Indices of relative weight and obesity

Association between METS-VF and sarcopenia among middle-aged and older adults in China: The first longitudinal evidence from CHARLS

BACKGROUND

The association between the Metabolic Score for Visceral Fat (METS-VF) and sarcopenia remains unclear. This study aims to explore the relationship between METS-VF and sarcopenia in the middle-aged and older adults in China.

METHODS

Data were collected from 2011 and 2015 of the China Health and Retirement Longitudinal Survey (CHARLS) and 2948 participants were enrolled in this study. METS-VF was calculated using data from CHARLS. Sarcopenia was defined according to the criteria set by the Asian Working Group for Sarcopenia (AWGS) 2019. Potential confounders were identified through the Directed Acyclic Graph (DAG). The association between METS-VF and sarcopenia was then analyzed using multivariate logistic regression and restricted cubic spline (RCS) analysis.

RESULTS

Compared with low METS-VF, high METS-VF (OR = 1.65, 95 % CI = 1.08-2.52) showed a significant association with the occurrence of sarcopenia. Subgroup and interaction analyses revealed that residence (P for interaction = 0.012) influenced the relationship between METS-VF and sarcopenia. Additionally, RCS analysis demonstrated a non-linear relationship between METS-VF and sarcopenia.

CONCLUSIONS

There is a positive non-linear correlation between METS-VF and sarcopenia with residence showing an impact on this association. Early identification of patients with possible sarcopenia by METS-VF is of great value for disease prediction, prevention, early diagnosis and timely treatment to reduce the potential disease burden.

Exploring the role of anthropometric measurements to assess nutritional status in amyotrophic lateral sclerosis: a longitudinal prospective cohort study

OBJECTIVE

To observe longitudinal correlations between limb anthropometry against weight, BMI and functional decline in patients with amyotrophic lateral sclerosis.

METHODS

A longitudinal, prospective, cohort study was undertaken. Four consecutive measurements of weight, height, triceps skinfold thickness (TSF), mid-upper arm (MUAC) and calf circumferences were collected at three-monthly intervals. Fat- and lean body mass were estimated using measurements of TSF and derivations of arm muscle area, respectively. Correlation analyses indicated associations between anthropometric assessments and functional decline (ALSFRS-R). Longitudinal changes were assessed using repeated measures analyses.

RESULTS

Data from 18 participants was analyzed. At enrollment, weight positively correlated with MUAC (n = 17, p = 0.0001), arm muscle area (n = 17, p = 0.04) and calf circumference (n = 17, p < 0.0001). The ALSFRS-R score negatively correlated with weight (n = 17, p = 0.03), MUAC (n = 18, p = 0.01), TSF (n = 18, p = 0.04), and calf circumference (n = 18, p = 0.003). Function significantly declined by a difference of 6.3 points per month (p = 0.009). A positive correlation was observed between the changes in weight and calf circumference over nine months (r = 0.70, p = 0.02, n = 10).

CONCLUSION

Limb anthropometric measurements may be surrogate indicators of weight and BMI; TSF may be a practical, reliable indicator of fat mass, whilst changes in calf circumference may be alternatively used to monitor changes in nutritional status in the clinic.

An optimized anthropometric index-a body shape index-cm-demonstrates superior performance in cardiovascular risk stratification

ObjectiveA body shape index is a novel indicator for assessing central obesity, but its relationship with cardiovascular disease and mortality remains unclear. This study aimed to assess whether a body shape index-cm, a refined version of a body shape index, improves cardiovascular risk stratification.MethodsUsing data from the National Health and Nutrition Examination Survey from 1999 to 2018, along with follow-up mortality data until 2019, we conducted an observational study to evaluate the performance of a body shape index-cm in identifying cardiovascular disease and predicting mortality. We compared a body shape index-cm with traditional anthropometric indices by employing receiver operating characteristic curve analysis, Cox proportional hazards regression, restricted cubic spline, and Kaplan-Meier survival analysis.ResultsAmong 47,668 participants, a body shape index-cm emerged as a superior screening tool for cardiovascular diseases, achieving an area under the curve of 0.701, surpassing those of waist-to-height ratio (0.631), waist circumference (0.624), and body mass index (0.556). A body shape index-cm showed the highest accuracy in identifying coronary heart disease (area under the curve: 0.728). A linear relationship was observed between a body shape index-cm and cardiovascular mortality risk, with each standard deviation increase in a body shape index-cm associated with a 20% increase in mortality risk.ConclusionsA body shape index-cm outperforms traditional measures in identifying cardiovascular disease and shows a linear correlation with cardiovascular mortality.

The relationship between body condition, body composition, and growth in amphibians

Body condition of animals is often assumed to reflect advantages in survival or reproduction, but body condition indices may not reflect body composition, or condition may be unrelated to fitness-associated traits. The relationship between body condition indices and composition has rarely been quantified in amphibians, and body condition has not previously been related to growth in adult amphibians. We used laboratory (quantitative magnetic resonance) and field methods to evaluate the relationship between body composition and the four common body condition indices for wildlife studies (body mass index, Fulton's index, scaled mass index, and residual index) in two frog and one salamander species in Montana, USA. We then assessed the relationship between body condition and summertime somatic growth during a 3-yr mark-recapture study of one of our study species (Columbia spotted frogs, Rana luteiventris). Correlation of body condition indices with fat and lean mass differed across species, sexes, and whether components were represented as percentages or were scaled based on size. Scaled mass index, residual index, and Fulton's index were most often well correlated (r > 0.6) with scaled body components, but Fulton's index was strongly correlated with body length. Scaled mass and residual indices predicted scaled fat relatively well and were uncorrelated with body length. Heavier condition predicted higher growth rates of Columbia spotted frogs, regardless of the index used. Frogs of heavy body condition (90th percentile residual index) grew 0.04 and 0.05 mm/day greater than frogs of light condition (10th percentile) for average length males and females, respectively. Frogs of short body length (10th percentile) grew 0.11 and 0.19 mm/day more than long (90th percentile) males and females, respectively. By examining the relationship between body condition indices and body composition and revealing a link between condition and future growth, our results provide an empirical basis for choosing the most appropriate condition index, as well as a potential link to fitness-related traits.

Effectiveness of the innovative Austrian phase III cardiac rehabilitation model on cardiovascular risk factors: a nationwide registry

INTRODUCTION

The Austrian model of outpatient cardiac rehabilitation (CR) begins right after discharge from the acute care hospital. During phase II (OUT-II), it provides a facility-based, professionally supervised, multidisciplinary programme of 6 weeks. The subsequent, supervised phase III (OUT-III) lasts 6 months. In 2017, a 3-6 months lasting unsupervised home-based training has been added, which is followed by a 4-week facility-based evaluation and training period, called 'refresher'. We aimed to assess the effectiveness of this programme using a nationwide registry.

METHODS

Anthropometric data, resting blood pressure, lipid profile, maximum exercise capacity (Pmax), anxiety (HADS-A) and depression (HADS-D) of all patients (n=1458) who participated in OUT-III between 1 January 2018 and 30 August 2022 were analysed. Data were assessed at the beginning of OUT-III (OUT-IIIstart), end of the supervised period (OUT-IIIend) and during the refresher (OUT-IIIrefresher).

RESULTS

From OUT-IIIstart to OUT-IIIend, Pmax (155±1.4 W to 167±1.6 W; p<0.001) and high-density lipoprotein (HDL) increased (49±0.4 mg/dL to 51±0.4 mg/dL; p<0.001), low-density lipoprotein (LDL) decreased (82±1.0 mg/dL to 79±1.1 mg/dL; p<0.001), while total cholesterol (CHOL) remained statistically unchanged (150±43.3 mg/dL to 149±43 mg/dL; p<0.999). From OUT-IIIend to OUT-IIIrefresher, Pmax slightly decreased (164±1.6 W; p<0.001), HDL further increased (52±0.5 mg/dL; p<0.020), whereas LDL (79±1.3 mg/dL; p<0.999) and CHOL remained unchanged (149±41 mg/dL; p<0.999).Anxiety (4.8±0.1 aU, 4.2±0.1 aU; p<0.001, 4.0±0.1 aU; p<0.001) and depression (3.7±0.1 aU, 34±0.1 aU; p<.001, 3.1±0.1 aU; p<0.001) continuously decreased from OUT-IIIstart to OUT-IIIend and the OUT-IIIrefresher.

CONCLUSION

OUT-III CR resulted in sustained improvement in Pmax, blood lipids, anxiety and depression.

First articulating os coxae, femur, and tibia of a small adult Paranthropus robustus from Member 1 (Hanging Remnant) of the Swartkrans Formation, South Africa

Since paleontological work began there in 1948, Swartkrans (South Africa) has yielded hundreds of Early Pleistocene hominin fossils, currently attributed to (in ascending order of quantity) cf. Australopithecus africanus, Homo spp., and Paranthropus robustus. The bulk of that large sample comprises craniodental remains, with (mostly fragmentary) postcranial materials being much less abundant at the site. In that context, our announcement here of the first articulating partial os coxae, nearly complete femur, and complete tibia of a young adult hominin (SWT1/HR-2), excavated from the <2.3 to >1.7-million-year-old Hanging Remnant (Member 1) of the Swartkrans Formation, represents an important addition to the understanding of hominin postural and locomotor behavior in Early Pleistocene South Africa. We provide qualitative and quantitative descriptions and initial functional morphological interpretations of the fossils, based mostly on external bone morphology. Epiphyseal fusion data, element dimensions, the crural index, and live body stature and mass estimates that we provide all indicate that SWT1/HR-2 is one of the smallest known adult hominins in the fossil record. We discuss the paleobiological implications of these findings in relation to our taxonomic diagnosis of SWT1/HR-2 as representing P. robustus.

Next Steps in Efforts to Address the Obesity Epidemic

Obesity prevalence continues to rise globally at alarming rates, with adverse health and economic implications. In this state-of-the-art review, we provide an analysis of selected evidence about the current knowledge in the obesity literature, including a synthesis of current challenges in obesity and its determinants. In addition, we review past and current efforts to combat the obesity epidemic, highlighting both successful efforts and areas for further development. Last, we offer insights into the next steps to address the obesity epidemic and advance the field of obesity through both research and practice by (a) adopting a systems perspective, (b) fostering cross-sector and community collaborations, (c) advancing health equity, (d) narrowing the research-to-practice and research-to-policy gaps with multidisciplinary approaches, and (e) embracing complementary approaches for concurrent obesity prevention and treatment.

Development and Validation of a Simple Model to Predict Patient Height

Background

Height recorded in electronic health records (EHRs) is used extensively in diagnosis and treatment, either in isolation or as a component of body-mass index (BMI), but is often falsely high because many adults overestimate their height. Statistical models to predict height could therefore improve population health, but to date models have required extensive input and have not been externally validated.

Methods

We used the National Health and Nutrition Examination Survey (NHANES) to develop sex-stratified predictive models for examiner-measured height based on self-reported height and age in a random 90% sample of data. We internally validated the model in a held-out 10% sample and externally validated the model in two cohorts: The National Adolescent to Adult Longitudinal Health Study (Add Health) and the University of Michigan Health and Retirement Study (HRS). We assessed discrimination with C-index, calibration by visual inspection of calibration plots, and accuracy using root mean square error (RMSE).

Results

Models were trained using 62,032 NHANES subjects (51.9% women, 21.7% Black, 23.9% Hispanic or Latino, with median age 48 [IQR 31 - 64]), and evaluated in the NHANES held-out test set (n=6,846), Add Health (n=5,749), and HRS (n=5,655). Models demonstrated excellent discrimination in all validation cohorts (C-index range 0.88 - 0.89). Models were well-calibrated in all validation cohorts. Model-predicted height demonstrated lower root mean square error (RMSE) compared to self-reported height in all validation cohorts and when stratified by race and ethnicity, with greatest improvements in participants aged 45 and over.

Conclusions and Relevance

A model requiring minimal input data improves estimation of height over self-reported height at least as much as more complex models across stratifications of sex, age, race and ethnicity in internal validation, and is the first model to improve height estimation that has demonstrated external validity.

American Society for Metabolic and Bariatric Surgery review of the body mass index

The body mass index was first described almost 200 years ago and has since been used as a measure of obesity. This review describes the history, advantages, disadvantages, and alternatives to the body mass index in the care of the metabolic and bariatric surgical patient.

Associations between mobile phone involvement, BMI levels, and sleep quality among Chinese university students: evidence from a multi-regional large-scale survey

Objective

This study aims to explore the association between mobile phone involvement, body mass index (BMI) levels, and the sleep quality of Chinese university students.

Methods

Using a cluster sampling method, we selected 17,085 university students from three universities in eastern, central, and western China as the study subjects. Demographic information such as age and sex were collected. The Pittsburgh Sleep Quality Index (PSQI) and the Mobile Phone Involvement Questionnaire (MPIQ) were utilized to measure their sleep quality scores and mobile phone involvement scores, respectively. Pearson correlation analysis, two-way ANOVA, and multiple linear regression were employed to examine the relationship between BMI levels, mobile phone involvement, and sleep quality.

Results

The results show that 15.87% (2,712 participants) are classified as overweight, and 18.45% (3,151 participants) are classified as obese. Additionally, 35.87% (6,125 participants) exhibit mobile phone involvement, while 57.94% (9,899 participants) reported poor sleep quality. Pearson correlation analysis indicates a significant negative correlation (p < 0.01) between sleep quality and both BMI levels and mobile phone involvement. Two-way ANOVA shows the significant effect of BMI levels (p < 0.001) and mobile phone involvement (p < 0.001) on sleep quality, and there is no interaction effect between the two. Additionally, the sleep quality of overweight and obese individuals is significantly poorer than that of those with normal weight (p < 0.05), while the sleep quality of overweight individuals is significantly lower than that of obese individuals (p < 0.05). Multiple linear regression analysis indicates that, after controlling for age and gender, both BMI (β = -2.69) levels and mobile phone involvement (β = -1.34) are significantly negatively associated with sleep quality (p < 0.001), accounting for 19% of the variance in poor sleep quality.

Conclusion

This study found that BMI levels and mobile phone involvement are both independently associated with sleep quality among Chinese university students. However, among individuals with excess BMI, although their sleep quality is worse than individuals with normal weight, overweight individuals may have poorer sleep quality than obese individuals. This study also revealed high rates of overweight and obesity, with over half of participants reporting poor sleep quality, highlighting the need for targeted interventions to address weight management and mobile phone usage to improve sleep health in this population.

Greater BMI across the lifespan is associated with better midlife cognition: The Bogalusa Heart Study

Studies of adiposity and cognition's relationship have been highly mixed, depending on points in the lifespan when adiposity and cognition were measured, primarily with low Black American representation. Therefore, we examined the association between adiposity (from early to mid-life) and mid-life cognition in an Black American (BA) and White American longitudinal cohort to address these literature gaps. The Bogalusa Heart Study has followed participants from childhood to adulthood since 1973. Adiposity was measured via body mass index (BMI) at roughly biannual visits from 1973-2016 and cognition was measured in 1295 participants between 2013- 2016. Cognition included Logical Memory I, II and II Recognition, Digit Spans Forward and Backward, Trail Making Tests A and B, and a global composite. BMI was averaged within age epochs (childhood/adolescence; early adulthood (EA); midlife (M)) with childhood/adolescence BMI as percentiles. Separate linear regression models were run for each cognitive measure (outcome), BMI within one epoch, and sex, race, and education (predictors). All analyses included the 1292 individuals who provided complete data across all epochs. Greater BMI within EA and M was associated with better global cognition (EA: Est. 0.139 S.D./BMI p = 0.000; M: Est. 0.094 S.D./BMI p = 0.022), and Logical Memory I (EA: Est. 0.036 S.D./BMI p = 0.000; M: Est. 0.022 S.D./BMI p = 0.000), II (EA: Est. 0.036 S.D./BMI p = 0.000; M: Est. 0.020 S.D./BMI p = 0.022) and II Recognition (EA: Est. 0.029 S.D./BMI p = 0.000; M: Est. 0.022 S.D./BMI p = 0.000) among men. Among BA, greater BMI within EA and M was associated with better Logical Memory I (EA: Est. 0.022 S.D./BMI p = 0.000; M: Est. 0.019 S.D./BMI p = 0.000) and II (EA: Est. 0.018 S.D./BMI p = 0.042; M: Est. 0.017 S.D./BMI p = 0.000). Greater adiposity from early adulthood to midlife was associated with better memory performance in midlife (associations strongest among men and Black Americans). More anatomically precise measurements of adiposity (e.g., subcutaneous vs. visceral fat) could help clarify the complex adiposity cognition relationship across the lifespan.

Depicting deterministic variables within directed acyclic graphs: an aid for identifying and interpreting causal effects involving derived variables and compositional data

Deterministic variables are variables that are functionally determined by one or more parent variables. They commonly arise when a variable has been functionally created from one or more parent variables, as with derived variables, and in compositional data, where the "whole" variable is determined from its "parts." This article introduces how deterministic variables may be depicted within directed acyclic graphs (DAGs) to help with identifying and interpreting causal effects involving derived variables and/or compositional data. We propose a 2-step approach in which all variables are initially considered, and a choice is made as to whether to focus on the deterministic variable or its determining parents. Depicting deterministic variables within DAGs brings several benefits. It is easier to identify and avoid misinterpreting tautological associations, that is, self-fulfilling associations between deterministic variables and their parents, or between sibling variables with shared parents. In compositional data, it is easier to understand the consequences of conditioning on the "whole" variable and to correctly identify total and relative causal effects. For derived variables, it encourages greater consideration of the target estimand and greater scrutiny of the consistency and exchangeability assumptions. DAGs with deterministic variables are a useful aid for planning and interpreting analyses involving derived variables and/or compositional data.

Overweight-Related Hypertension in Middle-Aged Men Is Linked to Elevated Leptin, TNF-α, IL-6, Cholesterol, and Reduced Testosterone

BACKGROUND/OBJECTIVES

One of the major causes of hypertension (HT) is the transition of normal weight (NW) status to overweight (OW) status and obesity in a population, which leads to cardiovascular disease (CVD) and other disorders. A variety of factors/variables are involved in the development of HT and OW-related hypertension (OHT). However, we planned to investigate the pathophysiological role of serum leptin (Lep), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), total cholesterol (TC) and serum testosterone (ST) in OHT in middle-aged men.

METHODS

We consulted three groups of middle-aged men (age: 51-60 years)-an HT group (n: 97, high normal weight (HNW), body mass index (BMI): 23-24.9 kg/m2); an OHT group (n: 97, high overweight (HOW), BMI: 28-29.9 kg/m2) and a normal control group (NC, n: 98, HNW)-to investigate the variations in and correlations of Lep, IL-6, TNF-α, ST, TC and other variables.

RESULTS

Significant variations were obtained for the comparisons of TNF-α, Lep, ST and TC for the patient groups. OHT vs. NC showed a significant difference for ST. OHT vs. NC and OHT vs. HT had significant variations for IL-6. Significant changes were obtained for the serum levels of TNF-α, Lep, IL-6, ST and TC among groups. Significant and positive linear associations were obtained for TNF-α, Lep, TC and IL-6. Significant and negative linear associations were found for ST plotted against Lep, TNF-α and IL-6.

CONCLUSIONS

The current report provides pathophysiological evidence of the interactive role of serum Lep, TNF-α, ST, TC and IL-6 in middle-aged men with HT and OHT. We suggest that the changes we noted in the present study would be helpful for further BMI-based studies in various subcategories of NW, OW and obese subjects with/without HT.

Obesity: a 100 year perspective

This review has examined the scientific basis for our current understanding of obesity that has developed over the past 100 plus years. Obesity was defined as an excess of body fat. Methods of establishing population and individual changes in levels of excess fat are discussed. Fat cells are important storage site for excess nutrients and their size and number affect the response to insulin and other hormones. Obesity as a reflection of a positive fat balance is influenced by a number of genetic and environmental factors and phenotypes of obesity can be developed from several perspectives, some of which have been elaborated here. Food intake is essential for maintenance of human health and for the storage of fat, both in normal amounts and in obesity in excess amounts. Treatment approaches have taken several forms. There have been numerous diets, behavioral approaches, along with the development of medications.. Bariatric/metabolic surgery provides the standard for successful weight loss and has been shown to have important effects on future health. Because so many people are classified with obesity, the problem has taken on important public health dimensions. In addition to the scientific background, obesity through publications and organizations has developed its own identity. While studying the problem of obesity this reviewer developed several aphorisms about the problem that are elaborated in the final section of this paper.

The evolution of the understanding of obesity over the last 100 years

The definition of obesity has evolved significantly over the last century, from a simplistic view of excessive eating and laziness to a complex, multifactorial disease with profound health and societal implications. As science progresses, it is essential that we keep improving our knowledge about obesity, taking into consideration, factors like genetics, metabolism, body composition, and the social determinants of health. This article explores how our understanding of this condition has been shaped over the last 100 years considering historical and scientific factors. The history and usefulness of the body mass index (BMI), the development of other anthropometric markers and the evolution in the incorporation of body composition into clinical practice, among other aspects related to the definition of obesity, are discussed. The challenges posed by obesity can be better addressed and more effective strategies for prevention and treatment can be developed adopting a more personalized and holistic approach. Obesity is not only a matter of individual responsibility but a multifaceted public health problem that requires a multidisciplinary and inclusive strategy to address its complexities.

Advances in body composition: a 100-year journey

Knowledge of human body composition at the dawn of the twentieth century was based largely on cadaver studies and chemical analyses of isolated organs and tissues. Matters soon changed by the nineteen twenties when the Czech anthropologist Jindřich Matiegka introduced an influential new anthropometric method of fractionating body mass into subcutaneous adipose tissue and other major body components. Today, one century later, investigators can not only quantify every major body component in vivo at the atomic, molecular, cellular, tissue-organ, and whole-body organizational levels, but go far beyond to organ and tissue-specific composition and metabolite estimates. These advances are leading to an improved understanding of adiposity structure-function relations, discovery of new obesity phenotypes, and a mechanistic basis of some weight-related pathophysiological processes and adverse clinical outcomes. What factors over the past one hundred years combined to generate these profound new body composition measurement capabilities in living humans? This perspective tracks the origins of these scientific innovations with the aim of providing insights on current methodology gaps and future research needs.

Integrating Bayesian Approaches and Expert Knowledge for Forecasting Continuous Glucose Monitoring Values in Type 2 Diabetes Mellitus

Precise and timely forecasting of blood glucose levels is essential for effective diabetes management. While extensive research has been conducted on Type 1 diabetes mellitus, Type 2 diabetes mellitus (T2DM) presents unique challenges due to its heterogeneity, underscoring the need for specialized blood glucose forecasting systems. This study introduces a novel blood glucose forecasting system, applied to a dataset of 100 patients from the ShanghaiT2DM study. Our study uniquely integrates knowledge-driven and data-driven approaches, leveraging expert knowledge to validate and interpret the relationships among diabetes-related variables and deploying the data-driven approach to provide accurate forecast blood glucose levels. The Bayesian network approach facilitates the analysis of dependencies among various diabetes-related variables, thus enabling the inference of continuous glucose monitoring (CGM) trajectories in similar individuals with T2DM. By incorporating past CGM data including inference CGM trajectories, dietary records, and individual-specific information, the Bayesian structural time series (BSTS) model effectively forecasts glucose levels across time intervals ranging from 15 to 60 minutes. Forecast results show a mean absolute error of mg/dL, a root mean square error of mg/dL, and a mean absolute percentage error of , for a 15-minute prediction horizon. This study makes the first application of the ShanghaiT2DM dataset for glucose level forecasting, considering the influences of diabetes-related variables. Its findings establish a foundational framework for developing personalized diabetes management strategies, potentially enhancing diabetes care through more accurate and timely interventions.

Ethnobotanical knowledge in Calabria (southern Italy): A summary review

This paper presents a comprehensive overview of ethnobotanical knowledge in Calabria, southern Italy. The diverse plant uses and knowledge in the region stem from the cultural contributions of various populations that have inhabited the area since ancient times. To achieve the stated objective, an in-depth review of 16 bibliographic sources published between 1950 and 2024 was conducted, and data on ethnobotanical uses was extracted. The data were then analyzed using various indices, including CI, CV, FC, PPV, RFC, RI, and UV, to determine the most relevant species, families, and plant parts. A total of 4873 records were collected. The analysis shows that the Asteraceae family is the most used, while Urtica dioica L. and Sambucus nigra L. are the most frequently used species according to the CV index. Medicinal and alimentary purposes are the most common types of use. This study could serve as a foundation for further detailed research, contributing to the valorisation of the ethnobotanical heritage of this region.

Gynaecological Health Patterns and Motherhood Experiences of Female Professional Football Players

The aim of this paper is to explore the gynaecological health patterns, contraceptive use, body perception, and motherhood experiences of female professional football players. The participants were recruited via email using FIFPRO (Football Players Worldwide). Online questionnaires were completed by consenting participants. The mean age at menarche was 13.5 years with an average cycle length of 26 days, and a bleeding period of 5 days. Cycle irregularities were experienced by 30%, and menstrual symptoms by 74%. Half of the participants used contraceptives, 60% using hormonal contraceptives, primarily oral contraceptive pills (38%), followed by implants (20%). The body satisfaction score was normal but there was a high drive-for-thinness (DT) score. The motherhood rate was low (1%), with participants experiencing normal conception, vaginal delivery, return to training after 6 weeks, and return to competition after 12 weeks. Our findings are consistent with findings in other elite female athletes with cycle irregularities and a significant number of cycle-related symptoms. The majority of those using contraceptives preferred hormonal contraceptives, reflecting trends seen in other elite athletes. While body satisfaction scores were normal, there was a high DT score, similar to that observed in lean and weight-category sports. The motherhood rate was low, consistent with previous findings in professional football players and other elite athletes. This may be due to a lack of financial support during pregnancy and the post-partum period. FIFPRO and its affiliated unions are negotiating better contracts for female football players.

Medicaid Expansion Increases Treatment for Patients with Colon Cancer

INTRODUCTION

Medicaid expansion (ME) has positively impacted colon cancer screening. ME's effect on colon cancer treatment is less clear. This study analyses the effect of ME on patterns of colon cancer treatment.

METHODS

Patients with primary invasive colon cancer were identified using the Louisiana Tumor Registry. Patients diagnosed with colon cancer prior to ME (2014-2015) were compared to those diagnosed after (2017-2018). Coordinate variables were analyzed using Fisher's exact test. Treatment status was modeled with multivariable logistic regression and the results are reported as adjusted odds ratios.

RESULTS

The proportion of uninsured patients decreased following ME (5.5 versus 1.9, p < 0.001), with the greatest reductions among patients between 45 and 54 years old (13.5% to 3.5%, p < 0.0001), African Americans (8.9 to 2.1%, p < 0.0001), and those in high-poverty neighborhoods (7.1 to 2.1%, p < 0.0001). Following ME, all patients with Stage I-III disease were more likely to receive surgery (OR = 1.95; 95%: CI 1.21-3.14)-especially the extremely impoverished (OR = 2.39; 95% CI 1.41-4.02). Young patients with Stage IV colon cancer were more likely to receive chemotherapy (OR-1.6; 95% CI 1.03-2.4). Patients with Stage IV colon cancer were less likely to receive treatment within 30 days of diagnosis (OR = 0.7; 95% CI 0.5-0.9), but, on subset analysis, this was only observed in non-Medicaid patients.

CONCLUSION

ME is associated with increased treatment for patients with colon cancer, and it did not appear to affect time to treatment. However, it seems to affect different subsets of the population differently.

Varying optimal power for height-standardisation of childhood weight, fat mass and fat-free mass across the obesity epidemic

INTRODUCTION

Childhood adiposity markers can be standardised for height in the form of indices (marker/heightp) to make meaningful comparisons of adiposity patterns within and between individuals of differing heights. The optimal value of p has been shown to differ by birth year, sex, age, and ethnicity. We investigated whether height powers for childhood weight and fat mass (FM) differed by birth year, sex, or age over the period before and during the child obesity epidemic in Copenhagen.

SETTING/METHODS

Population-based cross-sectional study of 391,801 schoolchildren aged 7 years, 10 years and 13 years, born between 1930 and 1996, from the Copenhagen School Health Records Register. Sex- and age-specific estimates of the height powers for weight and FM were obtained using log-log regression, stratified by a decade of birth.

RESULTS

For weight, amongst children born 1930-39, optimal height powers at 7 years were 2.20 (95% CI: 2.19-2.22) for boys and 2.28 (95% CI: 2.26-2.30) for girls. These increased with birth year to 2.82 (95% CI: 2.76-2.87) and 2.92 (95% CI: 2.87-2.97) for boys and girls born in 1990-96, respectively. For FM, amongst those born 1930-39, powers at 7 years were 2.46 (95% CI: 2.42-2.51) and 2.58 (95% CI: 2.53-2.63) for boys and girls, respectively, and increased with birth year reaching 3.89 (95% CI: 3.75-4.02) and 3.93 (95% CI: 3.80-4.06) for boys and girls born 1990-96, respectively. Powers within birth cohort groups for weight and FM were higher at 10 years than at 7 years, though similar increases across groups were observed at both ages. At 13 years, height powers for weight and FM initially increased with the birth year before declining from the 1970s/80s.

CONCLUSION

Due to increases in the standard deviation of weight and FM during the obesity epidemic, optimal height powers needed to standardise childhood weight and FM varied by birth year, sex, and age. Adiposity indices using a uniform height power mean different things for different birth cohort groups, sexes, and ages thus should be interpreted with caution. Alternative methods to account for height in epidemiological analyses are needed.

Glucose Metabolism Disorders and Parkinson's Disease: Coincidence or Indicator of Dysautonomia?

Background: Parkinson's disease (PD) and type 2 diabetes mellitus (T2DM) are both age-related diseases. Evidence from recent studies suggests a link between them. The existence of an interaction between autonomic nervous system dysfunction and the dysregulation of glucose metabolism is one of the proposed mechanisms to explain the complicated relationship between these diseases. The aims of this study are to assess the incidence of glycemic dysregulation in people with PD and to identify clinical factors that may predispose patients with PD to the occurrence of metabolic disturbances. Methods: In total, 35 individuals diagnosed with PD and 20 healthy control subjects matched in terms of age and gender participated in a study consisting of clinical and biometric assessments along with 14 days of continuous glucose monitoring (CGM) using the Freestyle Libre system. In the group of patients with PD, a comparative analysis was performed between patients with and without autonomic dysfunction. The severity of autonomic dysfunction was assessed using the SCOPA-AUT. Results: Participants diagnosed with PD demonstrated a trend toward lower morning glucose levels compared to the control group. PD patients with autonomic symptoms had greater glucose variability and a deeper trend toward lower glucose levels in the mornings. The presence of autonomic dysfunction, especially orthostatic hypotension and micturition disturbance, and the severity of autonomic symptoms were associated with greater glycemic variability. Conclusions: The occurrence of autonomic disorders in the course of Parkinson's disease predisposes patients to more profound glycemic dysregulation.

Weight-Adjusted Waist Index: an anthropometric measure for frailty in older adults

PURPOSE

Current measures of frailty often rely on subjective assessments or complex scoring systems. This study aims to investigate the utility of a novel anthropometric measure, the Weight-Adjusted Waist Index (WWI), as a simple and objective predictive marker for frailty in older adults.

METHODS

This cross-sectional study included 847 patients aged 65 years and older. Comprehensive geriatric assessments and anthropometric measurements were conducted. Frailty was diagnosed using the Clinical Frailty Scale (CFS). The association between WWI and frailty was analyzed using multivariate logistic regression analysis.

RESULTS

The mean age of the participants was 74.9 ± 6 years, with 56.3% (n = 477) being women and 14.8% (n = 125) classified as frail. The frail group had a significantly higher WWI than the non-frail group (p < 0.001). In multivariate logistic regression analysis, WWI remained significantly associated with frailty, even after adjusting for other potential confounding factors (OR = 2.51, 95% CI 1.77-3.57, p < 0.001). The predictive ability of WWI for frailty was measured by the area under the receiver operating characteristic (ROC) curve, which was 0.705 (95% CI 0.67-0.73; p < 0.001). The optimal WWI threshold for predicting frailty was identified as > 12.

CONCLUSION

The Weight-Adjusted Waist Index shows significant potential as a simple and objective predictive marker for frailty in older adults.

Impact of Body Mass Index and Anthropometric Measures on Cardiorespiratory Fitness in Non-obese Adult Males: A Cross-Sectional Observational Study

Introduction Cardiorespiratory fitness (CRF) is a key health indicator for assessing optimal physical function and overall well-being. Exploring the early impact of body mass index (BMI) and anthropometric measures on CRF in non-obese individuals is essential for identifying risk factors and guiding preventive strategies to address weight-related health challenges. This study aims to investigate the impact of BMI and anthropometric measures on CRF, focusing on maximal oxygen uptake (VO2max) and metabolic equivalents (METs) in non-obese adult males.  Methods This cross-sectional study included 108 non-obese male participants aged 18-40 years, categorized by BMI into three groups: underweight, normal weight, and overweight. Anthropometric assessments, including height, weight, waist circumference, hip circumference, and skinfold thickness, were conducted. CRF was evaluated by measuring VO2max and METs. Statistical analysis was performed using one-way analysis of variance (ANOVA) for between-group comparisons, followed by Tukey's post hoc test for pairwise analysis and Pearson's correlation to examine associations between anthropometric measures and fitness parameters. Results Significant differences in VO2max (p < 0.001) and METs (p = 0.013) were found across the BMI categories. Fair negative correlations were observed between BMI and both VO2max (r = -0.382, p < 0.001) and METs (r = -0.384, p < 0.001). Additionally, waist circumference and waist-to-hip ratio showed significant poor negative correlations with these fitness measures, while body density exhibited a fair positive correlation with VO2max (r = 0.37, p < 0.001). Conclusion The findings suggest that higher BMI is associated with reduced CRF, as indicated by lower VO2max and MET values, even within the non-obese category. Additionally, waist circumference, waist-to-hip ratio, and body density significantly influence these measures. These results highlight the importance of incorporating these crucial anthropometric factors into health strategies aimed at improving CRF in those with higher BMI, regardless of obesity status.

Both low and high body iron stores relate to metabolic syndrome in postmenopausal women: Findings from the VIKING Health Study-Shetland (VIKING I)

BACKGROUND

There are conflicting results among studies on the association between serum ferritin (SF) and metabolic syndrome (MetS), and by groups of sex/menopausal status. To date, there are no studies on British populations. The SF-MetS association might be U/J-shaped. We evaluated whether SF was independently associated with MetS (harmonized definition) in people from Shetland, Scotland.

METHODS

We analysed cross-sectional data from the Viking Health Study-Shetland (589 premenopausal women [PreMW], 625 postmenopausal women [PostW] and 832 men). Logistic regressions using two approaches, one with the lowest sex and menopausal status-specific ferritin quartile (Q) as the reference and other using the middle two quartiles combined (2-3) as the reference, were conducted to estimate the SF-MetS association. The shape of the association was verified via cubic spline analyses. The associations were adjusted for age, inflammatory and hepatic injury markers, alcohol intake, smoking and BMI.

RESULTS

Prevalence of MetS was 18.3%. Among PostMW both low and high SF were associated with MetS (fully adjusted odds ratios [95% confidence interval] compared to the middle two quartiles combined were: 1.99 [1.17-3.38] p =.011 for Q1 and 2.10 [1.27-3.49] p =.004 for Q4) This U-shaped pattern was confirmed in the cubic spline analysis in PostMW with a ferritin range of 15-200 ug/L. In men, a positive association between ferritin quartiles with Q1 as the reference, did not remain significant after adjustment for BMI.

CONCLUSION

Extreme quartiles of iron status were positively associated with MetS in PostMW, while no SF-MetS associations were found in men or PreMW. The ferritin-MetS association pattern differs between populations and U/J-shaped associations may exist.

Novel BMI cutoff points for obesity diagnosis in older Hispanic adults

Current body mass index (BMI) cutoff points (≥ 30 kg/m2) underestimate obesity prevalence in older adults. The aim of the present study was to propose new BMI cutoff points for identifying obesity in older Hispanic adults. In this study, new internally derived (ID) BMI cutoff point for obesity in older Hispanic adults was developed by analyzing data from the National Health and Nutrition Survey of 2018-2019 from Mexico. To evaluate the performance/validation of this newly proposed cutoff point, data from the "Study of the 1000", conducted in Northern Mexico, was utilized. Sensitivity, and negative predictive value (NPV) were assessed using receiver operating characteristic analysis, with obesity defined by fat mass index (FMI; ≥ 9.0 kg/m2 for men and ≥ 12.0 kg/m2 for women) as the reference method. The newly proposed ID BMI cutoff point was ≥ 27.2 kg/m2 which demonstrated high sensitivity (≥ 99.4%) and NPV (≥ 99.5%) in the total sample. Furthermore, the prevalence of obesity estimated by the new BMI cutoff point was comparable to that estimated by the FMI. The newly proposed BMI cutoff point provides a more accurate identification of obesity in older Hispanic adults. These findings have implications for improving obesity diagnosis and management in this population.

Predictive ability of anthropometric indices for risk of developing metabolic syndrome: a cross-sectional study

OBJECTIVE

To determine the discriminatory ability of different anthropometric indicators of body fat percentage for diagnosing metabolic syndrome (MetS) in a Peruvian sample.

METHODS

This was a cross-sectional, non-experimental, diagnostic accuracy study. Anthropometric and biochemical data for 948 participants were analyzed. Waist circumference (WC), body mass index, relative fat mass (RFM), conicity index, body roundness index (BRI), waist-to-height ratio (WHtR), and A Body Shape Index were assessed for their MetS discriminatory ability. The National Cholesterol Education Program's Adult Treatment Panel III criteria were used to diagnose MetS. Receiver operating characteristic curves and area under the curve (AUC) were used to determine the predictive power of each anthropometric measurement to diagnose MetS.

RESULTS

In both sexes, RFM, BRI, and WHtR showed the same predictive ability to diagnose MetS. In women, indicators incorporating WC showed high discriminatory ability: RFM, BRI, and WHtR (all AUC: 0.869, 95% confidence interval [CI]: 0.828-0.910). In men, WC had the highest AUC (0.829, 95% CI: 0.793-0.866).

CONCLUSIONS

In both sexes, RFM, WC, BRI, and WHtR were the best predictors of MetS diagnosis. This is the first study to identify RFM as a potentially useful clinical predictor of MetS in a Peruvian sample of educational workers.

Association between the weight-adjusted-waist index and testosterone deficiency in adult males: a cross-sectional study

Testosterone deficiency has been recognized as a significant health concern and is closely related to obesity. The weight-adjusted-waist index (WWI) is an innovative adiposity parameter that is superior to BMI in certain aspects, but its relationship with testosterone levels has not been elucidated. The aim of this study was to investigate the relationships of the WWI with total testosterone levels and testosterone deficiency. Data from the National Health and Nutrition Examination Survey (NHANES, 2011-2016) were utilized. The WWI was calculated as waist circumference (cm) over the square root of weight (kg), and a total testosterone level of less than 300 ng/dL was defined as testosterone deficiency. Weighted multivariable regression models were used to assess the associations. A total of 6859 participants were included, 26.28% of whom were testosterone deficient. The WWI was inversely related to total testosterone levels (β = -49.93, 95% CI: -60.07, -39.78, P < 0.001) and positively associated with testosterone deficiency (OR = 1.46, 95% CI: 1.23, 1.72, P < 0.001) in the fully adjusted model. A significant nonlinear relationship was also detected between WWI and testosterone deficiency (P for nonlinearity = 0.004) with an inflection point of 9.486 cm/√kg. The associations were consistent in the subgroup analysis (all P > 0.05), except for the participants with eGFR < 60 mL/(min*1.73m2) and hypertension. A higher WWI was linked to lower total testosterone levels and a greater risk of developing testosterone deficiency, especially among those who had an eGFR ≥ 60 mL/(min*1.73m2) and were nonhypertensive.

A study of granulysin and pentraxin 3 genetic polymorphisms and their contribution to acne susceptibility

This study aims to examine the genetic polymorphisms of the granulysin (GNLY) and pentraxin 3 (PTX3) genes and their association with acne in Egypt. Acne vulgaris is classified as a disorder of the pilosebaceous unit. Clinical, histological, and immunological findings indicate that inflammation is involved in every stage of acne development. GNLY and PTX3 are both involved in the body's immune system and may play a role in the pathophysiology of acne. This case-control study included 180 participants who have acne and 180 healthy controls. Real-time PCR was used to genotype GNLY rs7908 and PTX3 rs2305619 polymorphisms. Genotype occurrence and allelic spreading for both single nucleotide polymorphisms (SNP) are in Hardy-Weinberg equilibrium. Regarding rs7908, no statistical difference was observed in the genotype and allele distributions between acne patients and controls. On the other hand, rs2305619 showed a statistical difference in the genotype and allele distributions between acne patients and controls, with a marked prevalence of the GG group and G allele in acne patients. Our study revealed a significant link between the PTX3 rs2305619 and acne susceptibility in Egypt, with the AG + GG genotype strongly predicting acne. In contrast, the GNYL rs7908 polymorphism was not associated with acne. These results highlight a genetic component to acne and suggest that PTX3 rs2305619 could be a key marker for understanding acne susceptibility.

Body mass index is not associated with time on veno-venous extracorporeal membrane oxygenation or in-hospital mortality

Morbid obesity, as characterized by BMI, is often utilized as an exclusion criterion for VV-ECMO because of presumed poor prognosis and technically complex cannulation. However, the "obesity paradox" suggests obesity may be protective during critical illness, and BMI does not capture variations in body type, adiposity, or fluid balance. This study examines relationships between BMI and patient outcomes. Adult VV-ECMO patients with BMI ≥ 35 kg/m2 admitted January 2012 to June 2021 were identified from an institutional registry. BMI and outcomes were analyzed with Mann-Whitney U tests and Pearson correlations with Bayesian post-hoc analyses. 116 of 960 ECMO patients met inclusion criteria. Median (Q1, Q3) BMI was 42.3 (37.3, 50.8) and min, max of 35.0, 87.8 with 9.0 (5.0, 15.5) ECMO days. BMI was not significantly correlated with ECMO days (r = -0.102; p = .279). Bayesian analyses showed moderate evidence against BMI correlating with ECMO days. In-hospital mortality (27%) was significantly associated with ECMO days (p = .014) but not BMI (p = .485). In this cohort of high-BMI patients, BMI was not associated with survival or time on ECMO. BMI itself should not be used as an exclusion criterion for VV-ECMO.

Overview of BMI and Other Ways of Measuring and Screening for Obesity in Pediatric Patients

Despite a long history of advances in measuring body size and composition, body mass index (BMI) has remained the most commonly used clinical measure. We explore the advantages and disadvantages of using BMI and other measures to estimate adipose tissue, recognizing that no measure of body size or adiposity has fulfilled the goal of differentiating health from disease. BMI and waist circumference remain widely-used clinical screening measures for appropriate risk stratification as it relates to obesity.

Comparative Analysis of Dietary Habits and Obesity Prediction: Body Mass Index versus Body Fat Percentage Classification Using Bioelectrical Impedance Analysis

Background: Obesity remains a widely debated issue, often criticized for the limitations in its identification and classification. This study aims to compare two distinct systems for classifying obesity: body mass index (BMI) and body fat percentage (BFP) as assessed by bioelectrical impedance analysis (BIA). By examining these measures, the study seeks to clarify how different metrics of body composition influence the identification of obesity-related risk factors. Methods: The study enrolled 1255 adults, comprising 471 males and 784 females, with a mean age of 36 ± 12 years. Participants exhibited varying degrees of weight status, including optimal weight, overweight, and obesity. Body composition analysis was conducted using the TANITA Body Composition Analyzer BC-418 MA III device (T5896, Tokyo, Japan), evaluating the following parameters: current weight, basal metabolic rate (BMR), adipose tissue (%), muscle mass (%), and hydration status (%). Results: Age and psychological factors like cravings, fatigue, stress, and compulsive eating were significant predictors of obesity in the BMI model but not in the BFP model. Additionally, having a family history of diabetes was protective in the BMI model (OR: 0.33, 0.11-0.87) but increased risk in the BFP model (OR: 1.66, 1.01-2.76). The BMI model demonstrates exceptional predictive ability (AUC = 0.998). In contrast, the BFP model, while still performing well, exhibits a lower AUC (0.975), indicating slightly reduced discriminative power compared to the BMI model. Conclusions: BMI classification demonstrates superior predictive accuracy, specificity, and sensitivity. This suggests that BMI remains a more reliable measure for identifying obesity-related risk factors compared to the BFP model.

Relative muscle indices and healthy reference values for sarcopenia assessment using T10 through L5 computed tomography skeletal muscle area

Sarcopenia is the age-related loss of skeletal muscle mass and function. Computed tomography (CT) assessments of sarcopenia utilize measurements of skeletal muscle cross-sectional area (SMA), radiation attenuation (SMRA), and intramuscular adipose tissue (IMAT). Unadjusted SMA is strongly correlated with both height and body mass index (BMI); therefore, SMA must be adjusted for body size to assess sarcopenic low muscle mass fairly in individuals of different heights and BMI. SMA/height (rather than S M A / h e i g h t 2 ) provides optimal height adjustment, and vertebra-specific relative muscle index (RMI) equations optimally adjust for both height and BMI. Since L3 measurement is not available in all CT scans, sarcopenic low muscle mass may be assessed using other levels. Both a mid-vertebral slice and an inferior slice have been used to define 'L3 SMA', but the effect of vertebral slice location on SMA measurements is unexplored. Healthy reference values for skeletal muscle measures at mid- and inferior vertebra slices between T10 and L5, have not yet been reported. We extracted T10 through L5 SMA, SMRA, and IMAT at a mid-vertebral and inferior slice using non-contrast-enhanced CT scans from healthy, adult kidney donor candidates between age 18 and 73. We compared paired differences in SMA between the mid-vertebral slice versus the inferior slice. We calculated the skeletal muscle gauge as S M G HT = S M R A ∗ S M I HT . We used allometric analysis to find the optimal height scaling power for SMA. To enable comparisons with other published reference cohorts, we computed two height-adjusted measures; S M I HT = S M A / h e i g h t (optimal) and S M I H T 2 = S M A / h e i g h t 2 (traditional). Using the young, healthy reference cohort, we utilized multiple linear regression to calculate relative muscle index z-scores ( R M I HT , R M I H T 2 ), which adjust for both height and BMI, at each vertebra level. We assessed Pearson correlations of each muscle area measure versus age, height, weight, and BMI separately by sex and vertebra number. We assessed the differences in means between age 18-40 versus 20-40 as the healthy, young adult reference group. We reported means, standard deviations, and sarcopenia cutpoints (mean-2SD and 5th percentile) by sex and age group for all measures. Sex-specific allometric analysis showed that height to the power of one was the optimal adjustment for SMA in both men and women at all vertebra levels. Differences between mid-vertebra and inferior slice SMA were statistically significant at each vertebra level, except for T10 in men. S M I HT was uncorrelated with height, whereas S M I H T 2 was negatively correlated with height at all vertebra levels. Both S M I HT and S M I H T 2 were positively correlated with BMI at all vertebra levels. R M I HT was uncorrelated with BMI, weight, and height (minimal positive correlation in women at L3 inf , L4 mid , and L5 inf ) whereas R M I H T 2 was uncorrelated with BMI, but negatively correlated with height and weight at all levels. There were no significant differences in SMA between 18-40 versus 20-40 age groups. Healthy reference values and sarcopenic cutpoints are reported stratified by sex, vertebra level, and age group for each measure. Height to the power of one (SMA/height) is the optimal height adjustment factor for SMA at all levels between T10 mid through L5 inf . The use of S M A / h e i g h t 2 should be discontinued as it retains a significant negative correlation with height and is therefore biased towards identifying sarcopenia in taller individuals. Measurement of SMA at a mid-vertebral slice is significantly different from measurement of SMA at an inferior aspect slice. Reference values should be used for the appropriate slice. We report sarcopenic healthy reference values for skeletal muscle measures at the mid-vertebral and inferior aspect slice for T10 through L5 vertebra levels. Relative muscle index (RMI) equations developed here minimize correlation with both height and BMI, producing unbiased assessments of relative muscle mass across the full range of body sizes. We recommend the use of these RMI equations in other cohorts.

Multi-scaling allometry in human development, mammalian morphology, and tree growth

Various animal and plant species exhibit allometric relationships among their respective traits, wherein one trait undergoes expansion as a power-law function of another due to constraints acting on growth processes. For instance, the acknowledged consensus posits that tree height scales with the two-thirds power of stem diameter. In the context of human development, it is posited that body weight scales with the second power of height. This prevalent allometric relationship derives its nomenclature from fitting two variables linearly within a logarithmic framework, thus giving rise to the term "power-law relationship." Here, we challenge the conventional assumption that a singular power-law equation adequately encapsulates the allometric relationship between any two traits. We strategically leverage quantile regression analysis to demonstrate that the scaling exponent characterizing this power-law relationship is contingent upon the centile within these traits' distributions. This observation fundamentally underscores the proposition that individuals occupying disparate segments of the distribution may employ distinct growth strategies, as indicated by distinct power-law exponents. We introduce the innovative concept of "multi-scale allometry" to encapsulate this newfound insight. Through a comprehensive reevaluation of (i) the height-weight relationship within a cohort comprising 7, 863, 520 Japanese children aged 5-17 years for which the age, sex, height, and weight were recorded as part of a national study, (ii) the stem-diameter-height and crown-radius-height relationships within an expansive sample of 498, 838 georeferenced and taxonomically standardized records of individual trees spanning diverse geographical locations, and (iii) the brain-size-body-size relationship within an extensive dataset encompassing 1, 552 mammalian species, we resolutely substantiate the viability of multi-scale allometric analysis. This empirical substantiation advocates a paradigm shift from uni-scaling to multi-scaling allometric modeling, thereby affording greater prominence to the inherent growth processes that underlie the morphological diversity evident throughout the living world.

Genetic Variants Associated with Body Mass Index Changes in Korean Adults: The Anseong and Ansan Cohorts of the Korean Genome and Epidemiology Study

Although previous studies have examined the relationship between obesity and genetics in response to the growing obesity epidemic, research on the relationship between obesity and long-term changes in body mass index (BMI) is limited. To investigate this relationship, data from 1030 cases in the Anseong and Ansan cohorts were collected from the Korean Genome and Epidemiology Study conducted by the Korea National Institute of Health between 2000 and 2014. Cases lacking participants' BMI data throughout the study were excluded, resulting in a final sample size of 3074. An increase or decrease in BMI was analyzed using PLINK, STRING, and DAVID, with significant differences observed in the AEN, ANKS1B, CSF1, EEF2K, FRAS1, GRIK4, PDGFC, THTPA, and TREH genes. These genes were observed to cluster with pathways related to type 2 diabetes, cardiovascular disease, metabolic processes, and endocytosis-related genes. These results suggest that several genes are involved in BMI changes and that several pathways are associated with obesity risk. Moreover, some genetic variants appear to influence BMI changes in Korean adults.

Concurrent genotyping and expression of NLRP3 inflammasome in pityriasis versicolor patient's skin lesions

The goal of this study is to investigate the impact of the rs35829419 SNP on the serum level of NLRP3, and to assess the relationship between NLRP3 and its SNP and vulnerability to Pityriasis versicolor. Pityriasis versicolor (PV) is one of the most frequent skin conditions linked to skin pigmentation changes. Malassezia plays a key role in the pathogenesis of PV. A case-control study, 50 patients with pityriasis versicolor and 44 healthy controls. Real-time PCR was used to genotype NLRP3 (rs35829419) and ELISA assay of NLRP3 levels in tissue samples. There was a significantly higher median NLPR3 levels in PV patients than controls. A significant predominance of A allele of Q 705 K was in patients than controls. The risk of having the disease in the presence of A allele is nearly 10 times than having C allele. In PV patients, there was a significant relationship between NLPR3 levels and Q 705 K genotypes with higher NLPR3 levels in AA genotype. A potential correlation between PV and the Q705K polymorphism, pointing to evidence of NLRP3 alteration in PV patients. The NLRP3 inflammasome may be an appropriate therapeutic target for Malassezia-associated skin disorders.

The multifactorial approach and the food allergen-specific substitutive diet as a tool to manage and ameliorate adverse reactions to foodstuffs in adulthood: study protocol for a randomized controlled trial-the ALASKA study

BACKGROUND

Adverse reactions to foodstuffs (ARFS), specifically food allergy (FA) and food intolerance (FI), are increasing worldwide and represent a major public health concern. Thus, ARFS management, its identification, evaluation, and intervention, must provide a comprehensive solution.

OBJECTIVES

(a) To develop a multifactorial strategy for ARFS management in adults with FA and/or FI; (b) to describe the multiple influential variables in ARFS within the realm of ARFS management; and (c) to design a personalized food allergen-specific substitutive diet (FASSD), as a 6-month dietary treatment option for adults with ARFS and as a component of ARFS management.

METHODS

The ALASKA study will consider the following main variables as part of the ARFS management: (1) demographics and clinical information; (2) symptomatology, food and beverages intake and physical activity; (3) hematobiochemical study; (4) immunology; (5) enzymatic activity; (6) anthropometry, body composition, and physical fitness; (7) QoL; (8) 6-month intervention; (9) end of the study; and (10) other assessments. The FASSD will be designed with special emphasis on the commonly lacking micronutrients in the ARFS population: niacin, Mg, K, P, Ca, Zn, B12, folate, Fe, and fiber.

DISCUSSION

The ALASKA study protocol has been developed as a global strategy to manage and evaluate ARFS in Spanish adults older than 18 years of age. Approaching ARFS with multiple assessments, as influencing factors, will lead to a novel strategy for ARFS management. The FASSD has been designed as a personalized tool to avoid crucial micronutrient deficiencies that a current strict food allergen avoidance or elimination diet may provoke.

TRIAL REGISTRATION

The protocol has been approved by the Ethics Committee of the UPM (REF.20200602) and registered on ClinicalTrials.gov (NCT05802017).

Allometric multi-scaling of weight-for-height relation in children and adolescents: Revisiting the theoretical basis of body mass index of thinness and obesity assessment

The body mass index (BMI), defined as weight in kilograms divided by height in meters squared, has been widely used to assess thinness and obesity in all age groups, including children and adolescents. However, the validity and utility of BMI as a reliable measure of nutritional health have been questioned. This study discusses the mathematical conditions that support the validity of BMI based on population statistics. Here, we propose a condition defined as allometric uni-scaling to ensure the validity of BMI as an objective height-adjusted measure. Any given centile curve, including the median curve, in a weight-for-height distribution should be approximated using power-law functions with the same scaling exponent. In contrast, when the scaling exponent varies depending on the position of the centile curve, it is called allometric multi-scaling. By introducing a method for testing these scaling properties using quantile regression, we analyzed a large-scale Japanese database that included 7,863,520 children aged 5-17 years. We demonstrated the remarkable multi-scaling properties at ages 5-13 years for males and 5-11 years for females, and the convergence to uni-scaling with a scaling exponent close to 2 as they approached 17 years of age for both sexes. We confirmed that conventional BMI is appropriate as an objective height-adjusted mass measure at least 17 years of age, close to adulthood, for both males and females. However, the validity of BMI could not be confirmed in younger age groups. Our findings indicate that the growth of children's weight-for-height relation is much more complex than previously assumed. Therefore, a single BMI-type formula cannot be used to assess thinness and obesity in children and adolescents.

Adiposity, type 2 diabetes and atherosclerotic cardiovascular disease risk: Use and abuse of the body mass index

The worldwide prevalence of individuals with an elevated body weight has increased steadily over the past five decades. Billions of research dollars have been invested to improve our understanding of the causes and consequences of having an elevated body weight. All this knowledge has, however, failed to influence populational body weight trajectories of most countries around the world. Research on the definition of "obesity" has also evolved. Body mass index (BMI), the most commonly used tool to make its diagnosis, has major limitations. In this review article, we will highlight evidence from observational studies, genetic association studies and randomized clinical trials that have shown the remarkable inter-individual differences in the way humans store energy as body fat. Increasing evidence also suggests that, as opposed to weight inclusive, lifestyle-based approaches, weight-centric approaches advising people to simply eat less and move more are not sustainable for most people for long-term weight loss and maintenance. It is time to recognize that this outdated approach may have produced more harm than good. On the basis of pathophysiological, genetic and clinical evidence presented in this review, we propose that it may be time to shift away from the traditional clinical approach, which is BMI-centric. Rather, emphasis should be placed on actionable lifestyle-related risk factors aiming at improving overall diet quality and increasing physical activity level in the general population.

Exploring Biomarker Relationships in Both Type 1 and Type 2 Diabetes Mellitus Through a Bayesian Network Analysis Approach

Understanding the complex relationships of biomarkers in diabetes is pivotal for advancing treatment strategies, a pressing need in diabetes research. This study applies Bayesian network structure learning to analyze the Shanghai Type 1 and Type 2 diabetes mellitus datasets, revealing complex relationships among key diabetes-related biomarkers. The constructed Bayesian network presented notable predictive accuracy, particularly for Type 2 diabetes mellitus, with root mean squared error (RMSE) of 18.23 mg/dL, as validated through leave-one-domain experiments and Clarke error grid analysis. This study not only elucidates the intricate dynamics of diabetes through a deeper understanding of biomarker interplay but also underscores the significant potential of integrating data-driven and knowledge-driven methodologies in the realm of personalized diabetes management. Such an approach paves the way for more custom and effective treatment strategies, marking a notable advancement in the field.

Exploring Vegetarian and Omnivorous Approaches to Cardiovascular Risk and Body Composition

The role of nutrition in preventing non-communicable diseases has been widely studied in recent years, with indications that non-animal-based diets might improve body composition and therefore bring multiple health benefits. For all of these reasons, the main purpose was to compare body composition and metabolic status between vegetarian and omnivorous individuals and relate these values with cardiovascular risk. The present analysis included 176 participants (61 vegetarians and 115 omnivores). Body composition was assessed using a dual-energy X-ray absorptiometry, biochemical parameters obtained from capillary blood, and the 10-year cardiovascular risk (10RCVD) calculated by the QRISK3 score. No statistical differences were found between groups regarding body composition. Concerning metabolic markers, vegetarian individuals showed reduced values of total cholesterol, LDL cholesterol, and non-HDL cholesterol (p < 0.05). There were no differences in 10RCVD between groups. In both diets, moderate correlations between groups were found for cardiovascular risk and visceral adipose tissue. Our results suggest that the vegetarian regimen might be associated with better cardiometabolic biomarkers and better cardiovascular health, although controversial with the body composition trends observed. In conclusion, the results suggest that cardiovascular risk appears to be more influenced by body composition, mainly fat tissue, over dietary patterns itself.

Clinical and biochemical assessment of the effect of glutamine in management of radiation induced oral mucositis in patients with head and neck cancer: Randomized controlled clinical trial

BACKGROUND

This study aimed to evaluate the effect of oral glutamine suspension on salivary levels of transforming growth factor beta 1 (TGF-β1), a cytokine involved in inflammation and Tumor progression, and the severity of radiation-induced oral mucositis (RIOM) in head and neck cancer patients. This is the first study to investigate the impact of glutamine on TGF-β1 levels in head and neck cancer patients with radiation induced oral mucositis (RIOM).

METHODS

In this randomized controlled clinical trial, 50 HNC patients were enrolled and received either glutamine oral suspension or maltodextrin as a placebo from the baseline of RIOM to the end of radiotherapy. Salivary TGF-β1 levels were measured at baseline and after treatment. Also, RIOM was assessed using the World Health Organization (WHO) Oral Toxicity Scale, the Oral Mucositis Assessment Scale (OMAS), the Pain Visual Analog Scale (Pain-VAS), the incidence of opioid use, and body mass index (BMI).

RESULTS

Glutamine significantly reduced salivary TGF-β1 levels and improved RIOM symptoms, such as pain, opioid use, and weight loss. The reduction of TGF-β1 levels was associated with the improvement of RIOM severity.

CONCLUSION

Glutamine may modulate the inflammatory response and enhance wound healing in RIOM by decreasing salivary TGF-β1 levels. These findings support the use of glutamine as a potential intervention for RIOM and nutritional support for improving radiation sensitivity.

TRIAL REGISTRATION

This study was registered on clinicalTrials.gov with identifier no. NCT05856188.

Identifying the association between polymorphisms in the GZMB and IFIH1 genes and psoriasis in Egyptians

OBJECTIVES

This study aims to examine whether the genetic variants in the genes for Granzyme B (GZMB) and Interferon Induced with Helicase C domain 1 (IFIH1) were associated with psoriasis.

BACKGROUND

Psoriasis, a papulosquamous skin disease, was initially thought of as a disorder primarily of epidermal keratinocytes but is now recognized as one of the most common immune-mediated disorders. It is caused by the interplay between multiple genetic and environmental risk factors.

SUBJECTS AND METHODS

This case-control study has 65 participants with psoriasis and 65 healthy controls. Real-time PCR was used to genotype GZMB (rs8192917) and IFIH1 (rs35667974).

RESULTS

Genotype occurrence and allelic spreading for both SNPs are in Hardy - Weinberg equilibrium. The genotype and allele distributions of rs35667974 showed no differences between the studied groups. Regarding rs8192917, compared to Group II, there is a statistically significant rise in the CC genotype and C allele in Group I. Higher PASI scores are detected in the C/C and C/T genotypes more than the T/T genotype. Univariate and multivariate analyses revealed that BMI, catalase, MDA, and rs8192917 (C/C) are associated with psoriasis.

CONCLUSION

GZMB rs8192917 was significantly related to psoriasis risk; its C allele is likewise associated with psoriasis vulnerability. However, our investigation found no link between rs35667974 and psoriasis.

Aircraft noise exposure and body mass index among female participants in two Nurses' Health Study prospective cohorts living around 90 airports in the United States

OBJECTIVE

Aircraft noise exposure is linked to cardiovascular disease risk. One understudied candidate pathway is obesity. This study investigates the association between aircraft noise and obesity among female participants in two prospective Nurses' Health Study (NHS and NHSII) cohorts.

METHODS

Aircraft day-night average sound levels (DNL) were estimated at participant residential addresses from modeled 1 dB (dB) noise contours above 44 dB for 90 United States (U.S.) airports in 5-year intervals 1995-2010. Biennial surveys (1994-2017) provided information on body mass index (BMI; dichotomized, categorical) and other individual characteristics. Change in BMI from age 18 (BMI18; tertiles) was also calculated. Aircraft noise exposures were dichotomized (45, 55 dB), categorized (<45, 45-54, ≥55 dB) or continuous for exposure ≥45 dB. Multivariable multinomial logistic regression using generalized estimating equations were adjusted for individual characteristics and neighborhood socioeconomic status, greenness, population density, and environmental noise. Effect modification was assessed by U.S. Census region, climate boundary, airline hub type, hearing loss, and smoking status.

RESULTS

At baseline, the 74,848 female participants averaged 50.1 years old, with 83.0%, 14.8%, and 2.2% exposed to <45, 45-54, and ≥55 dB of aircraft noise, respectively. In fully adjusted models, exposure ≥55 dB was associated with 11% higher odds (95% confidence interval [95%CI]: -1%, 24%) of BMIs ≥30.0, and 15% higher odds (95%CI: 3%, 29%) of membership in the highest tertile of BMI18 (ΔBMI 6.7 to 71.6). Less-pronounced associations were observed for the 2nd tertile of BMI18 (ΔBMI 2.9 to 6.6) and BMI 25.0-29.9 as well as exposures ≥45 versus <45 dB. There was evidence of DNL-BMI trends (ptrends ≤ 0.02). Stronger associations were observed among participants living in the West, arid climate areas, and among former smokers.

DISCUSSION

In two nationwide cohorts of female nurses, higher aircraft noise exposure was associated with higher BMI, adding evidence to an aircraft noise-obesity-disease pathway.

Longitudinal Analysis of Latvian Child Growth: Anthropometric Parameters Dynamics from Birth to Adolescence

This study provides a comprehensive analysis of the physical development patterns from birth to adolescence, utilizing a longitudinal dataset of 70 children monitored from birth until 17 years of age. The research focuses on the variability of growth trajectories, emphasizing the role of genetic and environmental factors in influencing these patterns. Key findings indicate that most children undergo one or two periods of accelerated growth, with significant variability in the timing and magnitude of these growth spurts. The study also highlights the adaptive nature of growth changes over generations, influenced by ecological, nutritional, and socio-economic conditions. The longitudinal approach reveals critical insights into the timing of peak growth velocities, demonstrating that girls reach their growth peak approximately one year earlier than boys. The analysis of intergenerational growth patterns suggests a significant increase in average height over the century, attributed to genetic diversity and changes in lifestyle and nutrition. This study's findings emphasize the importance of updating physical development standards regularly to reflect the changing genetic and environmental landscape. The variability in growth patterns and their correlation with health outcomes in later life highlights the need for targeted public health strategies that address the underlying socio-economic and environmental determinants of health. This research contributes to the understanding of physical development trajectories and provides a foundation for future studies aimed at optimizing health outcomes from early childhood through adolescence. The primary objective of this article is to meticulously analyze the dynamics of height growth and accurately identify the periods of accelerated bodily development within the context of longitudinal research.

The Relationship between Myopia and Obesity in Adults

PURPOSE

To investigate the relationship between myopia and obesity through direct measurements of fat content.

METHODS

A cross-sectional study used a stratified, multistage survey, the Korea National Health and Nutrition Examination Survey (2008-2010). Subjects 19 years or older (n = 10,305) were included. Participants were divided into three groups according to refractive status: myopia (spherical equivalent [SE] ≤ -1.0 diopter [D]), emmetropia (-1.0 D < SE ≤ 1.0 D), and hyperopia (SE > 1.0 D). Obesity was investigated with assessment of fat mass and body mass index or waist circumference. Fat mass was measured with whole-body dual energy x-ray absorptiometry. Body fat percentage was calculated as (total fat mass / body weight × 100).

RESULTS

Higher obesity index was found in individuals with myopic eyes after adjustment for age, sex, education level, income status, physical activity, residence, and serum vitamin D level. The significant difference in total body fat percentages among myopia, emmetropia, and hyperopia was significant in the young age group (19-39 years, p < 0.05) but not in the middle age group (40-64 years) and the old age group (≥65 years). Individuals with a higher percentage of total body fat had greater odds ratios for myopia (fourth quartile of body fat; odds ratio, 1.352; 95% confidence interval, 1.178-1.551).

CONCLUSIONS

An association was found between adiposity and myopia in relatively young adults using direct measurements of fat mass.

Population pharmacokinetic model for oral ORIN1001 in Chinese patients with advanced solid tumors

Background: ORIN1001, a first-in-class oral IRE1-α endoribonuclease inhibitor to block the activation of XBP1, is currently in clinical development for inhibiting tumor growth and enhancing the effect of chemical or targeted therapy. Early establishment of a population pharmacokinetic (PopPK) model could characterize the pharmacokinetics (PK) of ORIN1001 and evaluate the effects of individual-specific factors on PK, which will facilitate the future development of this investigational drug. Methods: Non-linear mixed effect model was constructed by Phoenix NLME software, utilizing the information from Chinese patients with advanced solid tumors in a phase I clinical trial (Register No. NCT05154201). Statistically significant PK covariates were screened out by a stepwise process. The final model, after validating by the goodness-of-fit plots, non-parametric bootstrap, visual predictive check and test of normalized prediction distribution errors, was further applied to simulate and evaluate the impact of covariates on ORIN1001 exposure at steady state up to 900 mg per day as a single agent. Results: A two-compartment model with first-order absorption (with lag-time)/elimination was selected as the best structural model. Total bilirubin (TBIL) and lean body weight (LBW) were considered as the statistically significant covariates on clearance (CL/F) of ORIN1001. They were also confirmed to exert clinically significant effects on ORIN1001 steady-state exposure after model simulation. The necessity of dose adjustments based on these two covariates remains to be validated in a larger population. Conclusion: The first PopPK model of ORIN1001 was successfully constructed, which may provide some important references for future research.

Relation of body surface area-to-mass ratio to risk of exertional heat stroke in healthy men and women

Risk of exertional heat stroke (EHS) is an ongoing challenge for United States military personnel, for athletes and for individuals with occupational stressors that involve prolonged activity in hot environments. Higher body mass index (BMI) is significantly associated with increased risk for EHS in activity duty U.S. Soldiers. During exercise, heat is generated primarily by contracting skeletal muscle (and other metabolically active body mass) and dissipated based on body surface area (BSA). Thus, in compensable environments, a higher BSA·mass-1 may be a benefit to heat dissipation and decrease the risk of EHS. The purpose of the present analysis was to test the hypothesis that BSA·mass-1 ratio is an important biophysical characteristic contributing to the risk of EHS. We employed a matched case-control approach, where each individual with a diagnosis of EHS was matched to five controls who were never diagnosed with EHS but were in the same unit and had the same job title. We used a multivariate conditional logistic regression model including variables of BSA·mass-1, sex, age, military rank, and race. BSA·mass-1 significantly predicted EHS risk (P = 0.006), such that people with higher BSA·mass-1 were at lower risk of developing EHS when controlling for other potential factors such as age and race. This relationship persisted after adjustment for other anthropometric measures of body size including weight, BMI, and BSA. These data suggest that biophysical factors play an important role in EHS risk, particularly in a healthy military-aged cohort of men and women.NEW & NOTEWORTHY With the impacts of climate change yielding higher average ambient temperatures over time, the incidence of EHS for individuals participating in outdoor activities may consequently increase. With the larger sample size in this study compared with prior research in this field, we were able to use various methods that had not been applied before. For example, we were able to mutually adjust for different measurements of body size to understand which metric had the highest association with EHS risk. Understanding factors that may be modifiable may be important for developing interventions to counteract the increased risk of EHS associated with climate change.

Exposure to OPFRs Is Associated with Obesity and Dysregulated Serum Lipid Profiles: Data from 2017-2018 NHANES

Widespread exposure to organophosphorus flame retardants (OPFRs) has been observed in the general population. Emerging studies have revealed OPFRs possess endocrine-disturbing properties. The present study aims to assess the association between urinary metabolites of OPFRs, BMI, and serum lipid profiles. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were obtained, with 1334 adults enrolled in the current study. Urinary concentrations of bis (1-chloro-2-propyl) phosphate (BCIPP), bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), dibutyl phosphate (DBUP), and diphenyl phosphate (DPHP) were quantified to assess OPFR exposure. Covariate-adjusted linear and logistic regression models were conducted to explore the associations between log2-transformed concentrations of OPFR metabolites, BMI, obesity, and serum lipid profiles. Stratified analyses were performed to assess the heterogeneity of associations by age, gender, race, etc. Positive associations were found between OPFR exposure and the risk of obesity. The multivariate linear analysis indicated that a one-unit increase in log2-transformed urinary concentrations of BCEP and BDCPP was associated with 0.27 (95% CI: 0.02-0.52, p = 0.0338) and 0.56 (95% CI: 0.25-0.87, p = 0.0004) higher BMI value, respectively. One log2-unit increase in urinary BCEP and BDCPP concentrations was associated with 1.1-fold (95% CI: 1.02-1.18, p = 0.0096) and 1.19-fold (95% CI: 1.09-1.30, p = 0.0001) risk for developing obesity. Furthermore, the non-linear relationship between exposure to OPFRs and obesity was identified. Additionally, multivariable linear regression showed that urinary DPHP concentrations were inversely correlated with serum triglyceride (TG) levels (β = -7.41, 95% CI: -12.13 to -2.68, p = 0.0022). However, no other OPFR metabolites were found to be significantly statistically associated with serum lipid levels after adjusting for potential confounders. In conclusion, environmental exposure to OPFRs might contribute to obesity and dysregulated TG concentrations in adults. Future prospective research is warranted to confirm the causal relationship between metabolites of OPFRs and obesity.