Keyword: obesity

Exploratory results of circulating chemerin testing in humans

Objective: Currently, the global epidemiologic impact of obesity requires continuous seeking of practical biomarkers; hence, this current study aimed to address the gap of chemerin assays in obese versus non-obese females and to analyze its circulating levels in relationship with the glucose profile and other circulating adipokines. Methods: This is an exploratory, prospective, cross-sectional analysis in females aged between 50 and 80 years. We excluded individuals with diabetes, cancers, endocrine, kidney, cardiovascular, and bone conditions. Enzyme-linked immunosorbent assay-based circulating adipokines testing was performed. The final analysis was focused on circulating chemerin (ng/mL) in the obese [body mass index (BMI) ≥ 30 kg/sqm] versus non-obese (BMI < 30 kg/sqm) group. Results: The obesity (N=12) versus the non-obesity (N=12) group showed a statistically significantly higher HOMA-IR (p=0.04), fasting insulin (p=0.01), but similar circulating chemerin. Chemerin positively correlated with BMI only in the obesity group (r=0.881, p=0.0039), but not with patients’ age and glucose profile-based features in any group. Chemerin showed a statistically significant positive, strong correlation with VEGF-A level (r=0.857, p=0.0065) and an inverse statistically significant strong association with circulating leptin (r= -0.713, p=0.0092) and circulating IL-12 p40 (r= -0.829, p=0.0416) in the obesity group. Conclusion: As a potential hypothesis-generating analysis, this pilot study showed different statistical results in BMI-based groups, despite the fact that direct comparison of circulating chemerin and even leptin, VEGF-A, and IL-12 p40 did not reach between-group statistical significance. A larger sample size and a multimodal integration of the adipokines panel might serve for practical points in addressing obesity. Citation: Schipor SV, Manda D, Ciobica ML, Sima OC, Preda EM, Ciuche A, et al. Exploratory results of circulating chemerin testing in humans. R. J. Mil. Med. 2026, CXXIX(4): 404-412 https://doi.org/10.55453/rjmm.2026.129.4.6 Academic Editor: Raluca Mititelu

Physical effort – an underused preventable method in colorectal cancer

Colorectal cancer prevalence is increasing worldwide. Modifiable risk factors are responsible for almost 50 % of cases and this could imply a huge potential of preventability. Among these factors the level of physical activity is of paramount importance. Physical activity has a positive impact on health status in general and it decreases the prevalence of various cancers including colorectal cancer. Physical activity decreases the prevalence of benign colorectal adenomas and it prolongs the disease free interval after surgery in colorectal cancer, thus increasing survival. The mechanisms involved are multiple: decreasing bowel transit time, regulating energy balance, decreasing peripheral insulin resistance, decreasing hyperinsulinism, antiinflamatory effects, increasing vitamin D production.

Obesity and osteoporotic fractures

Obesity correlates with a higher risk of fractures in some sites as vertebras, upper arm, and legs. This is a narrative mini-review focused on several key points that link obesity with osteoporosis. Waist circumference may a better predictor of fractures than body mass index (BMI) in obese females. Even obese menopausal women have an extra source of estrogens in fat tissue this actually is not enough to offer a complete protection against osteoporotic fractures. Low levels of testosterone in males induce a higher risk of fall dependent or independent of sarcopenia (which is more evident in elderly). High BMI is correlated with vitamin D deficiency. Obesity is a contributor to muscle damage and decline due to fat accumulation and inefficient fuel utilisation by the muscle, namely sarcopenic obesity, regardless the age. Associated type 2 diabetes mellitus involves bone damage and fracture risk due to glycated proteins of the matrix, the changes of adipokines, increased cortical porosity, high risk of fall because of blood pressure and glycaemia anomalies, visual disturbances, renal and peripheral nerves diabetes-associated conditions etc. The fracture risk is also augmented via fat derived cytokines and chronic inflammation. Even it seems logical that the weight correction though bariatric surgery reduces the fracture risk in obesity, actually data from longitudinal studies pointed that, despite the procedure is life saving, it does not actually protect against osteoporosis which is regarded as a potential long-term complication. A high fracture burden in obesity should increase the level of awareness for practitioners of different medical areas due to multiple levels of complications and to the epidemiological impact of obesity.

Targeting Heart Disease in Cardiovascular–Kidney–Metabolic Syndrome: A Review of Novel Therapeutic Approaches with Prognostic and Quality-of-Life Impact

Cardiovascular-kidney-metabolic (CKM) syndrome describes the complex, bidirectional interplay among cardiovascular, renal, and metabolic dysfunctions, where impairment in one system accelerates decline in the others. This interconnected pathophysiology significantly elevates the risk and progression of heart disease, particularly heart failure, through mechanisms involving insulin resistance, systemic inflammation, neurohormonal activation, and endothelial dysfunction. In this context, therapeutic strategies targeting heart disease must address the multifaceted drivers of CKM. Recent advances highlight the need for an integrated, patient-centered approach that combines lifestyle interventions with pharmacological treatments tailored to individual cardiovascular risk. While foundational therapies such as RAAS inhibitors and statins remain essential, novel agents now offer additional prognostic and quality-of-life benefits. SGLT2 inhibitors have emerged as a cornerstone therapy, improving outcomes in heart failure with both preserved and reduced ejection fraction, independent of glycemic control. GLP-1 receptor agonists and dual GLP-1/GIP agonists like tirzepatide demonstrate cardiometabolic and renal protection, while finerenone shows promise in diabetic kidney disease and several heart failure phenotypes. These therapies not only target glycemic control but also reduce cardiovascular mortality, hospitalizations, and renal decline. Optimizing cardiovascular outcomes in CKM syndrome requires early, multifactorial therapeutic intervention, informed by evolving evidence and a deeper understanding of the heart–kidney–metabolism axis.

Colorectal cancer epidemiology and risk factors

Colorectal cancer is an important health problem, being the third most frequent cancer pathology both in men and women. Programmes have been developed to decrease CRC incidence and mortality, including primary prevention strategies focusing on population education regarding diet and physical activity and secondary prevention programmes such as screening. Modifiable risk factors are known to be diet, obesity, smoking, alcohol and read meat consumption. Non-modifiable risk factors are age, inflammatory bowel disease, genetic syndromes and family history of colorectal cancer.

Obesity impact on symptomatology associated with pelvic floor dysfunction

The increasing incidence of obesity, a significant health problem worldwide, represents a major socio-economic burden with a high impact on the quality of life. It is considered a risk factor for multiple medical conditions. More than half of women from developed countries are overweight or obese, this comorbidity can affect them from puberty through the reproductive period and then in the menopausal period, involving multiple medical and surgical specialties. It has a significant impact on the onset of puberty, the menstrual cycle, ovulation, fertility rate, and pregnancy outcome. In postmenopausal women, obesity represents an important risk factor for breast cancer, endometrial cancers or polyps, fibroids, pelvic organ prolapse, or stress urinary incontinence in addition to a higher risk of post-operative complications and also to some types of fragility fractures, especially if diabetes mellitus is associated. Pelvic floor disorders include pelvic organ prolapse, urinary or fecal incontinence. Obese patients seem more affected compare with normal-weighted females. We introduce a single-center, retrospective study on 74 patients (admitted between 2016 and 2019) with pelvic organ prolapses that were referred for surgical correction, and further on they were evaluated after one month, respective after 6 months since procedure. On admission, the subjects, aged between 41-82 years (median of 57 years) showed a strong correlation between the symptomatology caused by the prolapse degree and obesity (40.54% of them), as it appears that the discomfort and symptoms are significantly higher in the women with higher body mass index. In the reevaluation form, the patients with obesity complaint more frequently compared to the non-obese females about urinary and colorectal distress and low sexual desire and interest. The use of surgical treatment for pelvic organ dysfunctions is a contributor to improved quality of life in adult obese females.

Evaluation of morbid obese patients with attitudes toward obese persons scale prior to bariatric surgery: Obesity from the perspective of real patients

Background: The number of studies with the application of scales, such as Attitudes Toward Obese Persons Scale (ATOP), on morbid obese patients are limited. Therefore, we wanted to examine the attitudes toward obese people through the eyes of morbid obese patients. Methods: Between October 2019 - April 2020, 70 female and 20 male, morbid obese patients, who were admitted to the general surgery department to be evaluated for bariatric surgery were included in this study. These 90 morbid obese patients were asked to fill out ATOP, which included 20 statements. Results: The mean ATOP score of all morbid obese patients was 63.44±18.58 (range:19-116). The mean ATOP score of female patients was 63.47±20.34 (range:19-116), whereas the mean ATOP score of male patients was 63.35±10.69 (range:43-80) (p=0.98). The frequency of the responses given by the male and female patients to the third statement, which was “Most obese people are more self-conscious than other people” pointed out a statistically significant difference (p=0.02). Conclusions: Based on ATOP scores gained from morbid obese patients, 60% of morbid obese patients did not feel as happy as non-obese people, whereas 74.4% of the morbid obese patients thought that obese people were not as healthy as non- obese people. Moreover, ATOP scores which were slightly higher than 60 points in both female and male morbid obese patients indicated that morbid obese patients had neither negative nor highly positive attitudes toward obese people.

Obesity is not related to individuals but to environmental conditions; from the perspective of obese patients

Background: The Beliefs About Obese Persons Scale (BAOP) is used among non-obese people in English speaking countries to evaluate their opinions on obese people. Nevertheless, the data are scarce from the view of obese people. Therefore, we wanted to test BAOP on obese patients in order to evaluate their opinions from the perspective of obese patients. Methods: Between August 2019-June 2020, 115 (76.7%) female and 35 (23.3%) male, a total of 150 obese patients who were admitted to the general surgery department to be evaluated for bariatric surgey, were included in this study. Local ethics committee approval was obtained (2019/08-10). These obese patients were asked to fill out BAOP, which included 8 statements in which each statement was valued between -3 to +3 points. Results: Mean score of BAOP within all obese patients was 34.87 ± 8.12 (range: 5-48). The average score of BAOP was 34.33 ± 8.60 (range: 5-48) in females and 36.62 ± 6.06 (range: 21-48) in males (p = 0.14). The frequency of the answers given by the male and female patients to the 5th statement, which was “Most obese people eat more than non-obese people”, showed a statistically significant difference (p = 0.03). Conclusions: Obese patients had higher BAOP scores compared to previous BAOP studies performed with non-obese people. Within this study, obese patients considered obesity as a condition which was not under their control.

Gut microbiota and obesity

Worldwide, adults and childhood obesity are increasing alarmingly, being a major health problem. Obesity is correlated with an increased incidence of various systemic diseases including cancer, heart diseases, and diabetes mellitus type 2. Risk factors for obesity are dysbiosis, genetic, socioeconomic, behavioural and environmental. The gut microbiota has beneficial effects on human health, like host immune system stimulation, being influenced by pH, or nutrient intake. Studies performed on humans and animal models reported differences regarding microbiota at lean and obese individuals. The consumption of probiotics and prebiotics may balance the microbiota with positive effects in obesity. The main aim of this review is to reveal the interaction between dysbiosis and obesity.

The Impact of the Hypercaloric Diet versus the Mediterranean Diet on Insulin Sensitivity

Obesity affects the population worldwide. A hypercaloric diet associated with a sedentary life, stress, and genetic background, triggers various metabolic disorders, such as metabolic syndrome, diabetes mellitus, cancer, cardiovascular diseases, non-alcoholic fatty liver disease, and cognitive impairment. A healthy diet correlated with physical activity, not smoking, and moderate alcohol consumption reduces the risk of developing metabolic diseases. The Mediterranean diet contains antioxidants, fiber, polyunsaturated fats, and compounds with anti-inflammatory, anti-oxidant, anti-cancer, and anti-obesity properties. In a wide variety of species including humans, the reduction of calories between 20-40% significantly improves health, increases longevity, and delays the development of various pathologies. The main aim of this review is to present the comparative effects of the Mediterranean diet versus the hypercaloric diet on insulin sensitivity.