Objective To map human evidence (2019–2025) concerning APOA2, FTO, MC4R and adiposity, distinguishing genetic main effects from formal gene-diet interactions. Methods We conducted a PRISMA-ScR scoping review of MEDLINE/PubMed, Embase, Web of Science Core Collection and Cochrane Library records through September 23, 2025. Two reviewers screened records; study quality was appraised using design-matched tools. Results Nine reports represented eight unique cohorts. Four reports derived from randomized interventions, including secondary or ancillary analyses with differing estimands. In DIETFITS, 309 participants met the diet-specific SAT22 adherence criteria (healthy low-carbohydrate arm ≥22 g/day saturated fat; healthy low-fat arm <22 g/day). The 12-month APOA2 genotype × saturated-fat interaction was nominal (p = 0.035), did not meet a simple three-time-point Bonferroni benchmark (α ≈ 0.017), and remains exploratory; within-genotype diet comparisons are distinct from interaction tests. Within one large eMERGE dataset, MC4R coding variants were associated with overweight (OR 2.20, 95% CI 1.95–2.47), obesity (OR 2.40, 95% CI 2.12–2.72) and extreme obesity (OR 5.59, 95% CI 4.71–6.65). These findings do not constitute independent cross-cohort replication. Conclusions The heterogeneous evidence does not support routine genotype-guided dietary prescribing. The exploratory APOA2 interaction requires independent replication with prespecified multiplicity control and full interaction estimates.
Background and aims The impact of different ambulatory blood pressure thresholds on isolated nocturnal hypertension (INH) in type 2 diabetes remains uncertain. We evaluated their effects on prevalence and individual reclassification. Methods This cross-sectional study included 634 people living with type 2 diabetes who underwent ambulatory blood pressure monitoring. Nocturnal hypertension and ambulatory phenotypes were classified using European Society of Hypertension/International Society of Hypertension (ESH/ISH) and American College of Cardiology/American Heart Association (ACC/AHA) thresholds. Changes in prevalence, agreement, and individual reclassification were evaluated. Results Nocturnal hypertension prevalence increased from 62.5% (95% confidence interval, 58.7–66.2) with ESH/ISH thresholds to 83.3% (95% confidence interval, 80.4–86.2) with ACC/AHA thresholds, whereas INH prevalence remained virtually unchanged (21.6% vs. 22.1%). Agreement was moderate (unweighted κ = 0.475), with substantial individual reclassification across ambulatory phenotypes. More than half of participants with INH according to ESH/ISH were reclassified as having sustained hypertension by ACC/AHA, whereas more than half of those with INH according to ACC/AHA had been considered normotensive by ESH/ISH. Exploratory, unadjusted comparisons suggested differences in age, sex, and office blood pressure between INH subgroups. Conclusions Lower ACC/AHA thresholds markedly increased nocturnal hypertension prevalence and changed who was classified as having INH, despite similar overall INH prevalence. The clinical and prognostic significance of this reclassification remains uncertain.
Aims Abdominal obesity increases cardiovascular strain through heightened sympathetic activity and endothelial dysfunction, both of which contribute to cardiometabolic risk. Although body positioning is commonly used in clinical settings, its impact on cardiac workload among individuals with varying adiposity remains uncertain. This study aimed to examine hemodynamic responses to five common therapeutic positions in adults with and without abdominal obesity. Methods Fifty-two men (26 abdominal obesity; 26 normal weight), aged 30–59 years, maintained each position for 40 min (Fowler's, right lateral, left lateral, supine, prone). Hemodynamics (HR, EDV, CTi, SVi, CI, SVRi) were obtained by transthoracic bioimpedance (PhysioFlow®) Results The stroke volume index and cardiac index were highest in the supine position (p < 0.05), indicating efficient cardiac filling. The prone position showed higher heart rate and systolic pressure, suggesting increased cardiac workload, whereas the right lateral position had the lowest blood pressure (p < 0.05). These patterns were generally consistent between groups; however, participants with abdominal obesity exhibited lower stroke volume and cardiac indices in the right lateral position (p = 0.028 and p = 0.021) and higher contractility and systolic pressure in the prone position (p = 0.045 and p = 0.047). Conclusions The supine and semi-Fowler's positions supported better cardiac performance, while the right lateral position helped lower blood pressure. In contrast, the prone position increased cardiac workload, particularly in individuals with abdominal obesity. These findings suggest that appropriate body positioning may help maintain cardiovascular stability and reduce hemodynamic stress in clinical practice.
