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 assess the effectiveness of bariatric surgery for obese type 2 diabetes mellitus (T2DM) in Mainland China. Methods Such databases as the Cochrane Central Register of Controlled Trials (Issue 2, 2012), MEDLINE (1990 to February 2012), EMbase (1990 to February 2012), CBM (1990 to February 2012), CNKI (1990 to February 2012), WanFang Data (1999 to February 2012) and VIP (1996 to February 2012) were searched, and the references of the included literature were also retrieved. The studies were screened according to the predefined inclusion and exclusion criteria, the data were extracted, the quality was evaluated, and then the meta-analysis was performed using RevMan 5.2 software. Results A total of 6 controlled before-and-after studies involving 100 patients were included. The overall quality of all literature was as low as grade C. The results of meta-analysis showed that the following indexes after operation obviously decreased than before: 1-month postoperative fasting plasma glucose (MD= –2.27, 95%CI ?4.12 to ?0.42, P=0.02), 6-month postoperative fasting plasma glucose (MD= ?2.73, 95%CI ?2.91 to 2.56, Plt;0.000 01), and 6-month postoperative glycated hemoglobin (SMD= ?1.97, 95%CI ?2.98 to ?0.96, P=0.000 1), and the differences were statistically significant. The sensitivity analysis indicated the results of meta-analysis were credible and stable, but the funnel-plot analysis displayed publication bias might exist in the included studies. Conclusion Current studies show that bariatric surgery is effective for obese T2DM patients in mainland China. However, due to small sample size and low methodological quality of the included studies, its effect has to be proved by high quality, large sample, and long follow-up studies.
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.
Objective To evaluate the relationship between body mass index (BMI) and malignant lymphoma by means of Meta-analysis. Methods Such databases as Web of Science, PubMed, EBbase, CNKI, Wanfang, VIP and CBM were searched from the date of their establishment to April 2011 to collect the case control studies on the relationship between BMI and malignant lymphoma. Two researchers independently selected studies, extracted data and assessed the quality according to the inclusive and exclusive criteria, and then conducted Meta-analyses by using RevMan5.0 software for heterogeneity test and pooled OR calculation. Results Seven case control studies involving 8416 malignant lymphoma patients and 14760 other patients were included. The quality of all studies scored 4, indicating reliable quality. Meta-analyses of the low BMI, overweight and obesity population were OR=0.8, 95%CI 0.79 to 0.95, P=0.003; OR=1.04, 95%CI 0.98 to 1.11, P=0.16; and OR=1.22 95%CI 1.04 to 1.43, P=0.01, respectively. The stratified Meta-analysis on histological subtypes showed that obesity was associated with a significantly increased risk of diffuse large B cell lymphoma (OR=1.33 95%CI 1.18 to 1.50, Plt;0.000 01), but was not associated with the follicular lymphoma or small lymphocytic lymphoma/chronic lymphocytic leukemia. Conclusion These findings demonstrate that low BMI is associated with the decrease of malignant lymphoma, and obesity is an increasing risk of malignant lymphoma, especially, the diffuse large B cell lymphoma.
Objective To investigate the short term and long term effects of laparoscopic gastric bypass on obesity related type 2 diabetes. Methods Twenty obese patients with type 2 diabetes underwent laparoscopic gastric bypass between Nov. 2009 and Feb. 2012 were identified in the computer database of West China Hospital of Sichuan University. All patients had short term follow-up of less than 1 year and among them 11 were with long term follow-up of 1 year or more. Body weight， body mass index （BMI）， blood glucose， glycosylated hemoglobin （HbA1c）， homeostasis model assessment of insulin resistance-insulin resistance （HOMA-IR）， blood pressure， and blood lipids were examined. Short term （＜1 year） and long term （≥1 year） remission rates of diabetes were calculated and factors which might have effects on the remission of diabetes were analyzed. Results Of patients with short term follow-up，body weight， fasting plasma glucose （FPG）， 2h plasma glucose （2hPG）， HbA1c， and HOMA-IR were reduced significantly. Among them， 18 of 20 patients （90.0%） reached the glucose and medication standards of complete remission and partial remission， 9 patients were defined as completely remitted （9/20， 45.0%）. Those accompanied with hypertension and （or） hyperlipemia were all improved clinically. The duration of diabetes， fasting and 2 h C peptide were found to be related to short term diabetes remission. Patients with long term follow-up of 1 year or more were observed to have significant reductions in body weight， FPG， 2hPG， HbA1c， and HOMA-IR as well. Hypertension and hyperlipidemia were all well controlled. The remission rate of diabetes reached 9/11 （81.8%）and those who were defined as completely remitted took a proportion of 6/11 （54.5%）. In these patients， those who did not reach the standards of complete remission had longer duration of diabetes and higher FPG when compared with those who did. No severe adverse event was found during the follow-up in either group. Most patients investigated were satisfied with the surgery.Conclusion Laparoscopic gastric bypass is effective and safe on short term and long term treatment of obesity related type 2 diabetes.
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.
Objective To investigate the role of plasma neuropeptide Y ( NPY) level in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods The patients underwent polysomnography ( PSG)monitoring in the sleep disorder center of Zhongda Hospital from January 2008 to December 2009 were analyzed. Plasma NPY levels were compared between different groups allocated according to apnea-hypopnea index ( AHI) and body mass index ( BMI) . Plasma NPY levels were measured by enzyme-linked immunoassay. Results The plasmaNPY levels in the severe and moderate OSAHS groups were significantly higher than the groups withoutOSAHS of the same weight degree ( P lt;0. 05) . The plasmaNPY levels in the severe OSAHS groups were significantly higher than the groups with mild and moderate OSAHS of the sameweight degree. In the severe OSAHS patients, the plasma NPY level of the obese group was significantly higher than the overweight group and the normal weight group( P lt;0. 05) . In the non-OSAHS and mild to moderate OSAHS patients, there was no significant difference among different groups of weight ( P gt;0. 05) .Plasma NPY level in the OSAHS patients was correlated positively with AHI ( r =0. 667, P lt;0. 05) and BMI( r =0. 265, P lt;0. 05) , but negatively with LSaO2 ( r = - 0. 523, P lt; 0. 05) and MSaO2 ( r = - 0. 422, P lt;0. 05) . Conclusion Plasma NPY level is correlated with OSAHS, and increases with the severity of OSAHS. Plasma NPY level has no correlation with obesity.
Objective To evaluate the effects of oxidative stress in the airway inflammation and remodeling of high-fat diet induced obese mice with asthma. Methods Sixty female C57 /6J mice were randomly divided into four groups, ie. an asthma group, an obese group, an obese asthma group, and a control group. The mice in the asthma group were sensitized and challenged with ovalbumin ( OVA) and fed with normal diets. The mice in the obese group were fed with high-fat diets. The mice in the obese asthma group were sensitized and challenged as the asthma group, and fed as the obese group. The mice in the control group were sensitized and challenged with normal saline and fed with normal diets. After 12 weeks, bronchoalveolar lavage fluid ( BALF) were collected for total and differential cell count. IL-6 and 8-iso-prostaglandin F2α ( 8-iso-PGF2α) in lung tissue homognate were detected by ELISA. The pathological changes were observed under light microscope by HE staining. Meanwhile the remodeling indices including total bronchial wall area ( WAt) , smooth muscle area ( WAm) , and bronchial basement membrane perimeter ( Pbm) were measured. Results In comparison with the obese group and the asthma group, the leukocytes and eosinophils in BALF, WAt/ Pbm, and IL-6 in lung tissue increased significantly in the obese asthma group ( P lt; 0. 05) . 8-iso-PGF2αin lung tissue increased in sequence of the control group, the obese group, the asthma group, and the obese asthma group significantly. Pearson correlation analysis showed that leukocyte in BALF, WAt/ Pbm, and IL-6 were in positive correlation with 8-iso-PGF2α( r =0. 828, 0. 863, 0. 891, respectively, P lt;0. 01) . Conclusion Oxidative stress is involved in the airway inflammation and remodeling of obese asthma mice with high-fat diets.
Abstract： Objective To explore the impact of obesity on postoperative morbidity and mortality after pneumonectomy. Methods Clinical data of 3 494 patients with pulmonary diseases who underwent pneumonectomy in Shanghai Pulmonary Hospital from September 2003 to December 2007 were retrospectively analyzed. All the 3 494 patients were divided into two groups according to the patients’ preoperative body mass index （BMI）. There were 3 340 patients in the non-obesity group （BMI＜28 kg/m2） including 2 502 males and 838 females with their average age of 61.9±10.7 years， and 154 patients in the obesity group （BMI≥28 kg/m2） including 87 males and 67 females with their average age of 59.7±9.6 years. Univariate analysis and logistic regression were used to analyze the impact of obesity （BMI≥28 kg/m2） on postoperative morbidity after pneumonectomy. Results There were a total of 26 cases of perioperative death， including 23 patients in the non-obesity group and 3 patients in the obesity group. There was no statistical difference in mortality between the two groups ［0.7% （23/3 340） vs. 1.9% （3/154）， P=0.118］. There was no statistical difference in any particular postoperative morbidity or incidence of pulmonary complications between the two groups （P＞0.05）. Other than pulmonary complications， the incidence of postoperative complication in other body systems of the obesity group was significant higher than that of the non-obesity group （P＜0.05）. The incidence of cerebrovascular accidents， myocardial infarction and acute renal failure of the obesity group was significant higher than those of the non-obesity group （P＜0.05）. Logistic regression showed that obesity （BMI≥28 kg/m2） was not an independent risk factor for postoperative morbidity after pneumonectomy ［B=0.648， OR=1.911， 95% CI（0.711， 5.138），P=0.199］. Conclusion Obesity is not a significant risk factor of postoperative mortality or morbidity after pneumonectomy.
Objective To summarize and analyze the research progression of zinc deficiency in patients with type 2 diabetes mellitus or obesity after Roux-en-Y gastric bypass （RYGB） surgery. Method The domestic and international published literatures about zinc deficiency after RYGB in recent years were reviewed. Results There was a degree of zinc deficiency after RYGB surgery， its mechanisms had not been fully clarified， which were related to reduced intake and absorption of zinc， protein malnutrition， dietary factors， and specific ways of surgery and the zinc supplementation programmes after operation would also affect the postoperative zinc nutritional status. Conclusions Reasons for zinc deficiency after RYGB surgery are multifaceted and have not been clarified. Further research is needed to provide experimental and theoretical basis for management of zinc nutritional status after RYGB surgery.