. The network meta-analysis revealed that compared with standard diets, the 8-hour time-restricted eating combined with a low-carbohydrate diet (MD=−4.01, 95%CI −5.95 to −2.08, P<0.05) showed better weight reduction effects. Compared with standard diets, the 8-hour time-restricted eating combined with a low-carbohydrate diet (MD=−3.54, 95%CI −5.44 to −1.63, P<0.05) and the 8-hour time-restricted eating combined with a low-sugar diet (MD=−4.19, 95%CI −8.33 to −0.05, P<0.05) significantly improved overall fat mass. Compared with standard diets, the 8-hour time-restricted eating combined with a low-sugar diet (MD=−15.42, 95%CI −29.12 to −1.72, P<0.05) had a better effect on fasting blood glucose control. The 8-hour time-restricted eating combined with high-intensity interval training (MD=−3.68, 95%CI −6.57 to −0.79, P<0.05) showed better results in reducing waist circumference. No statistical significance was found in direct comparisons regarding bone mineral content. The efficacy ranking showed that the 8-hour time-restricted eating combined with a low-carbohydrate diet was most effective for weight reduction; the 8-hour time-restricted eating combined with a low-sugar diet was more effective in reducing overall fat mass and controlling fasting blood glucose; the 8-hour time-restricted eating combined with calorie restriction had significant effects on waist circumference improvement; and the 8-hour time-restricted eating combined with high-intensity interval training was more effective for increasing bone mineral content. ConclusionBased on the results of the network meta-analysis and ranking, different time-restricted eating strategies have specific advantages for the intervention of overweight or obese individuals. The choice of the appropriate strategy should consider individual dietary habits and health conditions. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.