Program

In-person AND virtual! – We are pioneering a new conference format that will connect in-person and virtual audiences to create a unique experience. Matching the innovation that comes through our members’ work, ISPOR is pushing the boundaries of innovation to design an event that works in today’s quickly changing environment. 

In-person registration included the full virtual experience, and virtual-only attendees will be able to tune into live in-person sessions and/or watch captured in-person sessions on-demand in addition to having a variety of virtual-only sessions to attend.

The Effect of Weight Loss on Hypothalamus Structure and Function in Obese Individuals: A Systematic Literature Review and Meta-Analysis

Speaker(s)

Gedda DUK1, Mekary RA2, Devi S3, Yadav N4, Chawla S5, Doucette J6, Moura LD7, Velloso LA8
1M.C.P.H.S University, Boston, MA, USA, 2MCPHS Univeristy, Boston, MA, USA, 3Kings College London, Boston, MA, USA, 4MCPHS University, Jersey City, NJ, USA, 5Faculty of Life Sciences and Medicine, King’s College London, London, UK, 6MCPHS University, Boston, MA, USA, 7University of Campinas, Limeira, Brazil, 8University of Campinas, San Paulo, Brazil

Presentation Documents

OBJECTIVES: Obesity (body mass index (BMI) ≥ 30 kg/m2) is usually presented with structural and functional hypothalamic dysfunction. However, it is currently unclear whether weight loss can modify these hypothalamic changes. We, therefore, aimed to conduct a systematic review and meta-analysis to determine the effect of body mass reduction in obese individuals on hypothalamic structure and function.

METHODS: PubMed, Embase and Cochrane databases were searched through 11/2020 for studies that evaluated the change in hypothalamic structure and function after weight loss. Qualitative and quantitative analyses were performed on reported magnetic resonance imaging techniques, medio-basal hypothalamus T2-relaxation time, blood oxygen level dependent (BOLD) contrast, voxel-based morphometry (VBM), and biomarkers including glucose, insulin, leptin, ghrelin, and interleukins. Mean differences pre- vs. post-weight loss and 95% confidence intervals (CI) were pooled using random-effects models.

RESULTS: Thirteen pre-post studies were included, of which six accounted for the meta-analysis. A favorable decrease in T2-relaxation time (one study) and BOLD contrast showed a favorable change in neural and functional activity of the hypothalamus after weight loss (four studies), with higher peak activities after surgical weight loss (two studies). No difference was found in VBM in the gray matter density of the hypothalamus after surgical weight loss (one study). Pooled mean differences pre- vs. post-surgical weight loss revealed a decrease of 8.53 mg/dl (95% CI: 5.17, 11.9; six studies) in glucose; 7.73 pmol/l (95% CI: 5.07, 10.4; four studies) in insulin; 15.5 ng/ml (95% CI: 9.40, 21.6; four studies) in leptin, 142.9 pg/ml (95% CI: 79.0, 206.8; two studies) in ghrelin, and 9.43 pg/ml (95% CI: -6.89, 25.7; two studies) in IL6.

CONCLUSIONS: Our results demonstrated that weight reduction in obesity escalated the activity of hypothalamus and upregulated body homeostasis along with improved markers related to metabolic regulation.

Code

MSR18

Topic

Epidemiology & Public Health, Organizational Practices, Study Approaches

Topic Subcategory

Academic & Educational, Literature Review & Synthesis, Meta-Analysis & Indirect Comparisons, Public Health

Disease

Diabetes/Endocrine/Metabolic Disorders, Surgery