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Article ; Online: Update on Pediatric Anti-obesity Medications-Current Landscape and Approach to Prescribing.

Ahn, Yoon Ji / Maya, Jacqueline / Singhal, Vibha

Current obesity reports

2024

Abstract: Purpose of review: To review the current medical therapies available for treatment of obesity in children and adolescents less than 18 years old in the United States and outline the approach to their use.: Recent findings: Obesity is a chronic ... ...

Abstract	Purpose of review: To review the current medical therapies available for treatment of obesity in children and adolescents less than 18 years old in the United States and outline the approach to their use. Recent findings: Obesity is a chronic disease with increasing prevalence in children and adolescents in the United States. Over the past few years, more FDA-approved medical treatments for obesity, such as GLP-1 receptor agonists, have emerged for patients less than 18 years old. Furthermore, there are medications with weight loss effects that can be used off-label for obesity in pediatric patients. However, access to many of these medications is limited due to age restrictions, insurance coverage, and cost. Medical options are improving to provide treatment for obesity in pediatric populations. FDA and off-label medications should be considered when appropriate to treat children and adolescents with obesity. However, further studies are needed to evaluate the efficacy and long-term safety of FDA-approved and off-label medications for obesity treatment in pediatric patients.
Language	English
Publishing date	2024-04-30
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2162-4968
ISSN (online)	2162-4968
DOI	10.1007/s13679-024-00566-z
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Article ; Online: Trajectory of Gonadal Hormones in Adolescent Males up to 2 Years After Sleeve Gastrectomy.

Kaur, Snimarjot / Bredella, Miriam A / Misra, Madhusmita / Singhal, Vibha

Obesity surgery

2023 Volume 33, Issue 10, Page(s) 3323–3326

Abstract: Sleeve gastrectomy (SG) has many metabolic benefits and leads to improvements in testosterone levels, which means improvement in the Leydig cell function of the testis. However, data about the effects of SG on Sertoli cell function (as assessed by ... ...

Abstract	Sleeve gastrectomy (SG) has many metabolic benefits and leads to improvements in testosterone levels, which means improvement in the Leydig cell function of the testis. However, data about the effects of SG on Sertoli cell function (as assessed by inhibin B) are not available. In this preliminary study, we evaluate, for the first time, the effect of SG in adolescents after SG. We evaluate 16 adolescent and young adult males, six of whom underwent SG and followed them for 2 years. We report that Leydig cell function (as assessed by testosterone levels) improved and was associated with degree of weight loss. Sertoli cell function improved only slightly in SG group and did not change compared to the nonsurgical controls, and these changes were not associated with degree of weight loss. Thus, we conclude that larger and long-term follow-up studies are required to evaluate the changes in Sertoli cell function after SG as that is integral to male fertility.Clinical Trial Registration: NCT02557438.
MeSH term(s)	Adolescent ; Humans ; Male ; Young Adult ; Gastrectomy ; Gastric Bypass ; Gonadal Hormones ; Obesity, Morbid/surgery ; Testosterone ; Weight Loss/physiology
Chemical Substances	Gonadal Hormones ; Testosterone (3XMK78S47O)
Language	English
Publishing date	2023-08-10
Publishing country	United States
Document type	Clinical Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06759-0
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Article: Role of religious beliefs of tribal communities from Jharkhand (India) in biodiversity conservation

Singhal, Vibha / Ghosh, Jyotirmoy / Bhat, Sheeraz Saleem

Journal of environmental planning and management. 2021 Oct. 13, v. 64, no. 13

2021

Abstract: Jharkhand is one of the most biodiversity-enriched regions in India because of its origin and diverse physiographic and climatic conditions. It comprises 29.61% forest area which exceeds the national average of 23%. However, the biodiversity rich status ... ...

Abstract	Jharkhand is one of the most biodiversity-enriched regions in India because of its origin and diverse physiographic and climatic conditions. It comprises 29.61% forest area which exceeds the national average of 23%. However, the biodiversity rich status of this region may also be attributed to its higher tribal population. Jharkhand has 26.3% tribal population of the total population in the state belong to 32 different groups. Santal, Munda and Ho are the dominant tribal groups in this area. They protect and conserve the plant and animal diversity in the landscape through their religious belief system which encompasses the concept of totemism, sacred trees and groves. However, intrusion of modernization, commercialization and weakening of indigenous belief systems has raised serious concerns in the conservation and management of floral and faunal biodiversity. Religion is a potent tool to convince people; hence their religious values and associated taboos must be protected against erosion
Keywords	animals ; biodiversity ; biodiversity conservation ; commercialization ; fauna ; forests ; landscapes ; modernization ; religion ; India
Language	English
Dates of publication	2021-1013
Size	p. 2277-2299.
Publishing place	Routledge
Document type	Article
ZDB-ID	2000921-5
ISSN	1360-0559 ; 0964-0568
ISSN (online)	1360-0559
ISSN	0964-0568
DOI	10.1080/09640568.2020.1861587
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Article: Effect of incubation time, litter diversity and species richness on decomposition dynamics of tree species from western Himalayas

Singhal, Vibha / Roy, Trisha / Singh, Charan / Ghosh, Jyotirmoy

Catena. 2021 Aug., v. 203

2021

Abstract: Biodiversity loss may seriously impact some of the major ecological functions like primary productivity, nutrient cycling and decomposition. Decomposition is a fundamental ecosystem process regulating nutrient mineralization, microbial community ... ...

Abstract	Biodiversity loss may seriously impact some of the major ecological functions like primary productivity, nutrient cycling and decomposition. Decomposition is a fundamental ecosystem process regulating nutrient mineralization, microbial community composition and structure, carbon sequestration in the soil. Therefore it is important to find out the link between biodiversity and decomposition dynamic which is of key interest recently among ecologists, hence we took up eleven combinations of leaf litter mixtures of four multipurpose tree species commonly occurring together in western Himalayas to find out the direction, magnitude and drivers of litter mixing effect. We found positive non significant effect of litter diversity for all mixtures except two which showed antagonistic effects after three months of decomposition. But we found positive non additive effects (NAE)/interaction effects for all litter mixtures at later stage of decomposition i.e. after nine months. The strength of litter mixing effect varied from 5.45% to 14.75% among litter mixtures. The interaction effects are observed to be greater for those litter mixtures which are more heterogeneous with respect to initial nitrogen, and phosphorus content. However the effect of chemical diversity is more marked on interaction effect/ NAE than variation in single trait(N or P content) as revealed by R² value (coefficient of determination). Interaction effect values increased with increase in percent of fast decomposing species in the litter mixture but rate of increase decreased when the mixtures move towards homogeneity. Interaction effect also increased with increase in species richness significantly up to three species, thereafter the increase is non significant. Our results indicate that tree diversity alters decomposition dynamics of component species in the mixture. Chemical diversity is more important factor in determining non additive effect rather than taxonomic diversity of a mixture.
Keywords	additive effect ; carbon sequestration ; catenas ; community structure ; ecosystems ; microbial communities ; mineralization ; multipurpose trees ; nitrogen ; phosphorus content ; plant litter ; primary productivity ; species richness ; Himalayan region
Language	English
Dates of publication	2021-08
Publishing place	Elsevier B.V.
Document type	Article
Note	NAL-AP-2-clean
ZDB-ID	519608-5
ISSN	1872-6887 ; 0008-7769 ; 0341-8162
ISSN (online)	1872-6887 ; 0008-7769
ISSN	0341-8162
DOI	10.1016/j.catena.2021.105281
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Article ; Online: Changes in Branched-Chain Amino Acids One Year after Sleeve Gastrectomy in Youth with Obesity and Their Association with Changes in Insulin Resistance.

Becetti, Imen / Lauze, Meghan / Lee, Hang / Bredella, Miriam A / Misra, Madhusmita / Singhal, Vibha

Nutrients

2023 Volume 15, Issue 17

Abstract: Adults with obesity have a reduction in branched-chain amino acid (BCAA) levels following metabolic and bariatric surgery (MBS), which is hypothesized to contribute to the metabolic advantages of MBS. We examined this relationship in 62 youth 13-24 years ...

Abstract	Adults with obesity have a reduction in branched-chain amino acid (BCAA) levels following metabolic and bariatric surgery (MBS), which is hypothesized to contribute to the metabolic advantages of MBS. We examined this relationship in 62 youth 13-24 years old with severe obesity (47 female) over 12 months. Thirty had sleeve gastrectomy (SG) and 32 were non-surgical controls (NS). We measured fasting insulin, glucose, glycated hemoglobin (HbA1c), isoleucine, leucine, and valine concentrations, and post-prandial insulin and glucose, following a mixed meal tolerance test. Twenty-four-hour food recalls were collected. At baseline, groups did not differ in the intake or the serum levels of BCAAs, HbA1C, HOMA-IR, Matsuda index, insulinogenic index, or oral Disposition index (oDI). Over 12 months, SG vs. NS had greater reductions in serum BCAAs, and SG had significant reductions in BCAA intake. SG vs. NS had greater reductions in HbA1c and HOMA-IR, with increases in the Matsuda index and oDI. In SG, baseline leucine and total BCAA concentrations were negatively correlated with the baseline Matsuda index. Reductions in serum leucine were positively associated with the reductions in HOMA-IR over 12 months. These associations suggest a potential role of BCAA in regulating metabolic health. Reducing dietary intake and serum BCAA concentrations may reduce insulin resistance.
MeSH term(s)	Adolescent ; Adult ; Humans ; Female ; Young Adult ; Amino Acids, Branched-Chain ; Insulin Resistance ; Leucine ; Glycated Hemoglobin ; Obesity/surgery ; Insulin ; Gastrectomy ; Glucose ; Meals
Chemical Substances	Amino Acids, Branched-Chain ; Leucine (GMW67QNF9C) ; Glycated Hemoglobin ; Insulin ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2023-08-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15173801
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Article ; Online: Differences in bone accrual over one year in young girls with obesity compared to Normal weight controls.

Singhal, Vibha / Kaur, Snimarjot / Haidar, Lea Abou / Lee, Hang / Bredella, Miriam A / Misra, Madhusmita

Bone

2023 Volume 172, Page(s) 116757

Abstract: Despite higher bone mineral density (BMD), women with obesity are at an increased risk of fracture compared to normal-weight women. Optimal adolescent bone accrual is critical for normal peak bone mass acquisition and future bone health. Whereas several ... ...

Abstract	Despite higher bone mineral density (BMD), women with obesity are at an increased risk of fracture compared to normal-weight women. Optimal adolescent bone accrual is critical for normal peak bone mass acquisition and future bone health. Whereas several studies have examined the impact of low body weight on bone accrual in youth, data are lacking regarding the impact of obesity on bone accrual. We examined bone accrual over one year in young women with moderate to severe obesity (OB) (n = 21) versus normal-weight controls (NWC) (n = 50). Participants were 13-25 years old. We used dual-energy X-ray absorptiometry to assess areal BMD (aBMD) and high resolution peripheral quantitative computed tomography (distal radius and tibia) to assess volumetric BMD (vBMD), bone geometry, and microarchitecture. Analyses were controlled for age and race. The mean age was 18.7 ± 2.7 years. OB and NWC were similar for age, race, height, and physical activity. OB had a higher BMI (p < 0.0001) and younger menarchal age (p = 0.022) than NWC. Over one year, OB did not demonstrate the increase in total hip BMD observed in NWC (p = 0.03). Increases in percent cortical area and cortical thickness, and cortical and total vBMD at the radius were lower in OB than in NWC (p ≤ 0.037). Groups did not differ for tibial bone accrual. We demonstrate that longitudinal bone accrual is impaired at the total hip and radial cortex in young women with obesity, raising concerns regarding their future bone health.
MeSH term(s)	Adolescent ; Humans ; Female ; Young Adult ; Adult ; Bone and Bones ; Bone Density ; Obesity ; Absorptiometry, Photon ; Fractures, Bone ; Radius/diagnostic imaging ; Tibia/diagnostic imaging
Language	English
Publishing date	2023-04-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	632515-4
ISSN	1873-2763 ; 8756-3282
ISSN (online)	1873-2763
ISSN	8756-3282
DOI	10.1016/j.bone.2023.116757
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Article ; Online: Two-Year Study on the Impact of Sleeve Gastrectomy on Depressive and Anxiety Symptoms in Adolescents and Young Adults with Moderate to Severe Obesity.

Tuli, Shubhangi / Lopez Lopez, Ana Paola / Nimmala, Supritha / Pedreira, Clarissa C / Singhal, Vibha / Bredella, Miriam A / Misra, Madhusmita

Obesity surgery

2024 Volume 34, Issue 2, Page(s) 568–575

MeSH term(s)	Humans ; Adolescent ; Female ; Young Adult ; Adult ; Obesity, Morbid/surgery ; Obesity/surgery ; Gastric Bypass ; Anxiety ; Gastrectomy ; Retrospective Studies
Language	English
Publishing date	2024-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-07025-z
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Article: One-Year Self-Reported Appetite Is Similar in Adolescents with Obesity Who Do or Do Not Undergo Sleeve Gastrectomy

Singhal, Vibha / Nimmala, Supritha / Karzar, Nazanin Hazhir / Bredella, Miriam A. / Misra, Madhusmita

Nutrients. 2022 July 26, v. 14, no. 15

2022

Abstract: Background: With the growing prevalence of severe obesity in adolescents, sleeve gastrectomy (SG), a type of metabolic bariatric surgery (MBS), is increasingly being performed at a younger age. Data regarding changes in homeostatic and hedonic appetite ... ...

Abstract	Background: With the growing prevalence of severe obesity in adolescents, sleeve gastrectomy (SG), a type of metabolic bariatric surgery (MBS), is increasingly being performed at a younger age. Data regarding changes in homeostatic and hedonic appetite following SG are conflicting in adults, with some studies showing no change and others showing a decrease in appetite. Data evaluating the effect of SG on appetite during adolescence, when appetite is more plastic, are currently lacking. Objective: To evaluate appetite changes one year after SG in adolescents with obesity vs. in non-surgical controls (NS). Methods: Thirty-nine subjects 13–21 years old with severe obesity were followed for a year; 19 underwent SG, and 20 were followed without surgery. Subjects had fasting blood tests for appetite-regulating hormones and completed a visual analog scale for appetite assessment (VAS). Results: The SG group had a decrease in body mass index (BMI) at one-year (baseline: 48.2 ± 1.7 kg/m²; one-year follow-up: 42.6 ± 1.0 kg/m² (p ≤ 0.0001)). No within- or between-group differences were noted in the one-year change in appetite in the SG and NS groups. After SG, fasting ghrelin decreased (p ≤ 0.0001); however, no changes were noted in peptide YY (PYY) levels. Changes in one homeostatic appetite measure following SG were inversely associated with changes in fasting PYY (r = −0.583, p = 0.011). Appetite changes were not associated with weight loss or final BMI. Conclusions: There were no changes in appetite measures one-year after SG from pre-surgery levels in adolescents with obesity, and appetite changes were not associated with changes in BMI. It is important to evaluate the impact of long-term appetite changes, if any, on weight loss after SG.
Keywords	adolescence ; appetite ; bariatric surgery ; blood ; body mass index ; ghrelin ; obesity ; peptide YY ; weight loss
Language	English
Dates of publication	2022-0726
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14153054
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Article ; Online: Marrow adipose tissue imaging in humans.

Singhal, Vibha / Bredella, Miriam A

Bone

2018 Volume 118, Page(s) 69–76

Abstract: Bone strength is affected not only by bone mineral density (BMD) and bone microarchitecture but also its microenvironment. Recent studies have focused on the role of marrow adipose tissue (MAT) in the pathogenesis of bone loss. Osteoblasts and adipocytes ...

Abstract	Bone strength is affected not only by bone mineral density (BMD) and bone microarchitecture but also its microenvironment. Recent studies have focused on the role of marrow adipose tissue (MAT) in the pathogenesis of bone loss. Osteoblasts and adipocytes arise from a common mesenchymal stem cell within bone marrow and many osteoporotic states, including aging, medication use, immobility, over - and undernutrition are associated with increased marrow adiposity. Advancements in imaging technology allow the non-invasive quantification of MAT. This article will review magnetic resonance imaging (MRI)- and computed tomography (CT)-based imaging technologies to assess the amount and composition of MAT. The techniques that will be discussed are anatomic T1-weighted MRI, water-fat imaging, proton MR spectroscopy, single energy CT and dual energy CT. Clinical applications of MRI and CT techniques to determine the role of MAT in patients with obesity, anorexia nervosa, and type 2 diabetes will be reviewed.
MeSH term(s)	Adipose Tissue/diagnostic imaging ; Adiposity ; Bone Marrow/diagnostic imaging ; Bone Marrow/pathology ; Humans ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2018-01-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	632515-4
ISSN	1873-2763 ; 8756-3282
ISSN (online)	1873-2763
ISSN	8756-3282
DOI	10.1016/j.bone.2018.01.009
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Article ; Online: Use of sleeve gastrectomy in adolescents and young adults with severe obesity.

Singhal, Vibha / Youssef, Soundos / Misra, Madhusmita

Current opinion in pediatrics

2020 Volume 32, Issue 4, Page(s) 547–553

Abstract: Purpose of review: The prevalence of pediatric obesity and its associated complications is increasing around the world. Treatment of obesity is challenging and metabolic and bariatric surgery (MBS) is currently the most effective treatment for this ... ...

Abstract	Purpose of review: The prevalence of pediatric obesity and its associated complications is increasing around the world. Treatment of obesity is challenging and metabolic and bariatric surgery (MBS) is currently the most effective treatment for this condition. At this time, vertical sleeve gastrectomy (VSG) is the most commonly performed bariatric procedure in adolescents. However, knowledge regarding the efficacy, safety, and durability of VSG in adolescents is still evolving. This review summarizes the most recent updates in the field of MBS particularly VSG in adolescents. Recent findings: MBS is recommended to treat moderate to severe obesity, especially when complicated by comorbidities. The use of VSG for weight loss is increasing among adolescents and produces similar weight loss at five years in both adolescents and adults. The physiologic mechanisms causing weight loss after VSG are multifactorial and still being investigated. The complication rate after VSG ranges between 0 and 17.5%. Summary: VSG appears to be a well-tolerated and effective procedure in adolescents. However, it continues to be underutilized despite the increasing prevalence of moderate to severe obesity in adolescents. It is thus important to educate providers regarding its benefits and safety profile.
MeSH term(s)	Adolescent ; Bariatric Surgery/methods ; Child ; Gastrectomy/adverse effects ; Humans ; Obesity, Morbid/surgery ; Pediatric Obesity/surgery ; Weight Loss ; Young Adult
Language	English
Publishing date	2020-07-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000000927
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