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Objective To investigate the impact of metabolic status on choroidal thickness (ChT) in healthy subjects, patients with obesity, and type 2 diabetes. Design and Methods Fasting blood glucose, insulin, insulin-like growth factor-1 (IGF-1), and ChT measured by optical coherence tomography were assessed in healthy normal-weight (n=17), obese participants (n=20), and obese participants with T2D (n=16). Results ChT increased in obese participants and obese participants with T2D as compared to healthy normal-weight participants (P<0.0001). A negative correlation was observed between IGF1 and ChT (r=−0.268, P=0.050) for all cohorts. Furthermore, body mass index (BMI; R2 =0.209; P=0.002; beta=0.388) and model assessment-estimated insulin resistance (HOMA-IR; R2 =0.074; P=0.015; beta=0.305) were independent variables of ChT, explaining 20.9 and 7.4% of its variance (both p<0.016), whereas age, sex, and IGF-1 were not significant confounders of ChT (p>0.975). Conclusion ChT is associated with metabolic characteristics, i. e., BMI and HOMA-IR. Due to the key role of choroidal function in retinal physiology, future studies are needed to evaluate whether metabolic traits, ChT, and potential metabolic eye complications are mechanistically linked. [ABSTRACT FROM AUTHOR]

Background Even subjects with severe obesity show a wide range of metabolic health states, with some showing marked alterations in glucose and lipid metabolism whereas others do not. In severely obese women, we could recently show that the degree of cardiorespiratory fitness is, independently of body mass and age, associated with several markers of glucose and lipid metabolism. Aims In our retrospective study on a clinical data set, we questioned whether such an association also exists in severely obese men. Methods Cardiorespiratory fitness, i. e. workload (Wpeak) and oxygen uptake (V̇O2,peak) at peak exercise, was assessed by a bicycle spiroergometry in 133 severely obese men (all BMI>35 kg m−2). The following metabolic blood markers were also measured: Fasting serum glucose, insulin, triglycerides (TG), total, low-, high-density cholesterol (Chol, LDL, HDL), uric acid, and whole blood glycated hemoglobin (HbA1c). The Chol/HDL ratio and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were also calculated. Results Multiple stepwise linear regression models including age, body mass, and smoking status as independent variables revealed that Wpeak and V̇O2,peak , explained 4.5 to 10.7% of variance in HbA1c and TG (all beta<− 0.22; all p<0.02). Including fat free mass instead of body mass in respective models revealed that both Wpeak and V̇O2,peak were predictors of HbA1c and TG (all beta<− 0.265; all p<0.013), respectively, while Wpeak also accounted for variance in glucose and Chol (both beta<− 0.259; both p<0.023). Conclusions Similar to previous observations in women, our data indicate that cardiorespiratory fitness assessed by bicycle ergospirometry test is associated with glucose and lipid metabolism in severely obese men. The strength of the found associations suggest a mild to moderate influence of cardiorespiratory fitness on metabolic health in severe obesity. [ABSTRACT FROM AUTHOR]

Background Recently, we showed that in subjects with a body mass index (BMI) > 35 kg/m2 waist circumference (WC) is associated with metabolic traits but associations were weaker in men than in women. Aims To confirm our previous observation that anthropometric measures of abdominal obesity are closer linked to metabolic traits in obese women than obese men. To test whether sagittal abdominal diameter (SAD) provides a better prediction of metabolic traits in obese subjects than WC related measures. Methods SAD and WC along with metabolic traits were assessed in 204 women and 69 men (BMI 30.1-64.0 kg/m2). Results In women, abdominal obesity measures were associated with glycated hemoglobin levels (HbA1c), fasting serum glucose, insulin, triglycerides (TG), total cholesterol (Chol), high-density lipoprotein (HDL), and uric acid levels as well as Chol/HDL ratio and homeostatic model assessment of insulin resistance (HOMA-IR) independently of age and BMI. SAD predicted serum insulin and Chol better than WC, whereas WC was superior to SAD in predicting HbA1c, glucose, HOMA-IR, TG, HDL, Chol/HDL, and uric acid. Of note, the combination of SAD and WC provided a better prediction of insulin, HOMA-IR, TG, and uric acid than each of these anthropometric alone. In men, only fasting glucose, Chol, and uric acid levels were associated with abdominal obesity markers. Conclusion Data show various associations between anthropometric measures of abdominal obesity and metabolic traits in obese women but overall much less in obese men. Most metabolic traits are better predicted by WC than by SAD. [ABSTRACT FROM AUTHOR]

Aims: Both severe obesity and type 2 diabetes (T2DM) are associated with reduced pulmonary function and reduced cardiorespiratory fitness. We investigated whether T2DM further aggravates the impaired pulmonary function and cardiorespiratory fitness in subjects with severe obesity. Methods: In this cross-sectional study pulmonary function (forced expiratory volume within 1 s, FEV1; vital capacity, VC) was assessed in 65 severely obese subjects with T2DM (T2DM group) and 65 severely obese subjects without T2DM (non-T2DM group), pairwise matched for sex, age, weight, and height. In 30 of the matched pairs, cardiorespiratory fitness was assessed by an incremental bicycle test (peak workload, Wpeak, oxygen uptake, VO2,peak). Results: FEV1 and VC did not differ between the T2DM and non-T2DM group (all p ≥ 0.110), whereas Wpeak and VO2,peak - absolute values as well as relative to body mass - were significantly lower in subjects with T2DM compared to those without T2DM (all p ≤ 0.030). Objective markers of maximal exertion, i. e., maximal heart rate and respiratory exchange ratio, did not differ between the 2 groups (both p ≥ 0.245). Conclusions: The presence of T2DM in subjects with severe obesity is associated with lower cardiorespiratory fitness but with no further reduction in pulmonary function compared to subjects with severe obesity but without T2DM. While the cause-effect relationship of this association is not yet clear, these findings highlight the interplay between cardiorespiratory fitness and metabolic health, even in subjects with severe obesity. [ABSTRACT FROM AUTHOR]