Effect of Different Obesity Phenotypes on Incidence of Chronic Kidney Disease in Tehranian Adults Lifestyle intervention in obese Arab women: a randomized controlled trial. The effectiveness of yoga to prevent diabetes mellitus type 2
Background : The aim of this community-based study is to ascertain the effect of different obesity phenotypes on the incidence of chronic kidney disease in Iranian adults . Study Design : A prospect i ve cohort study , the Tehran Lipid Glucose Study ( TLGS ) . Setting and Participants : Adults aged ≥ 20 years with a mean age of 40.38 years ( 54.8 % female ) who were free from chronic kidney disease ( CKD ) at baseline ( phase 1 ) and were followed up at 3 time stages ( phases 2 , 3 , and 4 ) for a mean duration of 9.4 years to assess the risk for CKD . Predictor : Obesity phenotypes . Outcome : Incidence of chronic kidney disease . Measurements : Glomerular filtration rate ( GFR ) was estimated from the simplified equation developed using data from the Modification of Diet in Renal Disease ( MDRD ) Study . Results : CKD events occurred in 1162 participants . The prevalence of the 2 known obesity phenotypes ( metabolically obese normal weight [ MONW ] and metabolically healthy but obese [ MHO ] ) in the overall population was 3.5 % and 8.8 % , respectively . According to Kaplan-Meier curves , rates of freedom from CKD in the MHO and MONW obesity phenotypes were 75.3 % and 60.6 % , respectively ( p < 0.0001 ) . Age- and sex-adjusted ( model 1 ) hazard ratios for participants with MHO or MONW obesity phenotype were 1.14 ( 95 % confidence interval [ CI ] , 0.91–1.43 ) and 1.43 ( 95 % CI , 1.09–1.88 ) , respectively . After further adjustment for confounder variables ( model 2 ) , multivariate-adjusted hazard ratios for CKD for participants with MHO or MONW obesity phenotypes were 1.23 ( 95 % CI , 0.93–1.62 ) and 1.43 ( 95 % CI , 1.08–1.90 ) , respectively . Conclusion : Adults with the MONW obesity phenotype compared to those with MHO obesity phenotype have a higher risk for incidence of CKD . The results indicate that having a normal weight is not the only factor to protect against incidence of CKD BACKGROUND Few r and omized controlled trials on lifestyle interventions have been reported in non-Western population s ; none have been reported in Arab population s. METHODS From 2 Muslim Arab communities in Israel , obese , nondiabetic women aged 35 to 54 years with 1 or more components of the metabolic syndrome were r and omized to either an intensive ( n = 100 ) or a moderate ( control ) ( n = 101 ) 12-month lifestyle intervention . Women in the intensive intervention had 11 individual and 11 group counseling sessions per year with a dietitian and 22 physical activity group sessions per year . Women in the moderate intervention had 3 individual and 2 group dietary counseling sessions per year and no guided physical activity . Cultural issues were addressed in the design and conduct of both interventions . The primary outcome measure was change in the metabolic syndrome and its components . RESULTS At 12 months , the intensive intervention group had median declines of 3.0 mg/dL ( to convert to millimoles per liter , multiply by 0.0555 ) in fasting plasma glucose and 4.5 mg/dL ( to convert to millimoles per liter , multiply by 0.0113 ) in triglyceride levels compared with median increases of 1 mg/dL in fasting plasma glucose and 5.8 mg/dL in triglyceride levels in the moderate intervention group ( P = .01 and P = .02 , respectively ) . The median waist circumference decreased by 5.4 cm in the intensive intervention group and by 3.1 cm in the moderate intervention group ( P = .10 ) . The prevalence of the metabolic syndrome decreased by 4.0 % in the intensive intervention group and increased by 5.2 % in the moderate intervention group ( P = .12 ) . CONCLUSION The 12-month culturally sensitive intensive lifestyle intervention was effective in improving some of the metabolic syndrome components in obese Arab women . Trial Registration clinical trials.gov Identifier : NCT00273572 Background : Type 2 diabetes mellitus ( T2DM ) is becoming a leading problem worldwide . Emerging reports reveal alarming evidence of increasing prevalence of T2DM that has reached p and emic levels . Despite the significant incidence , there are limited reliable data re sources and comprehensive systematic review and meta- analysis on the effects of yoga on people who are a prediabetic or high risk for developing T2DM . Objective : The objective of this protocol is to conduct a full-scale systematic review and meta-analyses on the effects of yoga on people who are prediabetes or high risk of developing T2DM . Methods : The articles enrolled in the study will be retrieved from the online data bases between 2002 and the date the search es are executed . The search es will be repeated just before the final analyses and further relevant studies for inclusion . We will conduct a bibliographic search in data bases : Medline / PubMed , Scopus , Cochrane Library , EBSCO , and IndMED using keywords including prediabetes state , high risk for diabetes , metabolic syndrome , and yoga . A defined search strategy will be implemented along with selection criteria to obtain full-text articles of relevant studies . This study protocol was prepared according to the Preferred Reporting Items for Systematic Review s and Meta- Analysis for Protocol s 2015 guidelines . There will be no language restrictions . Ethics and dissemination : The proposed study will be based on published studies and publicly available anonymized data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee . We published an outline of the protocol in the International Prospect i ve Register of Systematic Review s ( PROSPERO ) in 2018 . We plan to disseminate the findings of this systematic review and meta- analysis through publication in a peer- review ed journal and presentation at relevant conference proceedings . In addition , we believe the results of the systematic review will have implication s for policy and practice . We will prepare policymaker summary using a vali date d format , disseminate through social media and email discussion groups . Review registration number : PROSPERO registration number CRD
Following intervention , there was certain and significant improvement of metabolic state for metabolically abnormal obesity ( MAO ) subjects .
Only diastolic blood pressure had reduced for MHO individuals after intervention .
Conclusions : Almost one-third of the obese individuals are in metabolic health .
However , they are still at higher risk of advancing to unhealthy state .
Background : We conducted a systematic review and meta- analysis to firstly obtain a reliable estimation of the prevalence of metabolically healthy obese ( MHO ) individuals in obesity , then assessed the risk of developing metabolic abnormalities ( MA ) among MHO individuals .
At last , we evaluated the effects of traditional lifestyle interventions on metabolic level for MHO subjects .