BACKGROUND: Irisin is a myokine implicated in lipid and glucose metabolism. The objective of this study is to examine the effect of a body weight reduction on the serum irisin level and physical indicators in obese Japanese patients without diabetes. METHODS: The subjects were 22 patients (male/female, 5/17; age, 46.1±16.0 years; body mass index [BMI], 36.9±5.0 kg/m²) who completed a 6-month body weight reduction program at our clinic. The program included diet, exercise therapy and cognitive behavioral therapy. Blood parameters, body composition, exercise tolerance, homeostasis model assessment of insulin resistance (HOMA-IR), and serum irisin were determined before and after intervention, and relationships among changes in these data were examined. RESULTS: There were significant decreases in body weight and BMI after the intervention. Irisin before the intervention was significantly positively correlated with HOMA-IR (r=0.434, P<0.05). The mean irisin level showed no significant change after the intervention in all participants. However, improvements in % body fat, subcutaneous fat area, triglycerides, and fasting glucose were significantly greater in patients with an increase in irisin compared to those with a decrease in irisin after the intervention. Patients with an increase in irisin also had significantly lower fasting insulin (9.7±4.8 vs. 16.4±8.2, P<0.05) and HOMA-IR (2.2±1.1 vs. 3.7±1.6, P<0.05) after the intervention, compared to patients with a decrease in irisin. CONCLUSION: Body weight reduction did not alter irisin levels. However, irisin may play important roles in fat and glucose metabolism and insulin resistance, and the effects of body weight reduction on irisin kinetics may be a key for obesity treatment.
Adipose Tissue ; Asian Continental Ancestry Group ; Body Composition ; Body Mass Index ; Body Weight* ; Cognitive Therapy ; Diet ; Exercise Therapy ; Exercise Tolerance ; Fasting ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Kinetics ; Metabolism ; Obesity ; Subcutaneous Fat ; Triglycerides

BACKGROUND: It has recently been suggested that skeletal muscle has an important role in insulin resistance in obesity, in addition to exercise tolerance and the fat index. The aim of this study was to identify body composition factors that contribute to improvement of insulin resistance in female patients with obesity who reduce body weight. METHODS: We studied 92 female obese patients (age 40.9±10.4 years, body mass index 33.2±4.6 kg/m2) who reduced body weight by ≥5% after an intervention program including diet, exercise therapy, and cognitive behavioral therapy. Before and after the intervention, body composition was evaluated by dual-energy X-ray absorptiometry to examine changes in skeletal muscle mass. Homeostasis model assessment of insulin resistance (HOMA-IR) was measured as an index of insulin resistance. Cardiopulmonary exercise was also performed by all patients. RESULTS: There were significant improvements in body weight (-10.3%±4.5%), exercise tolerance (anaerobic threshold oxygen uptake 9.1%±18.4%, peak oxygen uptake 11.0%±14.2%), and HOMA-IR (-20.2%±38.3%). Regarding body composition, there were significant decreases in total body fat (-19.3%±9.6%), total fat-free mass (-2.7%±4.3%), and % body fat (-10.1%±7.5%), whereas % skeletal muscle significantly increased (8.9%±7.2%). In stepwise multiple linear regression analysis with change in HOMA-IR as the dependent variable, the change in % skeletal muscle was identified as an independent predictor (β=-0.280, R2=0.068, P<0.01). CONCLUSION: Improvement of insulin resistance in female obese patients requires maintenance of skeletal muscle mass.
Absorptiometry, Photon ; Adipose Tissue ; Body Composition ; Body Mass Index ; Body Weight* ; Cognitive Therapy ; Diet ; Exercise Therapy ; Exercise Tolerance ; Female* ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Linear Models ; Muscle, Skeletal ; Obesity* ; Oxygen

Objectives: The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors. Methods: A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale. Results: In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05). Conclusions Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.

Background: Suicide continues to be a leading cause of death worldwide. Recently, more than 45,000 children in the age group of 10 to 19 years died by suicide, making it the second leading cause of death in the age group of 15 to 19, surpassed only by traffic accidents, tuberculosis, and fighting. Objective: To determine the prevalence of suicidal ideation among adolescents whose parents are separated/divorced; and to explore the factors associated with suicidal ideation and describe adverse experiences among adolescents. Methods: A cross-sectional descriptive study was conducted in 309 adolescents with separated/separated parents in Hue City. Data was collected through direct interviews using a structured questionnaire. Suicidal ideation was defined as the presence of thoughts or plans related to suicide within the last 12 months. Multivariate logistic regression was applied to identify factors associated with suicidal ideation in adolescents with separated/ separated parents. Results: The study found that 15.5% (95% CI:11.7 - 20.1) of adolescents with separated /separated parents reported experiencing suicidal thoughts, in which men accounted 8.4% (95% CI:5.6 – 11.2) and women accounted 7.1% (95% CI:4.5 - 10.6). Several factors were identified as increasing the risk of suicidal ideation, including alcohol use (OR = 3.24; 95% CI:1.42 - 7.42), hyperactivity/inattention (OR = 4.96; 95% CI:1.58 - 15.605), and a poor quality of family relationships (OR = 4.82; 95% CI:1.26 - 18.50). On the contrary, certain factors were found to reduce the risk, including being in the 14-15 age group of 14-15 (OR = 0.26; 95% CI:0.10 - 0.69) and participating in physical activity (OR = 0.44; 95% CI:0.21 – 0.94). Conclusions: The research highlights a significant percentage of adolescents with separated / divided parents who experience suicidal ideation. Therefore, it is imperative for families, schools, and society to develop comprehensive strategies to monitor and address various risky behaviours among students simultaneously.