A Saudi comprehensive research center for obesity: experiences from the first 4 years.

Author:Alfadda, Assim A.
 
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Obesity--a term used to describe body weight that is much greater than what is considered to be healthy--is a chronic disease and the second leading cause of preventable deaths worldwide, following tobacco (Danaei et al., 2009; World Health Organization, 2009). In addition to obesity, high blood pressure and high blood glucose are among the top five global mortality risk factors throughout the world. Therefore, the burden of obesity as a mortality risk factor is considered to be even higher than would be expected, given that obesity is a determinant factor for both high blood pressure and high blood glucose (World Health Organization, 2009). Approximately two thirds of the adult population in the Kingdom of Saudi Arabia (KSA) is obese or overweight (Al-Nozha et al., 2005). A recent review of the prevalence of obese and overweight individuals in the KSA and other Gulf States reported that both genders are affected, with women being more likely to be obese but men being slightly more likely to be overweight (Ng, Zaghloul, Ali, Harrison, & Popkin, 2011). Furthermore, obesity levels are disturbingly high among Saudi children, similar to other parts of the world. Because of the expected longer course of the disease, obese children are more prone to obesity-related complications than obese adults (El Mouzan et al., 2010; Ng et al., 2011). Obesity is associated with a variety of metabolic diseases and co-morbidities, including type 2 diabetes, hypertension, coronary heart disease, and some types of cancer (Semenkovich, 2006). These diseases increase the burden on both the individual and society and have a negative impact on the economy. Therefore, various health authorities, scientific communities, and leading governments worldwide have addressed the growing public health problems associated with obesity. The Saudi government has recognized the negative consequences of obesity and has implemented appropriate strategies to approach and solve these problems.

The Science and Technology National Policy (STNP) in the KSA emphasizes the importance of research to achieve one of its primary goals: Serving sustained, balanced, and comprehensive development. The first recommendation of the STNP is to study the country's common health problems to understand the factors involved in their development and to determine ways to stop their progression. The third strategic principle of the STNP highlights the need to develop university-affiliated research centers that will become pivotal pillars and national references in their areas of interest (STNP, 2009).

Recognizing the significant impact of obesity on the Saudi society, we established a comprehensive research center, the Obesity Research Center (ORC) at the King Saud University (KSU) College of Medicine, in accordance with the STNP recommendations, to study obesity through a wide spectrum, ranging from genetic causes and molecular pathologic changes of obesity to the impact of environmental and lifestyle changes on body weight regulation. At the ORC, different stakeholders work together to achieve a multidisciplinary approach for studying obesity and its associated complications.

Here, we present the successful story of the ORC by discussing its initiation, establishment, maintenance, and fine-tuning phases. Our aim is to highlight the fundamental steps in the establishment of the ORC to provide a model for the foundation of similar centers in developing countries. The proposed model is flexible and can be adjusted to establish research centers with different interests and specialties.

THE INITIATION PHASE

We began our mission by reviewing the themes, structures, objectives, and work plans of similar previously established research centers worldwide. The intent was to begin at the level that others had already reached and to bypass obstacles that may have impeded the foundation of such centers. The ORC director and executive committee held weekly meetings to assign tasks and to discuss progress in detail. Our vision was to establish a distinct, specialized center for biomedical research on obesity and its related disorders; we are committed to perform excellent, multidisciplinary research with an emphasis on technology transfer and development.

The next stage was defining our strategic objectives, which focus on conducting high-quality research to address the complex obesity syndrome, training Saudis in world-class research methodology, and raising public awareness about the prevention and treatment of obesity through community-based programs.

A fundamental step in the process was to secure the necessary funding. We received a reasonable start-up fund from KSU for the establishment and/or renovation of our research laboratories. In addition, we applied for and successfully received a major grant that was funded by the National Plan for Science and Technology (NPST), King Abdulaziz City for Science and Technology (KACST).

THE ESTABLISHMENT PHASE

The cornerstone triad for the establishment phase was: (1) to build the necessary research infrastructure and to formulate the main research themes; (2) to recruit both national and international staff members; and (3) to establish national and international collaborations.

  1. Main research themes and laboratory infrastructure

    As stated above, we performed a comprehensive, multidisciplinary research on obesity that allows for a better understanding of its heterogenic nature and complex clinical consequences. We prioritized our starting research themes using various approaches to study obesity, as illustrated in Figure 1. In the following sections, we will discuss the main research themes and related research tools/techniques, with a special emphasis on their role in accomplishing the top goals of the ORC.

    Detection of novel biomarkers for obesity using a proteomic approach

    Obesity is an extremely heterogeneous disorder. Some obese individuals are more prone to developing complications than are other individuals. Furthermore, the type, timing, and severity of particular complications also vary among obese individuals. Characterizing new markers that can be useful for improving the stratification of obesity and the prediction of obese individuals who are more susceptible to develop a particular complication is crucial for successfully managing obesity at a much lower cost (i.e., efficient and cost-effective treatment). Because of the recent development of highly sensitive mass spectrometric equipments and difference in gel two-dimensional electrophoresis (DICE) technology, proteomic analysis tools have proven useful for new biomarker characterization in a growing list of chronic diseases, although there are only a few studies using proteomic approaches in the obesity research (Siwya, Vlahoub, Zimmerlic, Ziirbiga, & Schiffer, 2011). Therefore, through active international collaboration, we established a state-of-the-art proteomic facility in our center (Figure...

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