The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis
Background. Clinical studies suggest obesity paradoxically increases survival during bacterial infection and sepsis but decreases it with influenza, but these studies are observational. By contrast, animal studies of obesity in infection can prospectively compare obese versus nonobese controls. We p...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Obesity |
| Online Access: | http://dx.doi.org/10.1155/2020/1508764 |
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| author | Wanying Xu Dominique Pepper Junfeng Sun Judith Welsh Xizhong Cui Peter Q. Eichacker |
| author_facet | Wanying Xu Dominique Pepper Junfeng Sun Judith Welsh Xizhong Cui Peter Q. Eichacker |
| author_sort | Wanying Xu |
| collection | DOAJ |
| description | Background. Clinical studies suggest obesity paradoxically increases survival during bacterial infection and sepsis but decreases it with influenza, but these studies are observational. By contrast, animal studies of obesity in infection can prospectively compare obese versus nonobese controls. We performed a systematic review and meta-analysis of animal investigations to further examine obesity’s survival effect in infection and sepsis. Methods. Databases were searched for studies comparing survival in obese versus nonobese animals following bacteria, lipopolysaccharide, or influenza virus challenges. Results. Twenty-one studies (761 obese and 603 control animals) met the inclusion criteria. Obesity reduced survival in 19 studies (11 significantly) and the odds ratio (95% CI) of survival (0.21(0.13, 0.35); I2 = 64%, p<0.01p < 0.01) but with high heterogeneity. Obesity reduced survival (1) consistently in both single-strain bacteria- and lipopolysaccharide-challenged studies (n = 6 studies, 0.21(0.13, 0.34); I2 = 31%, p=0.20 and n = 5, 0.22(0.13, 0.36); I2 = 0%, p=0.59, respectively), (2) not significantly with cecal ligation and puncture (n = 4, 0.72(0.08, 6.23); I2 = 75%, p<0.01), and (3) significantly with influenza but with high heterogeneity (n = 6, 0.12(0.04, 0.34); I2 = 73%, p<0.01). Obesity’s survival effects did not differ significantly comparing the four challenge types (p=0.49). Animal models did not include antimicrobials or glycemic control and study quality was low. Conclusions. Preclinical and clinical studies together emphasize the need for prospective studies in patients accurately assessing obesity’s impact on survival during severe infection. |
| format | Article |
| id | doaj-art-b2aa7f8d7fcb42ec8b7a6621d3be0dc9 |
| institution | Kabale University |
| issn | 2090-0708 2090-0716 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Obesity |
| spelling | doaj-art-b2aa7f8d7fcb42ec8b7a6621d3be0dc92025-08-20T03:39:21ZengWileyJournal of Obesity2090-07082090-07162020-01-01202010.1155/2020/15087641508764The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-AnalysisWanying Xu0Dominique Pepper1Junfeng Sun2Judith Welsh3Xizhong Cui4Peter Q. Eichacker5Critical Care Medicine Department, NIH Clinical Center, National Institutes of Health, Bethesda, MD 20892, USACritical Care Medicine Department, NIH Clinical Center, National Institutes of Health, Bethesda, MD 20892, USACritical Care Medicine Department, NIH Clinical Center, National Institutes of Health, Bethesda, MD 20892, USANational Institutes of Health Library, National Institutes of Health, Bethesda, MD 20892, USACritical Care Medicine Department, NIH Clinical Center, National Institutes of Health, Bethesda, MD 20892, USACritical Care Medicine Department, NIH Clinical Center, National Institutes of Health, Bethesda, MD 20892, USABackground. Clinical studies suggest obesity paradoxically increases survival during bacterial infection and sepsis but decreases it with influenza, but these studies are observational. By contrast, animal studies of obesity in infection can prospectively compare obese versus nonobese controls. We performed a systematic review and meta-analysis of animal investigations to further examine obesity’s survival effect in infection and sepsis. Methods. Databases were searched for studies comparing survival in obese versus nonobese animals following bacteria, lipopolysaccharide, or influenza virus challenges. Results. Twenty-one studies (761 obese and 603 control animals) met the inclusion criteria. Obesity reduced survival in 19 studies (11 significantly) and the odds ratio (95% CI) of survival (0.21(0.13, 0.35); I2 = 64%, p<0.01p < 0.01) but with high heterogeneity. Obesity reduced survival (1) consistently in both single-strain bacteria- and lipopolysaccharide-challenged studies (n = 6 studies, 0.21(0.13, 0.34); I2 = 31%, p=0.20 and n = 5, 0.22(0.13, 0.36); I2 = 0%, p=0.59, respectively), (2) not significantly with cecal ligation and puncture (n = 4, 0.72(0.08, 6.23); I2 = 75%, p<0.01), and (3) significantly with influenza but with high heterogeneity (n = 6, 0.12(0.04, 0.34); I2 = 73%, p<0.01). Obesity’s survival effects did not differ significantly comparing the four challenge types (p=0.49). Animal models did not include antimicrobials or glycemic control and study quality was low. Conclusions. Preclinical and clinical studies together emphasize the need for prospective studies in patients accurately assessing obesity’s impact on survival during severe infection.http://dx.doi.org/10.1155/2020/1508764 |
| spellingShingle | Wanying Xu Dominique Pepper Junfeng Sun Judith Welsh Xizhong Cui Peter Q. Eichacker The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis Journal of Obesity |
| title | The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis |
| title_full | The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis |
| title_fullStr | The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis |
| title_short | The Effects of Obesity on Outcome in Preclinical Animal Models of Infection and Sepsis: A Systematic Review and Meta-Analysis |
| title_sort | effects of obesity on outcome in preclinical animal models of infection and sepsis a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2020/1508764 |
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