Obesity, obesity-related diseases and application of animal model in obesity research An overview

( Byung Sung Park ),( N K Singh ),( Am M T Reza ) 한국유화학회 2013 한국응용과학기술학회지 Vol.30 No.4

The multi-origin of obesity and its associated diseases made it’s a complex area of biomedical science research and severe health disorder. From the 1970s to onwards this health problem turned to an epidemic without having any report of declining yet and it created a red alert to the health sector. Meanwhile, many animal models have been developed to study the lethal effect of obesity. In consequence, many drugs, therapies and strategies have already been adopted based on the findings of those animal models. However, many complicated things based on molecular and generic mechanism has not been clarified to the date. Thus, it is important to develop a need based animal model for the better understanding and strategic planning to eliminate/avoid the obesity disorder. Therefore, the present review would unveil the pros and cons of presently established animal models for obesity research. In addition, it would indicate the required turning direction for further obesity and obesity based disease research.

중년기 비만여성에 있어서 건강지표를 위한 비만연령의 개발

이동준(Lee Dong-Jun),박태섭(Park Tae-Seop) 한국생명과학회 2009 생명과학회지 Vol.19 No.10

본 연구에서는 중년비만여성을 대상으로 비만의 발생요인으로 예상되는 요인을 이용하여 비만의 상태를 연령 척도화하여 비만연령(Obesity Age: OA)이라는 연령 추정식을 산출함과 동시에 비만도(비만연령)를 실제의 역연령과 검토하였고 비만연령의 추정식은 다음과 같다. OAS (Obesity Age Score)=0.106<SUP>*</SUP>X₁+0.035<SUP>*</SUP>X₂+0.048<SUP>*</SUP>X₃+0.041<SUP>*</SUP>X₄+0.003<SUP>*</SUP>X?-0.037<SUP>*</SUP>X?-10.66 (1) (X₁: BMI, X₂: 체중, X₃: 체지방률, X₄: 배둘레, X?: 중성지방, X?: VO2max) OA (Obesity Age)=7.3<SUP>*</SUP>OAS+49.6<SUP>*</SUP>(-1) (2) Z=(CA-49.6)(1-0.03) (3) OAc (Obesity Age corrected)=1.03<SUP>*</SUP>CA-7.3<SUP>*</SUP>OAS+1.47 (4) 그리고 역연령과 추정된 비만연령(Obesity Age corrected: OAc)의 비교에서는 유의한 차이를 나타내지 않아 타당성이 확인되었으며, 총 6개의 측정항목으로 구성된 비만연령을 통해 비만자 개개인의 비만건강도(상태)를 용이하게 평가할 수 있을 것으로 기대하며, 추후에는 다른 집단에서의 적용가능 여부를 알아보기 위해 교차타당성을 검토해야할 것이라고 사료된다 The purpose of this study was to compare Obesity Age (OA) and chronological age, to calculate Obesity Age (OA), which gauges the state of obesity, and to analyze presented factors of obesity using expectant factors on middle-aged obese women. The subjects were one hundred twenty seven middle-aged obese women (49.6±7.3 yr, BMI 29.41±2.9, fat 36.8±4.6%) who participated in different weight loss programs three times. The body composition, physical fitness, blood pressure and blood were measured before the weight loss programs. Informed consent was obtained from all subjects before enrollment in the study. The regression equation is as follows: (1) OAS (Obesity Age Score)=0.106<SUP>*</SUP>X₁ +0.035<SUP>*</SUP>X₂+0.048<SUP>*</SUP>X₃+0.041<SUP>*</SUP>X₄+0.003<SUP>*</SUP>X?-0.037<SUP>*</SUP>X?-10.667 (X₁: BMI, X₂: weight, X₃: %fat, X₄: WC, X?: TG, X?: VO2max), (2) OA (Obesity Age)=7.3<SUP>*</SUP>OAS+49.6<SUP>*</SUP>(-1), (3) Z (correction factor)=(CA-49.6)(1-0.03), (4) OAc (corrected Obesity Age)=1.03<SUP>*</SUP>CA-7.3<SUP>*</SUP>OAS+1.47. The comparison of corrected Obesity Age (OAc) and chronological age did not have any differences, and the average of the OAc was close to chronological age. The correlation coefficient between the OAc and chronological age was r=0.724 (p<0.05). The equation can be utilized for middle-aged obese women, because it could evaluate the obesity-related factors by including BMI, body weight, %fat, waist circumference, triglycerides and VO2max.

Exposure and Exercise Training in Hypoxic Conditions as a New Obesity Therapeutic Modality: A Mini Review

Park, Hun-Young,Kim, Jisu,Park, Mi-Young,Chung, Nana,Hwang, Hyejung,Nam, Sang-Seok,Lim, Kiwon Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.2

<P>Obesity is an important health problem caused by positive energy balance. Generally, low calorie dietary intake combined with regular exercise is the most common modality to lose bodily fat in obese people. Although this is the first modality of choice for obesity treatment, it needs to be applied to obese patients for at least 12 weeks or more and it does not provide consistent results because it is difficult to suppress increased appetite due to exercise. Recently, many researchers have been applying hypoxic conditions for the treatment of obesity, as many studies show that people residing in high altitudes have a lower percentage of body fat and fewer obesity-related illnesses than people living at sea level. Hypoxic therapy treatment, including hypoxic exposure or hypoxic exercise training, is recommended as a way to treat and prevent obesity by suppression of appetite, increasing basal metabolic rate and fat oxidation, and minimizing side effects. Hypoxic therapy inhibits energy intake and appetite-related hormones, and enhances various cardiovascular and metabolic function parameters. These observations indicate that hypoxic therapy is a new treatment modality for inducing fat reduction and promoting metabolic and cardiovascular health, which may be an important and necessary strategy for the treatment of obesity. As such, hypoxic therapy is now used as a general medical practice for obesity treatment in many developed countries. Therefore, hypoxic therapy could be a new, practical, and useful therapeutic modality for obesity and obesity-related comorbidities.</P>

Association between Sarcopenic Obesity Status and Nonalcoholic Fatty Liver Disease and Fibrosis

Song Wolhwa,Yoo Sung Hwan,Jang Jinsun,Baik Su Jung,Lee Byoung Kwon,Lee Hyun Woong,Park Jong Suk 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.1

Background/Aims: There are no data regarding the association between sarcopenic obesity status and nonalcoholic fatty liver disease (NAFLD) and NAFLD-associated liver fibrosis. Therefore, we aimed to investigate the relationship between sarcopenic obesity status (sarcopenia only, obesity only, and sarcopenic obesity) and NAFLD and liver fibrosis in Korean adults. Methods: In total, 2,191 subjects completed a health checkup program, including abdominal ultrasonography and FibroScan. Subjects were classified into the following four categories: optimal body composition (nonobese and nonsarcopenic), sarcopenia only (nonobese), obesity only (nonsarcopenic), and sarcopenic obesity. Sarcopenic obesity was stratified by the skeletal muscle mass index and body fat using bioelectrical impedance analysis. NAFLD was diagnosed by ultrasonography, and liver fibrosis was assessed using transient elastography in subjects with NAFLD. Results: The prevalence of NAFLD and liver fibrosis significantly increased according to the sarcopenic obesity status. In the logistic regression analysis, after adjusting for multiple risk factors, the odds ratio (OR) for the risk of NAFLD was largest in the sarcopenic obesity group (OR, 3.68; 95% confidence interval [CI], 2.94 to 4.60), followed by the obesity only (OR, 2.25; 95% CI, 1.67 to 3.03) and sarcopenia only (OR, 1.92; 95% CI, 1.30 to 2.84) groups, when compared with the optimal group. Additionally, liver fibrosis was independently associated with sarcopenic obesity status (OR 4.69, 95% CI 1.95 to 11.29; OR 4.17, 95% CI 1.56 to 11.17; OR 3.80, 95% CI 0.86 to 16.75, respectively). Conclusions: These results demonstrated that sarcopenic obesity was independently associated with NAFLD and liver fibrosis and increased the risk of NAFLD and liver fibrosis more than obesity or sarcopenia alone.

Development and Evaluation of an Obesity Ontology for Social Big Data Analysis

Kim, Ae Ran,Park, Hyeoun-Ae,Song, Tae-Min Korean Society of Medical Informatics 2017 Healthcare Informatics Research Vol.23 No.3

<P><B>Objectives</B></P><P>The aim of this study was to develop and evaluate an obesity ontology as a framework for collecting and analyzing unstructured obesity-related social media posts.</P><P><B>Methods</B></P><P>The obesity ontology was developed according to the ‘Ontology Development 101’. The coverage rate of the developed ontology was examined by mapping concepts and terms of the ontology with concepts and terms extracted from obesity-related Twitter postings. The structure and representative ability of the ontology was evaluated by nurse experts. We applied the ontology to the density analysis of keywords related to obesity types and management strategies and to the sentiment analysis of obesity and diet using social big data.</P><P><B>Results</B></P><P>The developed obesity ontology was represented by 8 superclasses and 124 subordinate classes. The superclasses comprised ‘risk factors,’ ‘types,’ ‘symptoms,’ ‘complications,’ ‘assessment,’ ‘diagnosis,’ ‘management strategies,’ and ‘settings.’ The coverage rate of the ontology was 100% for the concepts and 87.8% for the terms. The evaluation scores for representative ability were higher than 4.0 out of 5.0 for all of the evaluation items. The density analysis of keywords revealed that the top-two posted types of obesity were abdomen and thigh, and the top-three posted management strategies were diet, exercise, and dietary supplements or drug therapy. Positive expressions of obesity-related postings has increased annually in the sentiment analysis.</P><P><B>Conclusions</B></P><P>It was found that the developed obesity ontology was useful to identify the most frequently used terms on obesity and opinions and emotions toward obesity posted by the geneal population on social media.</P>

Perspective on Diagnostic Criteria for Obesity and Abdominal Obesity in Korean Adults

Nam, Ga Eun,Park, Hye Soon Korean Society for the Study of Obesity 2018 Journal of obesity & metabolic syndrome Vol.27 No.3

<P>Excessive body weight is associated with increased health risks in humans. In general, the risk of mortality increases with greater obesity. The 2018 guideline for the management of obesity by the Korean Society for the Study of Obesity proposed the body mass index (BMI) cut-off levels of 25 kg/m<SUP>2</SUP> and 23 kg/m<SUP>2</SUP> as diagnostic criteria for obesity and overweight (pre-obese) in Korean adults, respectively. Abdominal obesity has been defined as waist circumference (WC) ≥90 cm in men and WC ≥85 cm in women. In this review, the validity of these criteria for Korean adults was examined based on the evidence regarding the associations of obesity index with mortality and morbidity. The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm and American Diabetes Association guideline for the medical care of obese and overweight patients support a BMI of 25 kg/m<SUP>2</SUP> and 23 kg/m<SUP>2</SUP>, respectively, as the cut-off levels for Asians (and some ethnicities) corresponding to the BMI values of 30 kg/m<SUP>2</SUP> and 25 kg/m<SUP>2</SUP>, respectively, for Caucasians. In the future, the optimal cut-off levels for obesity and abdominal obesity may require adjustment as the demographic characteristics of the Korean population change. In addition, development of more valid indicators that better reflect health risks of obesity is needed.</P>

여고생들의 비만도 및 비만과 관련된 사회심리적 요인 분석

김경원,김영아,김정희 대한지역사회영양학회 1997 대한지역사회영양학회지 Vol.2 No.4

The purpose of this study was to investigate the dietary intake, obesity index and psychosocial factors influencing obesity among 200 high school girls in Seoul. The Social Cognitive Theory provided the Conceptual basis for this study. A cross-sectional survey was conducted to examine factors related to obesity, including self-efficacy for controlling overeating, social support for eating behavior, perception of body image and weight control, nutrition knowledge, and attitudes toward obesity. The data were analyzed using t-test and multiple logistic regression. The results of this study are as follows : 1) The mean age of the girls was 16.4 years, and the rate of overweight and obesity(measured by obesity index) was 27.0$\%$. 2) The mean energy intake of subjects was 1832.3$\pm$384.0kcal. The energy derived from carbohydrates, proteins and fats was 62.7$\%$, 13.8$\%$, and 23.5$\%$, respectively. There was no significant difference between the obese and the comparison group in energy intake. 3) The result of multivariate analysis indicated that obesity had a significant relation to the perception of ideal body image, social support for eating behavior, and self-efficacy for controlling overeating(p〈0.01). As subjects preferred thinner body images(OR=0.39) and received less social support(OR=0.93), the odds of being classified as obese increased. The odds of being obese were also associated with self-efficacy, however, the relation was not strong(OR=1.04). 4) Specific social support was related to obesity among adolescent girls. As subjects received more support from family member, the odds of being obese decreased. The emotional support as well as family member's positive nutrition behavior plays a significant role. In addition, instrumental support from friends was associated with obesity. With repect to self-efficacy, the odds of being obese were increased as subjects felt less confident in controlling overeating when tempting food was placed in front of them or after an argument. In contrast, the obese group felt more confident in controlling overeating for the rest of the specific situations examined. These findings suggest that educational interventions for weight control should incorporate strategies to help participants realize their degree of obesity, to reduce the discrepancy between current and ideal body image, to elicit and maintain social support from friends and family, and to increase the self-efficacy for changing eating behaviors. (Korean J Community Nutrition 2(4) : 496-504, 1997)

Evaluation and Treatment of Obesity and Its Comorbidities: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity

김경곤,함지희,김범택,김은미,박정환,이상열,전언주,강은구,남가은,구혜연,임정현,정조은,김종희,김종원,박정하,홍준화,Sang Eok Lee,민세희,김승준,김선영,김양현,이연지,조윤정,이영준,김연희,강지현,이창범,대한비만학회 진료지침위원회 대한비만학회 2023 Journal of obesity & metabolic syndrome Vol.32 No.1

The goal of the 8th edition of the Clinical Practice Guidelines for Obesity is to help primary care physician provide safe, effective care to patients with obesity by offering evidence-based recommendations to improve the quality of treatment. The Committee for Clinical Practice Guidelines comprised individuals with multidisciplinary expertise in obesity management. A steering board of seven experts oversaw the entire project. Recommendations were developed as the answers to key questions formulated in patient/problem, intervention, comparison, outcomes (PICO) format. Guidelines underwent multi-level review and cross-checking and received endorsement from relevant scientific societies. This edition of the guidelines includes criteria for diagnosing obesity, abdominal obesity, and metabolic syndrome; evaluation of obesity and its complications; weight loss goals; and treatment options such as diet, exercise, behavioral therapy, pharmacotherapy, and bariatric and metabolic surgery for Korean people with obesity. Compared to the previous edition of the guidelines, the current edition includes five new topics to keep up with the constantly evolving field of obesity: diagnosis of obesity, obesity in women, obesity in patients with mental illness, weight maintenance after weight loss, and the use of information and communication technology-based interventions for obesity treatment. This edition of the guidelines features has improved organization, more clearly linking key questions in PICO format to recommendations and key references. We are confident that these new Clinical Practice Guidelines for Obesity will be a valuable resource for all healthcare professionals as they describe the most current and evidence-based treatment options for obesity in a well-organized format.

Obesity, Body Image, Depression, and Weight-control Behaviour Among Female University Students in Korea

Eun Mi Jun,최승배 대한암예방학회 2014 Journal of cancer prevention Vol.19 No.3

Background: Obesity has become epidemic worldwide and 31.0% of Korean adults are obese. Obesity is the main cause of chronic diseases, such as diabetes, hypertension, cardiac disease, and cancer. The purpose of the study was to examine obesity, body image, depression, and weight-control behaviour among Korean female university students and investigate the differences in body image, depression, and weight-control behaviour with respect to obesity. Methods: This study examined obesity, body image, depression, and weight control in 700 female university students from 4 universities in South Korea. To evaluate obesity, both objective obesity (body mass index [BMI]) and subjective obesity (subjectively perceived) were measured. Results: There was a significant difference between objective and subjective obesity (χ2 = 231.280, P < 0.001). In addition, the objective obesity group had the lowest body image score (F = 19.867, P < 0.001) and difference in weight-control behaviour (F = 3.145, P = 0.045). Further, the subjective obesity group had the lowest body image score (F = 58.281, P < 0.001). The results revealed a statistically significant difference in body image and weight-control behaviour with respect to objective obesity. Conclusion: Objective and subjective obesity was negatively associated with body image, and no relationships between objective or subjective obesity and depression.

Association Between the Persistence of Obesity and the Risk of Gastric Cancer: A Nationwide Population-Based Study

임주현,신철민,한경도,이승우,진은효,최윤진,윤혁,박영수,김나영,이동호 대한암학회 2022 Cancer Research and Treatment Vol.54 No.1

Purpose There remains controversy about relationship between obesity and gastric cancer. We aimed to examine the association using obesity-persistence. Materials and Methods We analyzed a nationwide population-based cohort which underwent health check-up between 2009 and 2012. Among them, those who had annual examinations during the last 5 years were selected. Gastric cancer risk was compared between those without obesity during the 5 years (never-obesity group) and those with obesity diagnosis during the 5 years (non-persistent obesity group; persistent obesity group). Results Among 2,757,017 individuals, 13,441 developed gastric cancer after median 6.78 years of follow-up. Gastric cancer risk was the highest in persistent obesity group (incidence rate [IR], 0.89/1,000 person-years; hazard ratio [HR], 1.197; 95% confidence interval [CI], 1.117 to 1.284), followed by non-persistent obesity group (IR, 0.83/1,000 person-years; HR, 1.113; 95% CI, 1.056 to 1.172) compared with never-obesity group. In subgroup analysis, this positive relationship was true among those < 65 years old and male. Among heavy-drinkers, the impact of obesity-persistence on the gastric cancer risk far increased (non-persistent obesity: HR, 1.297; 95% CI, 1.094 to 1.538; persistent obesity: HR, 1.351; 95% CI, 1.076 to 1.698). Conclusion Obesity-persistence is associated with increased risk of gastric cancer in a dose-response manner, especially among male < 65 years old. The risk raising effect was much stronger among heavy-drinkers.