To compare the performance of triglyceride-glucose index combined with body mass index (TyG-BMI) and waist-to-height ratio (WHtR) in the diagnosis of visceral fat area (VFA) in overweight and obese people, and to explore their gender differences, so as to provide a simple and accurate assessment tool for clinical screening of central obesity and metabolic risk.

A total of 117 overweight and obese patients were enrolled. The quartiles of VFA (113.60 cm², 146.30 cm², 190.10 cm²)were used as the cut-off values and divided into four groups: S1 to S4. Anthropometric, serological and insulin resistance-related composite indicators were collected. Pearson correlation analysis was used to evaluate the correlation between each indicator and VFA. ROC curve analysis was used to compare the efficacy of each indicator in diagnosing high VFA, and gender subgroup analysis was performed. Clinical decision curve analysis (DCA) was used to evaluate the net clinical benefit of each index, and the positive predictive value (PPV) and negative predictive value (NPV) were calculated.

The body weight (107.07±17.40 vs 80.34±10.28 ), waist circumference (116.31±12.13 vs 97.60±8.81), waist-to-height ratio (0.69±0.07 vs 0.59±0.05) and TyG-BMI (340.34±45.48 vs 265.30±31.29) in group S4 were higher than those in group S1. Blood pressure (135.83±16.50 vs 125.27±18.74), liver function (24.90 vs 22.45) and fatty liver (355.34±42.39 vs 293.20±36.42) were higher than those in S1 group (P<0.05). Correlation analysis showed that TyG-BMI (r=0.559 ) and waist-to-height ratio (r=0.587) were positively correlated with VFA (P<0.05). Gender subgroup analysis showed that the cut-off values of TyG-BMI and waist-to-height ratio at different VFA cut-off points. There were gender differences. The cut-off point of TyG-BMI was 298.12-315.89 in males and 263.76-283.88 in females. The cut-off point of waist-to-height ratio was 0.62-0.65 in males and 0.58-0.63 in females. DCA showed that TyG-BMI had the greatest net clinical benefit, which was better than waist-to-height ratio, waist circumference and BMI. Taking VFA ≥100 cm² as the gold standard, PPV reached 97.7 % when TyG-BMI > 298.64, which was higher than waist-to-height ratio >0.62 (94.5%), waist circumference >103.7 cm (93.8%) and BMI >31.11 (94.8%). However, the NPV of the four indicators was low (24.7%-37.5%), suggesting that the exclusion ability was limited.

TyG-BMI and WHtR can be used as indicators of VFA in overweight and obese people, but there are gender differences. When TyG-BMI >282.73 (male >298.12) and WHtR >0.58 (male 0.62 ), It can be used as an early warning index for abnormal accumulation of visceral fat.it is preliminarily suggested that there may be significant visceral fat accumulation in individuals, which is worthy of further examination and dynamic observation of VFA.TyG-BMI has the best clinical net benefit and diagnostic efficacy in screening visceral obesity, and can be used as a convenient screening tool for high-risk groups, but negative results need to be further evaluated in combination with other indicators.

To explore the relationship between body mass index (BMI), weight-adjusted waist circumference index (WWI), body roundness index (BRI), and relative fat mass index (RFM) and the risk of diabetic foot ulcer (DFU) and all-cause mortality, and to provide a basis for risk stratification in diabetic patients.

Based on the data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004, 1,487 diabetic patients aged ≥35 years were included. Weighted logistic regression was used to analyze the association between BMI, WWI, BRI, and RFM and DFU and the pre-DFU state. ROC curves and restricted cubic splines were used to analyze the discriminatory ability of each index for DFU and its non-linear relationship. By linking to the National Death Index database, the patients were followed up until December 31, 2019, and weighted Cox proportional hazards regression was used to analyze the relationship between each index and all-cause mortality.

A total of 1,487 diabetic patients were included, among whom 100 (6.7%) had DFU and 733 (49.3%) were in the pre-DFU state. After fully adjusting for confounding factors, BMI, WWI, BRI, and RFM were all significantly associated with an increased risk of DFU, with OR values of 1.07, 1.95, 1.47, and 1.13, respectively; however, these indices were not significantly associated with the pre-DFU state. All four indices had moderate discriminatory power for DFU, with AUCs of approximately 0.71 to 0.72. RCS analysis showed a non-linear relationship between WWI and the risk of DFU. The analysis of all-cause mortality revealed that WWI, BRI, and RFM were significantly associated with an increased risk of death, while the association of BMI was relatively weak. Among them, WWI and BRI performed more prominently in the stratification of mortality risk.

Multiple obesity-related anthropometric indices are significantly associated with an increased risk of DFU in diabetic patients, and WWI and BRI are also associated with an increased risk of all-cause mortality. Simple and non-invasive anthropometric indices are promising for identifying high-risk populations for DFU and providing references for early prevention and risk stratification.

To investigate the application effect of a specialized disease management program based on the ORTCC model in perioperative care for patients with metabolic weight loss.

Eighty patients who underwent laparoscopic sleeve gastrectomy in our weight loss and metabolic surgery center from July 2024 to December 2024 were selected as the control group (n=80); another eighty patients who underwent laparoscopic sleeve gastrectomy in our weight loss and metabolic center from January 2025 to June 2025 were selected as the observation group (n=80). The control group received conventional nursing care, while the observation group received a specialized disease management program based on the ORTCC model. The preoperative assessment completeness rate, postoperative first ambulation time compliance rate, incidence of nausea and vomiting during hospitalization, health behavior awareness rate before discharge, and postoperative satisfaction scores were compared between the two groups.

The observation group exhibited higher preoperative assessment completeness rate, postoperative first ambulation time compliance rate, health behavior awareness rate before discharge, and postoperative satisfaction scores than the control group (P<0.05). The incidence of nausea and vomiting during hospitalization was lower in the observation group than in the control group (P<0.05).

The specialized disease management program based on the ORTCC model can reduce postoperative adverse reactions, optimize weight loss outcomes, enhance self-management capabilities in patients undergoing bariatric surgery, improve their quality of life, and achieve higher patient satisfaction.

To investigate the effect of the timing of prophylactic ondansetron administration on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic sleeve gastrectomy (LSG).

This retrospective study reviewed the clinical records of 110 patients who underwent elective LSG at the Bariatric and Metabolic Center of Dalang Hospital, Dongguan, China, between January 2023 and December 2025. Among these patients, 93 eligible cases were included in the final analysis. All procedures were performed by the same surgical and anesthesia team using a standardized three-port, seven-step LSG technique. Patients were divided into two groups according to the timing of prophylactic ondansetron administration: 46 patients received ondansetron at anesthesia induction (group G1), whereas 47 patients received the drug during gastric sleeve formation (group G2). Both groups received identical postoperative antiemetic and analgesic regimens, including the same rescue protocols. Baseline clinical characteristics, the frequency and severity of PONV, rescue antiemetic use, postoperative VAS pain scores, and number of rescue analgesic administrations were compared between the two groups at 0-6 h (T1), 6-12 h (T2), 12-18 h (T3), 18-24 h (T4), and 24-48 h (T5) after surgery.

No significant differences were observed between the two groups with respect to baseline characteristics, including age, sex, body mass index (BMI), and anesthesia duration (all P>0.05). Compared with Group G1, Group G2 had significantly fewer episodes of postoperative nausea and vomiting (PONV) at T1 [1 (1-1) vs 2 (2-3)], T2[2 (1-3) vs 3.5 (3-4)], and T3 [0 (0-1) vs 1 (0-1)] (all P<0.05). Similarly, the median PONV severity scores were significantly lower in Group G2 than in Group G1 at T1 [2 (1-3) vs 3 (3-4)] and T2 [3 (2-4) vs 4 (3-5)] (both P<0.05). In addition, the median postoperative visual analog scale (VAS) pain scores were significantly lower in Group G2 than in Group G1 at T1, T2, and T4 (all P<0.05).

Compared with administration during anesthesia induction, prophylactic administration of ondansetron during gastric sleeve creation more effectively reduces the incidence and severity of early postoperative nausea and vomiting and alleviates postoperative pain in patients with obesity undergoing laparoscopic sleeve gastrectomy.

The prevalence of type 2 diabetes (T2DM) combined with metabolic associated fatty liver disease (MAFLD) is high. Insulin resistance (IR) serves as the link between the two. Their combined effect leads to liver cell damage, liver fibrosis, and even progression to cirrhosis. The liver fibrosis process is more obvious in T2DM patients with MAFLD. The glycerol triose phosphate glucose index (TyG), as a non-insulin-dependent, reliable, economical, and simple-to-perform new indicator for evaluating IR, combined with body mass index (BMI), can be used for screening and management of MAFLD in T2DM patients, thereby strengthening the control of risk factors and avoiding irreversible progression of the disease. This article reviews the possible mechanisms and correlations between the glycerol triose phosphate glucose index (TyG-BMI) and liver fibrosis in T2DM patients with MAFLD, with the aim of providing a basis for early assessment of liver fibrosis and early prediction and intervention of risk factors.

Sleeve gastrectomy is one of the effective interventions for severe obesity; however, long-term weight regain after surgery substantially compromises its clinical benefits. Weight regain is not attributable to a single cause, but rather represents a coordinated defensive response across multiple systems under a state of negative energy balance. This review first outlines the epidemiology and definition of weight regain following sleeve gastrectomy. On this basis, we elaborate on the underlying biological mechanisms, including the "metabolic memory" of adipocytes and immune cells, which constitutes the tissue-level susceptibility basis; the remodeling of the gut microbiota-gut-brain axis, which participates in energy absorption and reprogramming of appetite centers; the loss of lean body mass and associated metabolic adaptation, which drive weight rebound through both energy expenditure and appetite regulation; and the structural and functional alterations in hypothalamic appetite-regulatory networks, which form the neural foundation for sustained increases in food intake. These mechanisms are interconnected and collectively shift energy balance toward a positive direction. Furthermore, we propose a three-tiered stepwise management strategy-"lifestyle intensification-pharmacological intervention-endoscopic and revisional surgery"-with a focused review of the evidence and differential efficacy of GLP-1 receptor agonists and revisional surgery in managing weight regain after sleeve gastrectomy. This review aims to provide clinicians with an integrated framework spanning mechanistic understanding to stratified intervention, facilitating the transition of bariatric surgery toward a long-term chronic disease management model.

With the continuous increase in the global prevalence of obesity, bariatric and metabolic surgery (BMS) has gradually been introduced to address severe obesity and metabolic syndrome. Post-operative patients may be anxious or depressed, suffer from changes in body image, and lose motivation for treatment; thus, their recovery may be impaired. Most current clinical psychological evaluations are self-report questionnaires and interviews; thus, they fail to provide timely, objective and continuous data on alterations in patients' emotions and behaviour. MER is a new objective that can quantify the psychological status and adherence behaviour of patients with BMS more intelligently. Future work will include multiple centre clinical validation trials to examine the actual effects. In addition, improve the interpretability and privacy protection design of the model, promote deeper integration of MER with nursing information systems, and advance the development of precision and continuous psychological nursing care models.

The frequent comorbidity of obesity and sleep disorders is well-established, with high-fat diet (HFD) serving as a critical modifiable factor whose mechanisms of action warrant further elucidation. This review systematically synthesizes the current evidence on how HFD-induced obesity affects sleep architecture and quality, aiming to integrate existing evidence and construct a multi-pathway synergistic mechanism network. Existing research indicates that HFD can disrupt sleep rhythms, reduce slow-wave activity, increase sleep fragmentation, and impair respiratory stability during sleep. The underlying mechanisms involve the interplay of multiple pathways, including dysregulation of orexin, leptin, ghrelin, and dopamine signaling, metabolic products, endoplasmic reticulum stress, and dysbiosis of the gut microbiota. By analyzing the heterogeneous evidence and clarifying the limitations and controversies in current research, we provide a theoretical foundation for future standardized mechanism validation and exploration of precise intervention targets.

To investigate the relationship between genetic polymorphisms and environmental factors, we conducted a meta-analysis.

According to the PRISMA guidelines, we conducted a systematic search across all relevant databases from the inception of the search until April 1, 2026. We also retained studies that addressed the interaction between obesity-related gene polymorphisms and modifiable environmental factors in overweight or obese children and adolescents. Continuous outcomes were summarized as standardized mean differences (SMD) and dichotomous outcomes as odds ratios (OR), with effect sizes combined under a random-effects model; heterogeneity was assessed by I² statistic, and publication bias was judged qualitatively from funnel plots.

23 studies meet the criteria. For FTO effect-allele carriers versus non-carriers, the pooled SMD was -0.13 (95%CI: -0.34 to 0.08, I²= 39%), a difference that did not reach statistical significance. Nine studies addressed the MC4R-diet interaction: carriers of the rs17782313 C allele showed a pooled OR of 1.35 (95%CI: 1.19 to 1.53, I²=0%, P<0.0001), roughly a 35% higher risk than non-carriers, with effect directions consistent and the result robust across studies. Eight studies informed the sleep analysis, where insufficient sleep carried a pooled OR for overweight/obesity of 1.54 (95%CI: 1.26 to 1.87, I²= 53%, P<0.0001); given the moderate-to-high heterogeneity, this estimate should be read with caution.

Childhood obesity is a result of both genetic predisposition and modifiable environmental factors, with genetic factors contributing to the risk.

Duodenal diverticulum is a common gastrointestinal lesion, but its complications are uncommon. Perforation of duodenal diverticulum following laparoscopic sleeve gastrectomy (LSG) is extremely rare and poses significant diagnostic and therapeutic challenges. This article reports a relevant case treated at Chu Hsien-I Memorial Hospital of Tianjin Medical University with favorable outcomes. The occurrence of duodenal diverticulum perforation after LSG may be associated with increased intraduodenal pressure caused by accelerated gastric emptying postoperatively and dietary factors. The treatment of such patients should be individualized based on the location of perforation, extent of infection, and general condition of the patient; in this case, percutaneous puncture and drainage achieved excellent results. Given that duodenal diverticulum may affect surgical implementation and postoperative prognosis, it is recommended that routine gastroduodenoscopy and abdominal computed tomography (CT) be performed before LSG to evaluate the diverticulum and optimize surgical decision-making. Whether gastric bypass surgery is a superior option for obese patients with concurrent duodenal diverticulum who require metabolic bariatric surgery remains a question worthy of further exploration.