Hypothalamic-pituitary hormones will be affected by the interaction between 5q13-14-rs2239670 (CARTPT) gene variants and diet in different obesity phenotypes

Objective Evidence show that cocaine and amphetamine regulated transcript-prepropeptide (CART-PT) gene variants may affect obesity related traits, but little is known about its end points. In the current study, we aimed to evaluate the interaction of CARTPT gene polymorphism with diet quality indices including dietary approaches to stop hypertension (DASH) and Mediterranean diet score (MDS) on cardio-metabolic risk factors. This cross sectional study recruited 288 apparently healthy obese individuals. Diet quality indices including DASH and MDS were evaluated using semi quantitative food frequency questionnaire (FFQ). Polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) was used for CARTPT genotypes. Results No significant differences was reported for general characteristics and biochemical parameters across genotypes except for QUICKI among females (P = 0.01) and it was higher in heterozygous genotype. There was significant CARTPT-DASH interactions affecting serum fasting glucose level (P = 0.049). However, in relation to CERTPT-MDS interactions, the highest level of insulin (P = 0.003) and HOMA-IR (P = 0.003) values were shown among AA carriers in high adherence to MDS, while AA carriers in high compliance to MDS experienced decreased level of QUICKI (P = 0.001).

Metabolically healthy obesity, transition to unhealthy phenotypes and type 2 diabetes in 0.5 million Chinese adults: The China Kadoorie Biobank

Objectives: To prospectively assess the association of metabolic health status and its transition with incident diabetes risk across body mass index (BMI) categories. Design: Cohort study based on the China Kadoorie Biobank (CKB) Methods: The CKB study enrolled 512,715 adults aged 30-79 years from 10 diverse areas in China during 2004-2008. After exclusion, 432,763 participants were cross-classified by BMI categories and the metabolic status during followed-up for incident diabetes disease. The changes in BMI and metabolic health status were defined from baseline to the second resurvey. Results: Type 2 diabetes risk is higher for metabolically healthy obese (MHO) subjects than metabolically healthy normal weight (MHN) individuals (HR: 3.97, 95% CI: 3.64-3.66), and it is highest for those affected by metabolically healthy obese (MUO) (HR: 6.47, 95% CI: 6.17-6.79). About 15.26% of participants with MHN converted to metabolically healthy overweight or obesity (MHOO), whereas 48.40% of MHOO remained unconverted throughout the follow-up. In obese or overweight people, the conversion from metabolically healthy to unhealthy might increase the chances of developing diabetes as compared to those with a stable metabolic healthy state (HR: 3.70, 95% CI: 2.99-4.59), while those with persistent metabolic disorders are most likely to have diabetes (HR: 8.32, 95% CI: 7.08-9.78). Conclusions: Metabolic healthy is a transient state, and individuals converted from metabolically healthy status to unhealthy phenotypes across all BMI categories might raise the risk of diabetes.

Future challenge on probiotics uses from fermented milk on the endocrine disorder in human

More than fifty different probiotics have been identified with different structures and modes of action. This study aimed to offer an overview of the evidence on the clinical microbiology activity of the probiotics group derived from fermented milk. We conducted a framework for reporting probiotics activity using the MICRO (Microbiology Investigation Criteria for Reporting Objectively) checklist. Two electronic databases (Pubmed and EMBASE) were used to conduct this study. The initial search discovered 22 references (Pubmed 8 and EMBASE 16). We included human study, clinical trial study, English written, and full articles in this review. Of all these original articles, only six articles were included in the review. These included articles reported the testing phase on the pre-analytical and analytical phases. This review found that probiotics such as Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp lactis BB-12 are beneficial in humans’ endocrine disorder therapy. This activity includes maintaining serum insulin levels in pregnant women and reducing weight in healthy obese men and women. Thus, probiotics, with their several features, may advance their candidacy as therapeutic agents. However, there is more effort to do. For example, finishing the analytical phase, especially on quality assurance and avoiding bias.

Magnesium intake is associated with the metabolically healthy obese phenotype

Although magnesium intake is inversely associated with the risk of metabolic abnormalities, whether magnesium intake plays a role on metabolically healthy obese (MHO) phenotype has not been explored. Therefore, the purpose of this study was to determine whether the magnesium intake is associated with the MHO phenotype. Apparently, healthy women and men aged 20–65 years with obesity were enrolled in a cross-sectional study. Subjects were allocated into MHO (n=124) and metabolically unhealthy obese (MUO) (n=123) groups. MHO phenotype was defined by abdominal obesity (waist circumference ≥90 cm in men and ≥80 cm in women) and none, or not more than one of the following risk factors: triglyceride levels ≥150 mg/dL; high-density lipoprotein cholesterol (HDL-C) levels <40 mg/dL in men and <50 mg/dL in women; fasting glucose ≥100 mg/dL; and systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg. The MUO individuals were characterized by abdominal obesity and the presence of two or more of the aforementioned criteria. The proportion of individuals with high blood pressure (40.7% vs 5.6%, p<0.001), hyperglycemia (69.1% vs 16.9%, p<0.001), hypertriglyceridemia (84.6% vs 36.3%, p<0.001), and low HDL-C (51.2% vs 12.9%, p<0.001) was significantly higher in the MUO individuals as compared with individuals in the MHO group. The logistic regression analysis adjusted by sex and age showed that dietary magnesium intake is significantly associated with the MHO phenotype (OR=1.17; 95% CI 1.07 to 1.25, p=0.005). Our results show that magnesium intake is significantly associated with the MHO phenotype.

Cardiovascular events in metabolically healthy obese. A nationwide cohort study

Background Obesity is a risk factor for cardiovascular disease (CVD) and has been increasing globally over the past 40 years in many countries worldwide. Metabolic abnormalities such as hypertension, dyslipidemia and diabetes mellitus are commonly associated and may mediate some of the deleterious effects of obesity. A subset of obese individuals without obesity-related metabolic abnormalities may be classified as being “metabolically healthy obese” (MHO). We aimed to evaluate the associations among MHO individuals and different types of incident cardiovascular events in a contemporary population at a nationwide level. Methods From the national hospitalization discharge database, all patients discharged from French hospitals in 2013 with at least 5 years or follow-up and without a history of major adverse cardiovascular event (myocardial infarction, heart failure [HF], ischemic stroke or cardiovascular death, MACE-HF) or underweight/ malnutrition were identified. They were categorized by phenotypes defined by obesity and 3 metabolic abnormalities (diabetes mellitus, hypertension, and hyperlipidemia). In total, 2,953,816 individuals were included in the analysis, among whom 272,838 (9.5%) were obese. We evaluated incidence rates and hazard ratios for MACE-HF, cardiovascular death, myocardial infarction, ischemic stroke, new-onset HF and new-onset atrial fibrillation (AF). Adjustments were made on age, sex and smoking status at baseline. Results During a mean follow-up of 4.9 years, obese individuals with no metabolic abnormalities had a higher risk of MACE-HF (multivariate-adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI]: 1.19–1.24), new-onset HF (HR 1.34, 95% CI 1.31–1.37), and AF (HR 1.33, 95% CI 1.30–1.37) compared with non-obese individuals with 0 metabolic abnormalities. By contrast, risks were not higher for myocardial infarction (HR 0.92, 95% CI 0.87–0.98), ischemic stroke (HR 0.93, 95% CI 0.88–0.98) and cardiovascular death (HR 0.99, 95% CI 0.93–1.04). In the models fully adjusted on all baseline characteristics, obesity was independently associated with a higher risk of MACE-HF events (HR 1.13, 95% CI 1.12–1.14), of new-onset HF (HR 1.19, 95% CI 1.18–1.20) and new-onset AF (HR 1.29, 95% CI 1.28–1.31). This was not the case for the association of obesity with cardiovascular death (HR 0.96, 95% CI 0.94–0.98), myocardial infarction (HR 0.93, 95% CI 0.91–0.95) and ischemic stroke (HR 0.93, 95% CI 0.91–0.96). Conclusions Metabolically healthy obese individuals do not have a higher risk of myocardial infarction, ischemic stroke or cardiovascular death than metabolically healthy non-obese individuals. By contrast they have a higher risk of new-onset HF and new onset AF. Even individuals who are non-obese can have metabolic abnormalities and be at high risk of cardiovascular disease events. Our observations suggest that specific studies investigating different aggressive preventive measures in specific subgroups of patients are warranted. FUNDunding Acknowledgement Type of funding sources: None.

163Lunch establishments are associated to metabolic phenotypes in Brazilian adults: CUME project

Background Studies have shown the relationship between food environment and obesity, but few explore metabolic phenotypes as outcomes. Methods We studied 4,311 adults (2,916 women, 1,395 men, with a mean age of 35.9 ± 9.4 y) from the Cohort of Universities in Minas Gerais, Brazil. Participants were classified as obese (BMI ≥ 30 kg/m²) or non-obese. Additionally, metabolic phenotypes were classified as healthy and unhealthy (≥ 1 conditions) based on the prevalence of hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia. We also evaluated the type of food establishment where participants usually had lunch. Multinomial logistic regression analyzes were used to assess the relationship between lunch establishments and metabolic phenotypes, using the Metabolically Healthy Non-Obesity as reference category. Results The Metabolically Healthy Obese (MHO) phenotype represented 4.6% and 40.5% of the total sample and obese population, respectively. We found no associations between having lunch at home, in university restaurants or à la carte restaurants with metabolic phenotypes. Having lunch at large fast-food chains increased 1.88 (95% 1.22 - 2.90) times the chance of healthy obese phenotype and 1.56 (95% 1.03 - 2.37) times the chance of unhealthy obese phenotype. Conclusions The food habit of having lunch in unhealthy food establishments was associated with obesity, regardless of the classification of the metabolic phenotype. Key messages The habit of having lunch in fast food restaurants is associated with obesity. Metabolically healthy obesity can be a transient state up to the unhealthy phenotype. This population must also be the target of nutritional interventions.

Metabolically healthy obesity and the risk of all-cause and cardiovascular disease mortality in a Korean population: a prospective cohort study

ObjectivesThis study aimed to examine the association between metabolically healthy obesity and all-cause and cardiovascular disease (CVD) mortality in a Korean population.DesignA prospective study.SettingThis study used data from the Korean Genome and Epidemiology Study.ParticipantsA total of 140 137 participants were followed up over a median period of 9.2 years. Participants were categorised into four groups according to obesity (obese: body mass index ≥25 kg/m2 or non-obese) and metabolic health (metabolically unhealthy: two or more metabolic abnormalities or metabolically healthy).Primary and secondary outcome measuresAll-cause and CVD mortality of the participants until 31 December 2018 were ascertained by the National Health Insurance Service of beneficiary status of Korea.ResultsMetabolically unhealthy non-obese participants were at elevated risk of all-cause mortality (HR, 1.12; 95% CI, 1.04 to 1.21; p=0.0019) and CVD mortality (HR, 1.39; 95% CI, 1.17 to 1.65; p=0.0002), particularly mortality from ischaemic heart disease (IHD) (HR, 1.54; 95% CI, 1.10 to 2.14; p=0.0116) compared with metabolically healthy non-obese participants. Surprisingly, metabolically healthy obese participants were at reduced risk of all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; p=0.0197). Metabolically unhealthy obese participants were at elevated risk of CVD mortality (HR, 1.51; 95% CI, 1.26 to 1.81; p<0.0001) and IHD mortality (HR, 1.88; 95% CI, 1.35 to 2.63; p=0.0002) compared with metabolically healthy non-obese participants.ConclusionsIn a Korean population, metabolically healthy obese participants had reduced risk of all-cause mortality compared with their non-obese counterparts, whereas metabolically unhealthy participants had elevated risk of CVD mortality, in particular mortality from IHD regardless of obesity.