BACKGROUND AND AIMS: Gastric restriction techniques have recently emerged as minimally invasive bariatric procedures. Endoscopic sutured gastroplasty (ESG) with the Endomina (Endo Tools Therapeutics, Gosselies, Belgium) triangulation platform proved to be safe and effective for the treatment of class I and II obesity in prospective studies. In this registry, we aimed to further assess on a larger scale the safety and efficacy of the procedure in routine practice with a dedicated device. METHODS: This was a multicenter, observational, prospective post-market study including patients with obesity undergoing Endomina ESG. The primary safety outcome was the occurrence of serious adverse device effects (SADEs) at 12 months. The primary efficacy outcome was the technical success defined by completing the procedure without premature abortion owing to technical issues. The rates of procedure-related adverse events, weight loss outcomes, and quality of life changes were collected. RESULTS: A total of 142 patients underwent ESG in 3 centers from July 2020 to March 2023. Of these, 67 (mean body mass index, 38.5 ± 6.3 kg/m2) reached at least 12 months of follow-up up to October 2022. Technical success was 100%. No SADEs occurred. Seven mild procedure-related adverse events were reported overall. Mean percentage of excess weight loss and total body weight loss at 12 months' follow-up were 48.5% ± 38.6 and 15.3% ± 10.6, respectively (n = 67). Improved quality of life was observed following ESG. CONCLUSIONS: ESG is safe and effective, thus offering a satisfactory therapeutic option for a wide range of obese patients on a large scale.
- MeSH
- dospělí MeSH
- gastroplastika * metody škodlivé účinky MeSH
- gastroskopie metody MeSH
- hmotnostní úbytek MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- morbidní obezita chirurgie MeSH
- obezita chirurgie komplikace MeSH
- pooperační komplikace MeSH
- postmarketingový dozor * MeSH
- prospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
INTRODUCTION: Obesity in older adults is linked to various chronic conditions and decreased quality of life. Traditional physical activity guidelines often overlook the specific postures and movements that older adults engage in daily. This study aims to explore the compositional associations between posture-specific behaviours and obesity risk in younger (M = 67.35 ± 2.03 years) and older (M = 75.73 ± 4.17 years) groups of older adults and investigate the differences in body mass index (BMI) associated with replacing time spent in lying, sitting and standing with moving or walking. METHODS: This cross-sectional study involved 309 older adults aged 65 and above from Czech Republic. Participants' movement behaviours, including lying, sitting, standing, moving, and walking, were measured using accelerometers. The data were analysed using compositional data analysis (CoDA) and isotemporal substitution models to assess the impact of reallocating time between different activities on self-reported (BMI). RESULTS: The younger group engaged in more overall movement (193.84 min/day vs. 172.41 min/day) and walking (92.15 min/day vs. 76.62 min/day) than the older group. Significant estimated increases in BMI were associated with reallocating 30 min from movement to lying, sitting, or standing (up to + 3.31 kg/m2), while reallocating the same amount of time from lying, sitting, or standing to movement was associated with estimated reductions in BMI (up to - 2.54 kg/m2). In the older group, reallocating time from slow walking to lying or sitting was associated with estimated increases in BMI (up to + 1.86 kg/m2), while increasing time spent slow walking at the expense of lying or sitting theoretically reduced BMI (up to - 0.95 kg/m2). CONCLUSIONS: The findings suggest that promoting movement and walking, including both slow and fast walking, may play a role in managing obesity risk in older adults. This study highlights the potential benefits of reducing sedentary time and encouraging low-intensity physical activity tailored to the capabilities of seniors, especially those aged 70+, as a possible strategy to mitigate obesity risk. However, further longitudinal studies are needed to confirm these associations and explore causal relationships.
- MeSH
- akcelerometrie metody MeSH
- chůze * fyziologie MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- obezita * epidemiologie patofyziologie MeSH
- postura těla fyziologie MeSH
- pozice sedu * MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stoj * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Hypothalamic Adult Neurogenesis (hAN) has been implicated in regulating energy homeostasis. Adult-generated neurons and adult Neural Stem Cells (aNSCs) in the hypothalamus control food intake and body weight. Conversely, diet-induced obesity (DIO) by high fat diets (HFD) exerts adverse influence on hAN. However, the effects of anti-obesity compounds on hAN are not known. To address this, we administered a lipidized analogue of an anti-obesity neuropeptide, Prolactin Releasing Peptide (PrRP), so-called LiPR, to mice. In the HFD context, LiPR rescued the survival of adult-born hypothalamic neurons and increased the number of aNSCs by reducing their activation. LiPR also rescued the reduction of immature hippocampal neurons and modulated calcium dynamics in iPSC-derived human neurons. In addition, some of these neurogenic effects were exerted by another anti-obesity compound, Liraglutide. These results show for the first time that anti-obesity neuropeptides influence adult neurogenesis and suggest that the neurogenic process can serve as a target of anti-obesity pharmacotherapy.
PURPOSE: Obesity and its related severe comorbidities are increasing rapidly. The duodenal-jejunal bypass is an endoscopically implanted device (mimicking the Roux-en-Y gastric bypass) developed to support weight reduction and improve type 2 diabetes control. MATERIALS AND METHODS: Retrospective data analysis of consecutive patients undergoing duodenal-jejunal bypass (EndoBarrier®, DJB) implantation between 2013 and 2017 was performed to evaluate safety as well as short- and long-term efficacy. RESULTS: One hundred and twenty-one patients (mean BMI of 43.1 ± 7.2 kg/m2 and weight of 138.2 ± 28.6 kg) underwent DJB implantation. The mean dwelling time was 15.5 months, the mean total body weight loss (%TBWL) after explantation was 10.3% ± 7.9% (14.2 kg, p < 0.0001), and the mean BMI was 39.5 ± 7.3 kg/m2 (p < 0.0001). There was no significant weight gain 24 months after the explantation. Seventy-seven patients had type 2 diabetes mellitus (T2DM) with a mean HbA1c before implantation of 5.6% (n = 52). The mean HbA1c after explantation was 5.1% (p = 0.0001). Significant reductions in transaminase and lipid levels before and after explantation were observed. One complication occurred during implantation and another during explantation. In 16 patients, the device had to be extracted earlier than expected (7 for severe adverse events and 9 for adverse events; 13.2%). CONCLUSION: Despite an evident rate of adverse events, the DJB shows promise as a weight-loss procedure. Our results show that some patients implanted with the device maintained reduced weight even 24 months after explantation, while many improved T2DM control.
- MeSH
- diabetes mellitus 2. typu * chirurgie komplikace MeSH
- duodenum chirurgie MeSH
- glykovaný hemoglobin MeSH
- hmotnostní úbytek MeSH
- jejunum chirurgie MeSH
- lidé MeSH
- morbidní obezita * chirurgie MeSH
- obezita chirurgie komplikace MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- žaludeční bypass * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Diabetes mellitus is a chronic disease affecting glucose metabolism. The pathophysiological reactions underpinning the disease can lead to the development of late diabetes complications. The gut microbiota plays important roles in weight regulation and the maintenance of a healthy digestive system. Obesity, diabetes mellitus, diabetic retinopathy, diabetic nephropathy and diabetic neuropathy are all associated with a microbial imbalance in the gut. Modern technical equipment and advanced diagnostic procedures, including xmolecular methods, are commonly used to detect both quantitative and qualitative changes in the gut microbiota. This review summarises collective knowledge on the role of the gut microbiota in both types of diabetes mellitus and their late complications, with a particular focus on diabetic foot syndrome.
- MeSH
- diabetes mellitus * MeSH
- diabetická noha * MeSH
- diabetická retinopatie * MeSH
- diabetické nefropatie * etiologie MeSH
- lidé MeSH
- obezita MeSH
- střevní mikroflóra * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Limited empirical evidence is available regarding the effect of technology-assisted cardiac rehabilitation (TACR) among coronary heart disease (CHD) patients with central obesity. AIM: To determine the effects of 12-week TACR on health outcomes of patients with CHD. DESIGN: Two-arm randomized controlled trial. SETTING: Cardiovascular department of a regional hospital. POPULATION: Coronary heart disease patients with central obesity. METHODS: The study randomized 78 hospitalized CHD patients to receive either the 12-week TACR intervention or usual care. Guided by social cognitive theory, the intervention began with an in-person assessment and orientation session to assess and identify individual risks and familiarize with the e-platform/device before discharge. After discharge, patients were encouraged to visit the interactive CR website for knowledge and skills acquisition, data uploading, use the pedometer for daily step tracking, and interact with peers and professionals via social media for problem-solving and mutual support. Data were collected at baseline (T0), six-week (T1), and 12-week (T2). RESULTS: Participants in the intervention group showed significant improvement in daily steps at six weeks but not 12 weeks (T1: β=2713.48, P=0.03; T2:β=2450.70, P=0.08), weekly sitting minutes (T1: β=-665.17, P=0.002; T2: β=-722.29, P=0.02), and total (vigorous, moderate, and walking) exercise at 12-week (β=-2445.99, P=0.008). Improvement in health-promoting lifestyle profile (T1: β=24.9, P<0.001; T2: β=15.50, P<0.001), smoking cessation (T2: β=-2.28, P<0.04), self-efficacy (T2: β=0.63, P=0.02), body mass index (T1:β =-0.97, P=0.03; T2: β=-0.73, P=0.04) and waist circumferences (T1: β =-1.97, P=0.003; T2: β =-3.14, P=0.002) were identified. CONCLUSIONS: Results indicated the effectiveness of the TACR intervention in improving healthy behaviors and anthropometric parameters for CHD patients with central obesity. Individual assessment, collaborative action planning, and ongoing obesity management support should be highlighted in TACR programs for CHD patients. CLINICAL REHABILITATION IMPACT: Central obesity should be assessed and highlighted in TACR intervention as an independent risk factor that requires corresponding behavior change and body fat management.
Článek popisuje, jak se v odpověď na celosvětovou epidemii obezity vyvíjela v posledních 40 letech obezitologie jako nový medicínský obor. Tato originální medicínská specializace odráží pokroky v pochopení interakce hereditárních a environmentálních faktorů v patogenezi obezity jako i stěžejní úlohy adipokinů a viscerální tukové tkáně při rozvoji kardiometabolických onemocnění a některých nádorů. Obezitologické společnosti, které vznikly v mnoha zemích po celém světě, pořádaly národní a mezinárodní obezitologické kongresy, připravily doporučené postupy pro léčbu a prevenci obezity a přispěly k vydávání specializovaných obezitologických časopisů. Aby se zlepšily znalosti v obezitologii u poskytovatelů zdravotní péče, byla publikována řada českých i mezinárodních učebnic o obezitě. Česká republika sehrává významnou úlohu v začlenění obezitologických center a redukčních klubů do sítě komplexní léčby obezity. Obezitologie je výjimečná v tom, že vyžaduje sjednocující přístup, který integruje znalosti různých lékařských oborů, například vnitřního a dětského lékařství, endokrinologie, diabetologie, výživy a dietologie, fyziatrie a fyziologie cvičení, psychiatrie, psychologie, bariatrické chirurgie, genetiky, kardiologie, revmatologie a dalších.
The paper describes how obesity medicine has developed as a new medical discipline in response to the global obesity epidemic over the last forty years. This novel medical discipline reflects advances in understanding the interaction between hereditary and environmental factors in the pathogenesis of obesity as well as the crucial role of adipokines and visceral adipose tissue in the development of cardiometabolic diseases and certain cancers. Obesity associations established in many countries across the world have organized national and international congresses on obesity, prepared guidelines on obesity management and prevention, and contributed to the publication of journals focused on obesity. Many Czech and international textbooks on obesity have been published to improve knowledge about obesity among health care providers. The Czech Republic has played an important role in the implementation of obesity management centres and weight reduction clubs into the network of comprehensive obesity management. Obesity medicine is unique in that the required holistic approach integrates knowledge from different medical disciplines such as internal medicine and pediatrics, endocrinology, diabetology, nutrition and dietetics, physiatrics and exercise physiology, psychiatry, psychology, bariatric surgery, genetics, cardiology, rheumatology and more.
- Klíčová slova
- obezitologie,
- MeSH
- lidé MeSH
- obezita * dějiny prevence a kontrola terapie MeSH
- periodika jako téma MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- společnosti lékařské MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
Obezita je v poslední době vnímána většinou zdravotníků jako onemocnění se závažnými zdravotními a socioekonomickými následky. Přesto, podle několika šetření prováděných napříč světem, je léčba obezity jako chronické nemoci s opakovanými relapsy podceňována jak lékaři, tak ostatními zdravotníky. Článek shrnuje hlavní překážky v patřičné léčbě pacientů s obezitou. Nedostatečné znalosti o obezitě u zdravotníků představují významnou zábranu v implementaci sofistikovaných principů v její léčbě. Proto jsou zde představeny zkušenosti s postgraduálním vzděláváním v obezitologii v České republice a v zahraničí. Autoři rovněž popisují různé přístupy při vzdělávání a certifikaci obezitologů jako lékařů, kteří dosáhli způsobilosti v péči o pacienty s obezitou. Obezitologové by měli sehrávat významnou úlohu nejen v komplexní multidisciplinární léčbě obezity, ale i při vzdělávání ostatních zdravotníků v obezitologii. To se jeví významné zejména dnes, kdy lze očekávat častou indikaci k dlouhodobé léčbě novými účinnými antiobezitiky a méně invazivními bariatrickými operacemi.
Obesity has recently been recognized as a disease with serious health and socioeconomic consequences by most health professionals. However, according to several surveys conducted across the world, comprehensive management of chronic relapsing disease such obesity continues to be underestimated by both physicians and other healthcare providers. The paper highlights the main obstacles to the appropriate treatment of patients with obesity. One key barrier is the insufficient knowledge about obesity among healthcare providers, which hinders the implementation of advanced principles in obesity management. This paper also explores experiences in postgraduate education on obesity both in the Czech Republic and abroad. The authors further describe different attitudes toward educating and certifying obesity specialists, i.e. physicians who achieved a competency in obesity care. Obesity specialists should play an important role not only in comprehensive multidisciplinary treatment of obesity but also in educating other health professionals about obesity medicine. This role is increasingly significant nowadays as the demand for long-term treatment with new, efficient anti-obesity drugs and less invasive bariatric surgery grows.
- Klíčová slova
- obezitologie,
- MeSH
- endokrinologie MeSH
- kontinuální vzdělávání lékařů * MeSH
- lidé MeSH
- obezita * MeSH
- odborná způsobilost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- MeSH
- bariatrická chirurgie * metody škodlivé účinky MeSH
- diabetes mellitus 2. typu terapie MeSH
- léčba obezity MeSH
- lidé MeSH
- obezita komplikace terapie MeSH
- pooperační péče MeSH
- týmová péče o pacienty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- agonisté receptoru pro glukagonu podobný peptid 1 aplikace a dávkování farmakologie terapeutické užití MeSH
- diabetes mellitus 2. typu farmakoterapie MeSH
- glifloziny aplikace a dávkování farmakologie terapeutické užití MeSH
- hypoglykemika aplikace a dávkování farmakologie terapeutické užití MeSH
- látky proti obezitě aplikace a dávkování farmakologie škodlivé účinky terapeutické užití MeSH
- léčba obezity MeSH
- lidé MeSH
- obezita * farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
