BACKGROUND & AIMS: :Obesity affects multiple points along the breast cancer control continuum from prevention to screening and treatment, often in opposing directions. Obesity is also more prevalent in Blacks than Whites at most ages so it might contribute to observed racial disparities in mortality. We use two established simulation models from the Cancer Intervention and Surveillance Modeling Network (CISNET) to evaluate the impact of obesity on race-specific breast cancer outcomes. The models use common national data to inform parameters for the multiple US birth cohorts of Black and White women, including age- and race-specific incidence, competing mortality, mammography characteristics, and treatment effectiveness. Parameters are modified by obesity (BMI of ≥ 30 kg/m(2)) in conjunction with its age-, race-, cohort- and time-period-specific prevalence. We measure age-standardized breast cancer incidence and mortality and cases and deaths attributable to obesity. Obesity is more prevalent among Blacks than Whites until age 74; after age 74 it is more prevalent in Whites. The models estimate that the fraction of the US breast cancer cases attributable to obesity is 3.9-4.5 % (range across models) for Whites and 2.5-3.6 % for Blacks. Given the protective effects of obesity on risk among women <50 years, elimination of obesity in this age group could increase cases for both the races, but decrease cases for women ≥ 50 years. Overall, obesity accounts for 4.4-9.2 % and 3.1-8.4 % of the total number of breast cancer deaths in Whites and Blacks, respectively, across models. However, variations in obesity prevalence have no net effect on race disparities in breast cancer mortality because of the opposing effects of age on risk and patterns of age- and race-specific prevalence. Despite its modest impact on breast cancer control and race disparities, obesity remains one of the few known modifiable risks for cancer and other diseases, underlining its relevance as a public health target.

背景与目标： 从肥胖症的预防到筛查和治疗，肥胖症通常会在相反的方向上影响着乳腺癌控制连续性的多个方面。在大多数年龄段，肥胖症在黑人中也比白人更为普遍，因此它可能导致观察到的种族差异。我们使用来自癌症干预和监视模型网络（CISNET）的两个已建立的仿真模型来评估肥胖对特定种族乳腺癌结果的影响。该模型使用共同的国家数据为美国多个黑人和白人妇女的出生队列提供参数，包括特定年龄和种族的发病率，竞争性死亡率，乳房X线照相特征和治疗效果。肥胖（BMI≥30 kg / m（2））及其特定于年龄，种族，队列和时间段的患病率会改变参数。我们测量年龄标准化的乳腺癌的发病率和死亡率，以及肥胖引起的病例和死亡。直到74岁，肥胖症在黑人中比白人更为普遍。 74岁以后，它在白人中更为普遍。模型估计，美国肥胖导致的乳腺癌病例中，白人占3.9-4.5％（黑人），黑人占2.5-3.6％。考虑到肥胖对<50岁女性的风险具有保护作用，在这个年龄段消除肥胖可能会增加两个种族的发病率，但会减少≥50岁女性的发病率。总体而言，跨模型的肥胖症分别占白人和黑人乳腺癌死亡总数的4.4-9.2％和3.1-8.4％。但是，由于年龄对风险和年龄和种族特定患病率的模式有相反的影响，因此肥胖患病率的变化对乳腺癌死亡率的种族差异没有净影响。尽管肥胖症对乳腺癌的控制和种族差异影响不大，但肥胖症仍然是为数不多的已知可改变的癌症和其他疾病风险之一，突显了肥胖症作为公共卫生目标的重要性。

BACKGROUND & AIMS: OBJECTIVE:The epidemic of obesity and type 2 diabetes is evident in sub-Saharan Africa (SSA). However, their associations have hardly been examined in this region. METHODS:A hospital-based case-control study in urban Ghana consisting of 1221 adults (542 cases and 679 controls) investigated the role of anthropometric parameters for diabetes. Logistic regression was used for analysis. The discriminative power and population-specific cut-off points for diabetes were identified by receiver operating characteristic curves. RESULTS:The strongest association with diabetes was observed for waist-to-hip ratio: age-adjusted odds ratios per 1 standard deviation difference were 1.95 (95% confidence interval [CI]: 1.64-2.31) in women and 1.40 [1.01-1.94] in men. Also, among women, the odds of diabetes increased with higher waist circumference (1.35 [1.17-1.57]) and waist-to-height ratio (1.29 [1.12-1.50]). Among men, this was not discernible. Rather, hip circumference was inversely related (0.69 [0.50-0.95]). Body mass index was neither associated with diabetes in women (1.01 [0.88-1.15]) nor in men (0.74 [0.52-1.04]). Among both genders, waist-to-hip ratio showed the best discriminative ability for diabetes in this population and the optimal cut-off points were ≥ 0.88 in women and ≥ 0.90 in men. Recommended cut-off points for body mass index and waist circumference had a poor predictive ability. CONCLUSION:Our findings suggest that measures of central rather than general obesity relate to type 2 diabetes in SSA. It remains to be verified from larger population-based epidemiological studies whether anthropometric targets of obesity prevention in SSA differ from those in developed countries.

背景与目标： 目的：肥胖症和2型糖尿病的流行在撒哈拉以南非洲（SSA）很明显。但是，在该地区几乎没有检查过它们的关联。
方法：在加纳市区以医院为基础的病例对照研究，由1221名成人（542例和679例对照组）组成，调查了人体测量学参数在糖尿病中的作用。使用逻辑回归进行分析。糖尿病的鉴别力和特定人群的临界点通过接受者的操作特征曲线来确定。
结果：腰臀比与糖尿病的关系最大：女性每1个标准差的年龄校正比值比为1.95（95％置信区间[CI]：1.64-2.31），而女性为1.40 [1.01-1.94] ]的男人。另外，在女性中，糖尿病的几率随着腰围（1.35 [1.17-1.57]）和腰高比（1.29 [1.12-1.50]）的增加而增加。在男人中，这是不明显的。相反，髋围呈负相关（0.69 [0.50-0.95]）。体重指数与女性（1.01 [0.88-1.15]）和男性（0.74 [0.52-1.04]）都不与糖尿病相关。在这两个性别中，腰臀比在该人群中表现出对糖尿病的最佳判别能力，并且最佳的分界点是女性≥0.88，男性≥0.90。推荐的体重指数和腰围临界点的预测能力较差。
结论：我们的研究结果表明，中枢性肥胖而非一般性肥胖与SSA中的2型糖尿病有关。撒哈拉以南非洲地区预防肥胖症的人体测量指标是否与发达国家不同，尚需从更大的基于人群的流行病学研究中得到验证。

BACKGROUND & AIMS: PURPOSE:Long-term evaluation of an empirically based program for the treatment of morbidly obese, low-income, minority adolescents. METHODS:In the first year, 150 participants received cognitive-behavior therapy, nutritional education, medical monitoring, and structured exercise training. Weights and heights were collected at follow-up. Successful and Less Successful groups were delineated based on change in body mass index z-scores. Medical record review provided weight and height data one year before treatment for a subset of participants (comparison group). Analyses of variance examined differences between groups. Discriminant function analyses examined predictors of success in the domains of socioeconomic status, individual factors and psychological functioning, family factors, and prior weight loss behaviors. Correlates of success were explored. RESULTS:Eighty-three adolescents participated in the follow-up, on average 23 months (SD = 3.8) after initial assessment. Nineteen (23%) participants achieved clinically meaningful weight change (-.70 z-scores or better). Discriminant function analyses, correlations, and direct comparisons showed that the Successful group, compared with the Less Successful group, on average, attended 50% more sessions over 84% more weeks, were heavier initially, had somewhat better critical weight control skills (e.g., self-monitoring) before and during the program, and were somewhat more psychologically and intellectually challenged before treatment. CONCLUSION:Although some of these very high risk adolescents made clinically significant progress, more intensive treatments, like long-term residential treatments and bariatric surgery, may produce even more favorable outcomes.

背景与目标： 目的：对以经验为基础的病态肥胖，低收入，少数族裔青少年的治疗方案进行长期评估。
方法：第一年，有150名参与者接受了认知行为疗法，营养教育，医学监测和结构化运动训练。随访时收集体重和身高。根据体重指数z得分的变化来划定成功和不成功的人群。病历审查提供了治疗前一年对一部分参与者（比较组）的体重和身高数据。方差分析检查了组之间的差异。判别功能分析检查了社会经济地位，个人因素和心理功能，家庭因素以及先前的减肥行为领域中成功的预测因素。探索成功的相关性。
结果：83名青少年参加了随访，平均在初次评估后23个月（SD = 3.8）。 19名（23％）参与者达到了临床上有意义的体重变化（-.70 Z分数或更高）。判别功能分析，相关性和直接比较表明，与不成功组相比，成功组平均每周多参加50％的课程，多于84％的星期，最初较重，关键体重控制技能更好（例如，自我监控），并且在治疗之前受到了更多的心理和智力挑战。
结论：尽管这些高风险青少年中有一些在临床上取得了显着进展，但长期住院治疗和减肥手术等更深入的治疗可能会产生更好的结果。

BACKGROUND & AIMS: :Insulin resistance occurs under conditions of obesity, metabolic syndrome, and type 2 diabetes. It was found to be accompanied by down-regulation of the insulin-responsive glucose transporter GLUT4. Decreased adipocyte GLUT4 caused secretion by adipocytes of the serum retinol-binding protein RBP4. Enhanced levels of serum RBP4 appeared to be the signal for the development of systemic insulin resistance both in experimental animals and in humans. In mice, increased levels of serum RBP4 led to impaired glucose uptake into skeletal muscle and increased glucose production by liver, whereas lowered serum RBP4 levels greatly enhanced insulin sensitivity. Thus, a link has been established between obesity and insulin resistance: RBP4, the vitamin A-transport protein secreted into the circulation by adipocytes.

背景与目标： 胰岛素抵抗在肥胖，代谢综合症和2型糖尿病的情况下发生。发现伴随着胰岛素反应性葡萄糖转运蛋白GLUT4的下调。脂肪细胞GLUT4的减少导致脂肪细胞分泌视黄醇结合蛋白RBP4。血清RBP4水平升高似乎是实验动物和人类体内系统性胰岛素抵抗发展的信号。在小鼠中，血清RBP4水平升高会导致葡萄糖吸收到骨骼肌中，并增加肝脏产生的葡萄糖，而降低血清RBP4水平会大大增强胰岛素敏感性。因此，肥胖与胰岛素抵抗之间建立了联系：RBP4，脂肪细胞分泌到循环中的维生素A转运蛋白。

BACKGROUND & AIMS: BACKGROUND:In Asia, obesity has reached epidemic proportions and physicians are likely to face a burden of obesity-related disorders, of which osteoarthritis of the knee is one. However, it is unclear whether obesity affects improvement of conventional TKAs in Asian patients. PURPOSE:We therefore asked whether obese patients with a BMI of 30 kg/m(2) or greater would have worse ROM and function after TKA compared with their nonobese counterparts and whether they would have less improvement preoperatively to postoperatively. METHODS:We retrospectively reviewed 369 patients who underwent TKAs from 2006 to 2010. We stratified patients into four groups: (1) 98 patients with BMIs less than 25 kg/m(2); (2) 158 patients with BMIs between 25 kg/m(2) and 29.9 kg/m(2); (3) 87 patients with BMIs between 30 kg/m(2) and 34.9 kg/m(2); and (4) 26 patients with BMIs greater than 35 kg/m(2). We then compared ROM, function score, Knee Society score, Oxford Knee Questionnaire, and SF-36 questionnaire(®) across the four groups at 6- and 12-month follow-ups. RESULTS:At the 6-month followup, we found a difference only in the ROM. At the 2-year followup, there were no differences in any functional scores across the four groups. Severely obese patients had greater improvement in postoperative ROM than the other groups but did not have any greater improvement in function. CONCLUSION:BMI had little clinical impact on short-term outcomes of conventional TKAs in Asian patients. The data suggest that BMI should not be used as a major determinant to exclude obese patients from surgery with the presumption of poorer outcomes.

背景与目标： 背景：在亚洲，肥胖症已达到流行病的程度，医生可能会面临与肥胖症相关的疾病负担，其中膝部骨关节炎就是其中之一。然而，目前尚不清楚肥胖是否会影响亚洲患者传统TKA的改善。
目的：因此，我们询问BMI为30 kg / m（2）或更高的肥胖患者与非肥胖患者相比，TKA后ROM和功能是否较差，并且他们在术前至术后的改善是否会较小。
方法：我们回顾性分析了2006年至2010年接受TKA的369例患者。我们将患者分为四组：（1）98例BMI低于25 kg / m的患者（2）。 （2）158名BMI在25 kg / m（2）至29.9 kg / m（2）之间的患者; （3）87名BMI在30 kg / m（2）至34.9 kg / m（2）之间的患者; （4）26例BMI大于35 kg / m的患者（2）。然后，我们在6个月和12个月的随访中比较了四组的ROM，功能评分，膝关节评分，牛津膝盖问卷和SF-36问卷。
结果：在6个月的随访中，我们仅在ROM中发现了差异。在为期2年的随访中，四组的任何功能评分均无差异。严重肥胖的患者术后ROM较其他组有更大的改善，但功能没有任何改善。
结论：BMI对亚洲患者传统TKA的短期预后影响不大。数据表明，不应将BMI作为排除肥胖患者的主要决定因素，因为他们认为结果较差。

BACKGROUND & AIMS: OBJECTIVES:Obesity prevalence is increasing worldwide and associated with a high health risk. Unfavourable psychological factors, lower self-ratings of health and worse health-related behaviour can be found in individuals with a low socioeconomic status (SES). Therefore, the aim of our study was to investigate whether normal weight vs. obese subjects with a high vs. low socioeconomic status (SES) differ with regard to self-perceived health, quality of life and health-related behaviour. METHODS:Data of the Austrian Health Interview Survey (ATHIS) 2006/07, precisely of 8015 subjects were analysed stratified by sex and adjusted by age concerning these outcomes. RESULTS:The results have shown that men and women with a low SES differ significantly from those with a high SES in terms of self-perceived health, quality of life, intensity of physical activities, alcohol consumption, and eating behaviour (men: p <0.001; women: p<0.001). A significant interaction between the body mass index (BMI) and SES occurred in men concerning quality of life in the domains physical (p<0.05) and psychological health (p<0.01), in women as to self-perceived health (p<0.01), quality of life in the domains physical health (p<0.01) and environment (p<0.05), as well as physical activities (p<0.01). CONCLUSION:The SES has a strong negative impact on health-related variables, especially in obese subjects, and therefore risk assessment in the primary health-care setting should include socioeconomic factors. Furthermore, a continued strong public health programme is required with an absolute priority placed on obese subjects of low SES.

背景与目标： 目的：肥胖症的患病率在全球范围内呈上升趋势，并具有很高的健康风险。社会经济地位低下（SES）的人会发现不利的心理因素，健康的自我评价较低以及与健康相关的行为较差。因此，我们研究的目的是调查在社会自我状态，生活质量和健康相关行为方面，正常体重与肥胖者之间社会经济地位高低的关系是否存在差异。
方法：根据2006/07年奥地利健康访问调查（ATHIS）的数据，精确地对8015名受试者进行了分层分析，并根据年龄对这些结果进行了调整。
结果：结果表明，SES较低的男女与SES较高的男女在自我感知的健康，生活质量，体育活动强度，饮酒和饮食行为方面存在显着差异（男性：p < 0.001；女性：p <0.001）。男性的身体质量指数（BMI）与SES之间存在显着的相互作用，涉及身体（p <0.05）和心理健康（p <0.01）领域的生活质量，女性在自我感觉健康方面（p <0.01） ），身体健康（p <0.01）和环境（p <0.05）以及身体活动（p <0.01）等领域的生活质量。
结论：SES对与健康相关的变量具有强烈的负面影响，尤其是在肥胖受试者中，因此，初级保健环境中的风险评估应包括社会经济因素。此外，需要持续不断的强有力的公共卫生计划，绝对优先考虑低SES的肥胖受试者。

BACKGROUND & AIMS: :Obesity has been shown to impair muscle blood flow in humans. Vasodilatory control mechanisms such as metabolic control, myogenic mechanisms, conducted vasodilation, and release of endothelium-derived factors may be impaired in obesity due to insulin resistance, hyperglycemia, dyslipidemia, inflammation, oxidative stress, and endothelial dysfunction. The physiological importance of these blood flow control mechanisms has predominately been determined during the increase in blood flow (functional hyperemia) that occurs in response to the increased metabolism associated with exercise. This review examines the mechanisms by which functional hyperemia may be impaired in obesity and indicates areas where further studies are needed. The most extensively studied area of obesity-induced changes in muscle blood flow has been the role of endothelium-derived mediators during resting blood flow and exercise-induced hyperemia. Elevations in oxidative stress alter endothelium-derived factors, resulting in impaired vasodilatory responses. Alterations in metabolic and conducted vasodilatory regulation of blood flow have not been extensively studied in obesity, providing a potential area of research.

背景与目标： 肥胖已被证明会削弱人的肌肉血液流动。在肥胖中，由于胰岛素抵抗，高血糖，血脂异常，炎症，氧化应激和内皮功能障碍，可能会损害代谢控制，肌生成机制，血管舒张和内皮源性因子释放等血管舒张控制机制。这些血流控制机制的生理重要性主要是在因与运动有关的新陈代谢增加而引起的血流增加（功能性充血）过程中确定的。这篇综述检查了肥胖中功能性充血可能受到损害的机制，并指出了需要进一步研究的领域。肥胖引起的肌肉血流变化最广泛研究的领域是在静息血流和运动引起的充血过程中内皮源性介质的作用。氧化应激的升高会改变内皮衍生因子，导致血管舒张反应受损。肥胖方面尚未广泛研究代谢的改变和进行的血流的血管舒张调节，这提供了潜在的研究领域。

BACKGROUND & AIMS: :The aim of the present study was to test the influence of obesity and the presence of type 2 diabetes mellitus (T2DM) on the expression of ten housekeeping genes and of the 18S rRNA in a group of human adipose tissue samples from the omental and subcutaneous depot. Adipose tissue biopsies were obtained by laparoscopic surgery from lean and obese patients. After the extraction, mRNA levels in adipose tissue samples were quantified by real-time PCR using the commercial HUMAN ENDOGENOUS CONTROL PLATES. From the genes analyzed, 18S rRNA exhibited the most stable expression levels in both depots regardless of the pathophysiological conditions of obesity and obesity-associated T2DM. Contrarily, GAPD was the gene with the highest variation in its expression levels, being upregulated (8.0-fold) in the obese group and downregulated (3.5-fold) in obesity-associated T2DM. Our results show that 18S rRNA may be the most suitable gene for normalization in expression studies performed in human adipose tissue samples obtained from patients suffering from obesity and/or obesity-associated T2DM, whereas GAPD is less appropriate for comparison purposes under these circumstances.

背景与目标： ：本研究的目的是测试肥胖和2型糖尿病（T2DM）的存在对网膜和皮下一组人体脂肪组织样品中10个管家基因和18S rRNA表达的影响仓库。通过腹腔镜手术从瘦和肥胖患者中获得脂肪组织活检。提取后，使用商业人类内源对照板通过实时PCR定量测定脂肪组织样品中的mRNA水平。从分析的基因来看，无论肥胖和与肥胖相关的T2DM的病理生理状况如何，18S rRNA在两个库中均表现出最稳定的表达水平。相反，GAPD是其表达水平变化最大的基因，在肥胖组中被上调（8.0倍），在与肥胖相关的T2DM中被下调（3.5倍）。我们的结果表明，在从患有肥胖症和/或肥胖症相关性T2DM的患者获得的人脂肪组织样品中进行的表达研究中，18S rRNA可能是最适合标准化的基因，而GAPD在这种情况下不太适合进行比较。

BACKGROUND & AIMS: OBJECTIVE:We determined the longitudinal association of glucose metabolism with retinopathy in a sample of the Australian population. RESEARCH DESIGN AND METHODS:The Australian Diabetes Obesity and Lifestyle (AusDiab) study is a national, longitudinal study of adults aged > or =25 years from 42 randomly selected areas of Australia. Retinopathy was assessed at baseline in 1999-2000 and 5 years later in 2004-2005 in participants identified as having diabetes (based on self-report and oral glucose tolerance test) and impaired glucose metabolism and in a random sample with normal glucose tolerance. Complete retinal data were available for 1,192 participants. Photographs were graded at two time points according to a simplified version of the Wisconsin grading system. RESULTS:The 5-year incidences of retinopathy were 13.9 and 3.0% among those with known and newly diagnosed diabetes at baseline, respectively. Of those who developed incident newly diagnosed diabetes at follow-up, 11.9% had retinopathy at baseline compared with 5.6% of those who did not progress to incident newly diagnosed diabetes (P = 0.037). After adjustment for factors identified as risk factors for diabetes, individuals with retinopathy signs at baseline were twice as likely to develop incident newly diagnosed diabetes compared with those who did not have retinopathy signs at baseline. CONCLUSIONS:The 5-year incidence of retinopathy was 13.9% among individuals with known diabetes. Nondiabetic individuals with retinopathy signs at baseline had a twofold higher risk of developing incident newly diagnosed diabetes 5 years later. This result provides further evidence that mild retinopathy signs may be a preclinical marker of underlying microvascular disease and future diabetes risk.

背景与目标： 目的：我们确定了澳大利亚人群样本中葡萄糖代谢与视网膜病变的纵向相关性。
研究设计和方法：澳大利亚糖尿病肥胖与生活方式研究（AusDiab）是一项全国性的纵向研究，研究对象是来自澳大利亚42个随机选择地区的25岁以上的成年人。在1999-2000年和5年后的2004-2005年对基线视网膜病变进行评估，这些参与者被确定患有糖尿病（基于自我报告和口服葡萄糖耐量试验）并且糖代谢受损，并且在随机样本中具有正常的葡萄糖耐量。完整的视网膜数据可供1,192名参与者使用。根据简化版的威斯康星州评分系统，在两个时间点对照片进行了评分。
结果：在基线时已知和新诊断的糖尿病患者中，视网膜病变的5年发生率分别为13.9％和3.0％。在随访中发展为新诊断为糖尿病的人中，基线时有11.9％的视网膜病变，而未进展为新诊断为糖尿病的人为5.6％（P = 0.037）。在对确定为糖尿病危险因素的因素进行校正后，基线时视网膜病变征象的个体发生新近诊断出的糖尿病的可能性是基线时没有视网膜病变征象的个体的两倍。
结论：已知糖尿病患者的5年视网膜病变发生率为13.9％。基线时具有视网膜病变征象的非糖尿病患者在5年后患新诊断出的糖尿病的风险要高两倍。该结果提供了进一步的证据，表明轻度的视网膜病变征象可能是潜在的微血管疾病和未来糖尿病风险的临床前标志物。

BACKGROUND & AIMS: :This study was designed to evaluate the effects of maternal obesity and diabetes mellitus on the risk of nonchromosomal congenital defects. We used data from 22,951 pregnant women enrolled in a prospective cohort study of early prenatal exposures and pregnancy outcome. The relative risks [prevalence ratios (PRs)] of major nonchromosomal congenital defects associated with obesity and diabetes, alone or in combination, were calculated using multiple logistic regression analysis. In this study, in the absence of diabetes, obese women (body mass index > or =28) had no higher risk, overall, of having an offspring with a major defect [PR = 0.95; 95% confidence interval (CI) = 0.62-1.5]. Their offspring, however, did have a higher prevalence of certain types of defects, including orofacial clefts; club foot; cardiac septal defects; and, to a lesser extent, hydrocephaly and abdominal wall defects. Women with pre-existing or gestational diabetes who were not obese also had no excess risk overall of having offspring affected by a major defect (PR = 0.98; 95% CI = 0.43-2.2), although they did have a higher prevalence of musculoskeletal defects. The pregnancies of women who were both obese and diabetic were 3.1 times as likely (95% CI = 1.2-7.6) to result in an offspring with a defect than were those of nonobese, nondiabetic women, which suggests that obesity and diabetes mellitus may act synergistically in the pathogenesis of congenital anomalies. The defects were largely craniofacial or musculoskeletal.

背景与目标： ：本研究旨在评估孕妇肥胖和糖尿病对非染色体先天性缺陷风险的影响。我们使用了22951名孕妇的数据，这些孕妇参加了有关产前早期暴露和妊娠结局的前瞻性队列研究。肥胖或糖尿病相关的主要非染色体先天性缺陷的相对危险度[患病率（PRs）]，单独或组合使用多元逻辑回归分析进行了计算。在这项研究中，在没有糖尿病的情况下，肥胖妇女（体重指数≥28）总体上没有较大缺陷的后代[PR = 0.95; 95％置信区间（CI）= 0.62-1.5]。然而，他们的后代在某些类型的缺陷（包括口颌裂）中的患病率更高。马蹄内翻足;心脏间隔缺损;以及较小程度的脑积水和腹壁缺损。既往患有糖尿病或妊娠糖尿病的女性，尽管没有肥胖，但其肌肉骨骼疾病的患病率较高，总体上也没有过度的后代受重大缺陷影响的风险（PR = 0.98； 95％CI = 0.43-2.2）。 。肥胖和糖尿病的女性怀孕导致后代有缺陷的可能性是非肥胖，非糖尿病女性的3.1倍（95％CI = 1.2-7.6），这表明肥胖和糖尿病可能起作用先天性异常的发病机理中具有协同作用。缺陷主要是颅面或肌肉骨骼。

BACKGROUND & AIMS: :Excessive uptake of fatty acids and glucose by adipose tissue triggers adipocyte dysfunction and infiltration of immune cells. Altered metabolic homeostasis in adipose tissue promotes insulin resistance, type 2 diabetes, hypertension, and cardiovascular disease. Inflammatory and metabolic processes are mediated by certain proteolytic enzymes that share a common cellular target, protease-activated receptor 2 (PAR2). This study showed that human and rat obesity correlated in vivo with increased expression of PAR2 in adipose tissue, primarily in stromal vascular cells (SVCs) including macrophages. PAR2 was expressed more than other PARs on human macrophages and was increased by dietary fatty acids (palmitic, stearic, and myristic). A novel PAR2 antagonist, GB88 (5-isoxazoyl-Cha-Ile-spiroindene-1,4-piperidine), given orally at 10 mg/kg/d (wk 8-16) reduced body weight by ∼10% in obese rats fed a high-carbohydrate high-fat (HCHF) diet for 16 wk, and strongly attenuated adiposity, adipose tissue inflammation, infiltrated macrophages and mast cells, insulin resistance, and cardiac fibrosis and remodeling; while reversing liver and pancreatic dysfunction and normalizing secretion of PAR2-directed glucose-stimulated insulin secretion in MIN6 β cells. In summary, PAR2 is a new biomarker for obesity, and its expression is stimulated by dietary fatty acids; PAR2 is a substantial contributor to inflammatory and metabolic dysfunction; and a PAR2 antagonist inhibits diet-induced obesity and inflammatory, metabolic, and cardiovascular dysfunction.

背景与目标： ：脂肪组织摄入过多的脂肪酸和葡萄糖会触发脂肪细胞功能障碍和免疫细胞浸润。脂肪组织中代谢稳态的改变会促进胰岛素抵抗，2型糖尿病，高血压和心血管疾病。炎症和代谢过程由共享共同细胞靶标，蛋白酶激活受体2（PAR2）的某些蛋白水解酶介导。这项研究表明，人和大鼠的肥胖症在体内与PAR2在脂肪组织（主要是在包括巨噬细胞的基质血管细胞（SVC））中表达的增加有关。 PAR2在人类巨噬细胞上的表达高于其他PAR，并且通过膳食脂肪酸（棕榈酸，硬脂酸和肉豆蔻酸）增加。以10 mg / kg / d（wk 8-16）口服给予的新型PAR2拮抗剂GB88（5-isoxazoyl-Cha-Ile-spiroindene-1,4-piperidine）在体重减轻的肥胖大鼠中体重减轻了约10％ 16周的高碳水化合物高脂（HCHF）饮食，可大大减轻肥胖，脂肪组织炎症，巨噬细胞和肥大细胞浸润，胰岛素抵抗以及心脏纤维化和重塑；同时逆转肝和胰腺功能障碍，并使MIN6β细胞中PAR2指导的葡萄糖刺激的胰岛素分泌正常化。总之，PAR2是肥胖的一种新的生物标志物，它的表达受到饮食脂肪酸的刺激。 PAR2是导致炎症和代谢功能障碍的重要因素。 PAR2拮抗剂可抑制饮食引起的肥胖症以及炎症，代谢和心血管功能障碍。

BACKGROUND & AIMS: AIM:This study investigates the prevalence of disturbed eating behaviours in children and adolescents initiating obesity treatment, and how the prevalence varies with age, sex and body mass index (BMI) standard deviation score (SDS). Secondly, it examines whether the presence of disturbed eating behaviours at enrolment is associated with the degree of weight loss after 12 months of treatment. METHODS:A total of 3621 patients aged 3-18 years enrolled in a multidisciplinary obesity treatment programme were studied. Follow-up data after a median of 12.4 months were available for 2055 patients. Upon entry, patients were assessed for the following disturbed eating behaviours: meal skipping, emotional eating, overeating and rapid eating. Height and weight were measured at baseline and follow-up. RESULTS:At enrolment, median age was 11.4 years, median BMI SDS was 2.87, and 82.2% of patients exhibited one or more disturbed eating behaviours. The prevalence of meal skipping, emotional eating and rapid eating increased with age (P < 0.01). Patients who reported overeating or rapid eating exhibited a 0.06-0.11 higher BMI SDS at enrolment than patients without these disturbed eating behaviours (P < 0.02). After 1 year of treatment, BMI SDS was reduced in 75.7% of patients, and the median reduction was 0.24 (95% confidence interval: 0.22-0.27). Overeating was associated with a higher degree of weight loss, while meal skipping, emotional eating and rapid eating did not associate with the degree of weight loss at follow-up. CONCLUSIONS:Disturbed eating behaviours were highly prevalent in children and adolescents with overweight or obesity, and varied with age and sex. After 1 year of treatment, the degree of obesity improved, regardless of the presence of disturbed eating behaviours at treatment initiation.

背景与目标： 目的：本研究调查了开始肥胖治疗的儿童和青少年的饮食不当行为的患病率，以及患病率随年龄，性别和体重指数（BMI）标准差评分（SDS）的变化而变化。其次，它检查入组时进食行为是否受干扰与治疗12个月后的体重减轻程度是否相关。
方法：对纳入多学科肥胖治疗计划的3621名年龄在3-18岁之间的患者进行了研究。中位数为12.4个月后的随访数据可用于2055例患者。入院后，对患者进行以下饮食紊乱行为评估：不进餐，情绪饮食，暴饮暴食和快速饮食。在基线和随访时测量身高和体重。
结果：入组时，中位年龄为11.4岁，BMI SDS中值为2.87，82.2％的患者表现出一种或多种饮食行为紊乱。随年龄增长，不进餐，情感饮食和快速饮食的患病率增加（P <0.01）。报告暴饮暴食或速食的患者入选时的BMI SDS比无饮食行为紊乱的患者高0.06-0.11（P <0.02）。治疗1年后，BMI SDS降低了75.7％，中位数降低了0.24（95％置信区间：0.22-0.27）。暴饮暴食与体重减轻程度较高有关，而进餐不进食，情感饮食和快速饮食与随访时的体重减轻程度无关。
结论：超重或肥胖的儿童和青少年的饮食失调行为非常普遍，并且随年龄和性别而变化。治疗1年后，无论开始治疗时有无进食行为，肥胖程度均得到改善。

BACKGROUND & AIMS: OBJECTIVE:Auriculotherapy is based on the stimulation of reflex points in the ear. However, little is known about its weight-reducing effects. The aim of the present systematic review and meta-analysis was to investigate the effects of auriculotherapy on weight and/or (BMI) reduction in overweight or patients with obesity. METHODS:Twelve articles were selected for systematic review. Four randomized controlled trials (RCTs) investigating weight reduction and five investigating BMI reduction were selected for the meta-analyzes. RESULTS:The results revealed an association between auriculotherapy and weight reduction (WMD, 1.507; 95% CI, 0.606-2.407; p < 0.000). Auriculotherapy was also significantly associated with BMI reduction (WMD, 0.865; 95% CI, 0.533-1.196; p < 0.004). CONCLUSIONS:We found that auriculotherapy was effective in reducing weight and/or BMI in overweight or patients with obesity. However, the findings should be interpreted with caution due to heterogeneity.

背景与目标： 目的：耳穴疗法是基于刺激耳朵的反射点。但是，人们对其减重效果知之甚少。本系统综述和荟萃分析的目的是研究耳穴疗法对超重或肥胖患者体重和/或（BMI）降低的影响。
方法：选择十二篇文章进行系统评价。荟萃分析选择了四个研究体重减轻的随机对照试验（RCT）和五个研究体重减轻的随机对照试验。
结果：结果表明，耳治疗与体重减轻之间存在关联（WMD，1.507； 95％CI，0.606-2.407； p <0.000）。听觉疗法也与BMI降低显着相关（WMD，0.865; 95％CI，0.533-1.196; p <0.004）。
结论：我们发现耳穴疗法可有效减轻超重或肥胖患者的体重和/或BMI。但是，由于异质性，应谨慎解释研究结果。

BACKGROUND & AIMS: OBJECTIVE:To examine church leaders' views on the role of faith-based organizations in promoting healthy eating and physical activity in children. DESIGN:Qualitative research using semi-structured in-depth interviews. SETTING:South Carolina. PARTICIPANTS:Leaders (n = 26) from United Methodist churches (n = 20). PHENOMENON OF INTEREST:Perceptions of health promotion efforts for children in faith-based settings, including primary health concerns, perceived opportunities, partnerships, and the relationship of these efforts to the overall church mission. ANALYSIS:Interviews were transcribed verbatim and coded using a constant comparative method. RESULTS:Five themes emerged related to (1) multiple concerns about health issues facing children; (2) existing church structures influencing health behaviors; (3) potential partnerships to address children's health; (4) importance of role models; and (5) the need for a tailored approach. CONCLUSIONS AND IMPLICATIONS:Church leaders viewed childhood health behaviors as an important area of concern for the church and identified links between physical and spiritual health. They identified multiple existing and potential organizational and community structures as important in improving healthy eating and physical activity. Faith-based organizations can play an important role in developing and delivering health programming for children but desired assistance through partnerships with subject matter experts.

背景与目标： 目的：探讨教会领袖关于基于信仰的组织在促进儿童健康饮食和体育锻炼中的作用的观点。
设计：使用半结构化深度访谈进行定性研究。
地点：南卡罗来纳州。
参加者：联合卫理公会教堂（n = 20）的领导者（n = 26）。
兴趣现象：在基于信仰的环境中对儿童进行健康促进工作的看法，包括主要的健康问题，感知的机会，伙伴关系以及这些努力与整体教会使命的关系。
分析：对访谈进行逐字记录，并使用恒定比较方法进行编码。
结果：出现了五个主题，这些主题与（1）对儿童所面临的健康问题的多重关注； （2）影响健康行为的现有教堂结构； （3）潜在的伙伴关系，以解决儿童的健康问题； （4）榜样的重要性； （5）需要量身定制的方法。
结论和启示：教会领导人将儿童的健康行为视为教会关注的重要领域，并确定了身体和精神健康之间的联系。他们确定了多种现有的和潜在的组织和社区结构对改善健康饮食和体育锻炼很重要。基于信仰的组织可以在制定和执行针对儿童的健康计划方面发挥重要作用，但希望通过与主题专家的合作伙伴关系获得帮助。

BACKGROUND & AIMS: PURPOSE:Obesity has emerged as one of the biggest health crisis and is the leading cause of death and disabilities around the world. BMI trends suggest that majority of the increase in T2D is resulting from the increased prevalence of obesity. In fact, 85.2% of people with T2D are overweight or obese. The highest prevalence for obesity is seen in non-Hispanic, African American women (56.6%). T2D is classified as an inflammatory disease because of elevated, circulating pro-inflammatory cytokines and acute-phase inflammatory proteins. This study was designed to determine how high HbA1c and serum glucose correlate with circulatory cytokine levels in obese, African American women. METHODS:We investigated cytokine/chemokine serum levels using a multiplex assay. Then we used Pairwise Pearson Correlation Test to determine the relationship between clinical metabolic parameters and cytokine/chemokine serum levels. RESULTS:The results indicated that participants with elevated HbA1c exhibited an up regulation of IL-3, IL-4, IL-7, TNF-α, IFN-α2 and CX3CL1 serum levels compared to participants with normal HbA1c. These cytokines were also correlated with several clinical metabolic parameters. CONCLUSIONS:The results suggest that IL-3, IL-4, IL-7, TNF-α, IFN-α2 and CX3CL1 serum levels may contribute to the development and onset of type 2 diabetes.

背景与目标： 目的：肥胖已经成为最大的健康危机之一，并且是导致世界范围内死亡和残疾的主要原因。 BMI趋势表明，T2D的增加大部分是由肥胖症患病率增加引起的。实际上，患有T2D的人中有85.2％是超重或肥胖。在非西班牙裔非裔美国女性中，肥胖发生率最高（56.6％）。由于升高的循环中的促炎细胞因子和急性期炎性蛋白，T2D被归类为炎性疾病。这项研究旨在确定肥胖的非洲裔美国妇女中高水平的HbA1c和血清葡萄糖与循环细胞因子水平的相关性。
方法：我们使用多重分析研究了细胞因子/趋化因子的血清水平。然后，我们使用成对皮尔逊相关检验确定临床代谢参数与细胞因子/趋化因子血清水平之间的关系。
结果：与正常的HbA1c参与者相比，HbA1c升高的参与者表现出IL-3，IL-4，IL-7，TNF-α，IFN-α2和CX3CL1血清水平的上调。这些细胞因子也与几种临床代谢参数相关。
结论：结果提示IL-3，IL-4，IL-7，TNF-α，IFN-α2和CX3CL1血清水平可能与2型糖尿病的发生和发作有关。