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Xiang YY, Won JH, Lee SJ, Baek KW. The Effect of Exercise on Mesenchymal Stem Cells and their Application in Obesity Treatment. Stem Cell Rev Rep 2024; 20:1732-1751. [PMID: 38954390 DOI: 10.1007/s12015-024-10755-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
Mesenchymal stem cells (MSCs) have demonstrated considerable potential in tissue repair and the treatment of immune-related diseases, but there are problems with homing efficiency during MSCs transplantation. Exercise, as an intervention, has been shown to have an important impact on the properties of MSCs. This review summarizes the effects of exercise on the properties (including proliferation, apoptosis, differentiation, and homing) of bone marrow-derived MSCs and adipose-derived MSCs. Studies indicated that exercise enhances bone marrow-derived MSCs proliferation, osteogenic differentiation, and homing while reducing adipogenic differentiation. For adipose-derived MSCs, exercise enhances proliferation and reduces adipogenic differentiation. In addition, studies have investigated the therapeutic effects of combined therapy of MSCs transplantation with exercise on diseases of the bone, cardiac, and nervous systems. The combined therapy improves tissue repair by increasing the homing of transplanted MSCs and cytokine secretion (such as neurotrophin 4). Furthermore, MSCs transplantation also has potential for the treatment of obesity. Although the effect is not significant in weight loss, MSCs transplantation shows effects in controlling blood glucose, improving dyslipidemia, reducing inflammation, and improving liver disease. Finally, the potential role of combined MSCs transplantation and exercise therapy in addressing obesity is discussed.
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Affiliation(s)
- Ying-Ying Xiang
- Department of Physical Education, Gyeongsang National University, Jinju, 52828, Korea
| | - Jong-Hwa Won
- Department of Physical Education, Gyeongsang National University, Jinju, 52828, Korea
| | - Sam-Jun Lee
- Department of Sport Rehabilitation, College of Health, Tongmyong University, Welfare, and Education, Busan, 48520, Korea
| | - Kyung-Wan Baek
- Research Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju, 52828, Korea.
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Kral P, Holst-Hansen T, Olivieri AV, Ivanescu C, Lamotte M, Larsen S. The Correlation Between Body Mass Index and Health-Related Quality of Life: Data from Two Weight Loss Intervention Studies. Adv Ther 2024:10.1007/s12325-024-02932-8. [PMID: 39316288 DOI: 10.1007/s12325-024-02932-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/14/2024] [Indexed: 09/25/2024]
Abstract
INTRODUCTION The correlation between body mass index (BMI) and utility in participants with obesity was assessed using health-related quality-of-life data collected in two weight loss intervention studies, SCALE and STEP 1. METHODS Short Form Health Survey 36-Item (SF-36) scores from SCALE and STEP 1 were mapped to EuroQoL-5 dimensions-3 levels (EQ-5D-3L) using an established algorithm to derive utilities for the UK. SF-36 scores from STEP 1 were converted into Short Form 6 dimension (SF-6D) utilities for Portugal using the tool developed by the University of Sheffield. The correlation between baseline BMI and utility was assessed by multiple linear regression analyses, controlling for demographic and clinical parameters. RESULTS A higher baseline BMI correlated with lower EQ-5D-3L and SF-6D utilities, although the trend was non-significant. Assuming linearity between BMI ranges 30-40 kg/m2, an additional unit of BMI correlated with 0.0041 and 0.0031 lower EQ-5D-3L scores in SCALE and 0.0039 and 0.0047 lower EQ-5D-3L and 0.0027 and 0.0020 lower SF-6D scores in STEP 1 for men and women, respectively. CONCLUSION In individuals with comparable demographic characteristics and weight-related comorbidities, a 1 unit change in BMI leads to a difference of up to 0.005 in utility indices. TRIAL REGISTRATION ClinicalTrials.gov identifiers: SCALE (NCT01272219) and STEP 1 (NCT03548935).
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Affiliation(s)
| | | | | | | | | | - Sara Larsen
- Novo Nordisk A/S, Vandtårnsvej 108-110, 2860, Søborg, Denmark.
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3
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Phuong-Nguyen K, O’Hely M, Kowalski GM, McGee SL, Aston-Mourney K, Connor T, Mahmood MQ, Rivera LR. The Impact of Yoyo Dieting and Resistant Starch on Weight Loss and Gut Microbiome in C57Bl/6 Mice. Nutrients 2024; 16:3138. [PMID: 39339738 PMCID: PMC11435396 DOI: 10.3390/nu16183138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/05/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Cyclic weight loss and subsequent regain after dieting and non-dieting periods, a phenomenon termed yoyo dieting, places individuals at greater risk of metabolic complications and alters gut microbiome composition. Resistant starch (RS) improves gut health and systemic metabolism. This study aimed to investigate the effect of yoyo dieting and RS on the metabolism and gut microbiome. C57BL/6 mice were assigned to 6 diets for 20 weeks, including control, high fat (HF), yoyo (alternating HF and control diets every 5 weeks), control with RS, HF with RS, and yoyo with RS. Metabolic outcomes and microbiota profiling using 16S rRNA sequencing were examined. Yoyo dieting resulted in short-term weight loss, which led to improved liver health and insulin tolerance but also a greater rate of weight gain compared to continuous HF feeding, as well as a different microbiota profile that was in an intermediate configuration between the control and HF states. Mice fed HF and yoyo diets supplemented with RS gained less weight than those fed without RS. RS supplementation in yoyo mice appeared to shift the gut microbiota composition closer to the control state. In conclusion, yoyo dieting leads to obesity relapse, and increased RS intake reduces weight gain and might help prevent rapid weight regain via gut microbiome restoration.
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Affiliation(s)
- Kate Phuong-Nguyen
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (M.O.); (S.L.M.); (K.A.-M.); (T.C.)
- Metabolic Research Unit, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Martin O’Hely
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (M.O.); (S.L.M.); (K.A.-M.); (T.C.)
- Murdoch Children’s Research Institute, Royal Children’s Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Greg M. Kowalski
- Metabolic Research Unit, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Waurn Ponds, VIC 3216, Australia
| | - Sean L. McGee
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (M.O.); (S.L.M.); (K.A.-M.); (T.C.)
- Metabolic Research Unit, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Kathryn Aston-Mourney
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (M.O.); (S.L.M.); (K.A.-M.); (T.C.)
- Metabolic Research Unit, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Timothy Connor
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (M.O.); (S.L.M.); (K.A.-M.); (T.C.)
- Metabolic Research Unit, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Malik Q. Mahmood
- School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Leni R. Rivera
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC 3220, Australia; (M.O.); (S.L.M.); (K.A.-M.); (T.C.)
- Metabolic Research Unit, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
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Roberts MJ, Johnson W, Qooja S, Moorthy A, Bishop NC. Combined associations of obesity and physical activity with pain, fatigue, stiffness and anxiety in adults with spondyloarthropathies: UK Biobank study. Rheumatol Adv Pract 2024; 8:rkae109. [PMID: 39282621 PMCID: PMC11401743 DOI: 10.1093/rap/rkae109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 08/26/2024] [Indexed: 09/19/2024] Open
Abstract
Objective Inflammatory spondyloarthropathies are associated with pain, fatigue, stiffness and anxiety. The National Institute for Health and Care Excellence and the EULAR provide limited lifestyle guidance for managing symptoms with inflammatory spondyloarthropathies. We investigated the combined associations of obesity and physical activity with symptom severity in inflammatory spondyloarthropathies. Methods The relationship between BMI, physical activity and symptom severity (spinal and general pain, fatigue, anxiety, mobility) was examined in people with ISpAs (n = 1577). BMI categories were normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) and obese (≥30 kg/m2). Physical activity was assessed via the International Physical Activity Questionnaire (low < 600 metabolic equivalent of task (MET)-min/week, moderate ≥ 600 METs, high ≥ 3000 METs). Statistical models adjusted for confounders, including medication, estimated the likelihood (odds ratios, OR) of higher symptom severity across BMI and physical activity categories. Results Overweight and obesity, compared with normal weight, were linked to higher severity of all symptoms, with stronger associations for obesity (OR ≥ 2.34, P < 0.001) than overweight (OR ≥ 1.37, P ≤ 0.032). Moderate activity, compared with low, was associated with lower severity of all symptoms (OR ≤ 0.77, P ≤ 0.032). High activity, compared with low, was associated with lower severity of fatigue, anxiety and mobility issues (OR ≤ 0.74, P ≤ 0.029), but associations with spinal and general pain were not significant (OR ≤ 0.80, P ≥ 0.056). No BMI-by-physical activity combinations were detected, indicating physical activity benefits all BMI groups to a similar extent. Conclusion National Institute for Health and Care Excellence and EULAR guidance for inflammatory spondyloarthropathies should emphasize maintaining a normal weight. Moderate physical activity is optimal for reducing symptom severity and should be promoted in lifestyle guidance.
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Affiliation(s)
- Matthew J Roberts
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, UK
| | - William Johnson
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, UK
| | - Sepehr Qooja
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, UK
| | - Arumugam Moorthy
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Department of Rheumatology, University Hospitals of NHS Trust, College of Life Sciences, University of Leicester, Leicester, UK
| | - Nicolette C Bishop
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, UK
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Cavanaugh C, Orroth K, Qian X, Kumparatana P, Klyachkin Y, Colgan S, Cordey M. Diabetes and obesity burden and improvements in cardiometabolic parameters in patients with psoriasis or psoriatic arthritis receiving apremilast in a real-world setting. JAAD Int 2024; 16:244-251. [PMID: 39072263 PMCID: PMC11279948 DOI: 10.1016/j.jdin.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction Patients with psoriasis and psoriatic arthritis have a higher prevalence of cardiometabolic comorbidities compared to the general population. Clinical data suggest apremilast may reduce weight and glycated hemoglobin (HbA1c). Objective To describe changes in cardiometabolic parameters among patients with psoriasis and psoriatic arthritis newly treated with apremilast by prediabetes/diabetes or obesity status. Methods This was a retrospective cohort study of electronic medical records from patients with psoriasis and/or psoriatic arthritis in the OM1 Real-World Data Cloud who newly initiated apremilast. Changes from baseline in body mass index, weight, HbA1c, and lipids were evaluated at 6 and 12 months using a multivariable linear regression model stratified by prediabetes/diabetes or obesity status. Results Of 8487 patients initiating apremilast, 24% had diabetes. Of 8250 patients with body mass index available, 27% were obese and 34% were severely obese. Patients experienced decreases in body mass index and weight at 6 and 12 months regardless of diabetes or obesity status, with the greatest reductions seen in those with diabetes and obesity. Reductions in HbA1c at 6 months were seen in patients without diabetes and patients with severe obesity. Conclusions Treatment with apremilast may provide the greatest cardiometabolic benefit to those with the greatest burden of cardiometabolic disease.
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Affiliation(s)
| | | | - Xi Qian
- OM1, Inc, Boston, Massachusetts
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Sharaiha RZ, Wilson EB, Zundel N, Ujiki MB, Dayyeh BKA. Randomized Controlled Trial Based US Commercial Payor Cost-Effectiveness Analysis of Endoscopic Sleeve Gastroplasty Versus Lifestyle Modification Alone for Adults With Class I/II Obesity. Obes Surg 2024; 34:3275-3284. [PMID: 39107454 DOI: 10.1007/s11695-024-07324-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/29/2024] [Accepted: 05/29/2024] [Indexed: 08/29/2024]
Abstract
PURPOSE Endoscopic sleeve gastroplasty (ESG) is a minimally invasive day procedure that the MERIT randomized controlled trial (RCT) has demonstrated to be an effective and safe method of weight loss versus lifestyle modification alone. We sought to evaluate the cost-effectiveness of ESG from the perspective of a US commercial payer in a cohort of adults with class II and class I obesity with diabetes based on this RCT. MATERIALS We used a Markov modelling approach with BMI group health states and an absorbing death state. Baseline characteristics, utilities, BMI group transition probabilities, and adverse events (AEs) were informed by patient-level data from the MERIT RCT. Mortality was estimated by applying BMI-specific hazard ratios to US general population mortality rates. We used BMI-based health state utilities to reflect the impact of obesity comorbidities and applied disutilities due to ESG AEs. Costs included intervention costs, AE costs, and BMI-based annual direct healthcare costs to account for costs associated with obesity comorbidities. A willingness-to-pay threshold of $100,000 per quality-adjusted life year (QALY) was assumed. RESULTS In our base-case analysis over a 5-year time horizon, ESG was cost-effective versus lifestyle modification alone with an incremental cost-effectiveness ratio of $23,432/QALY. ESG remained cost-effective in all sensitivity analyses we conducted and was dominant in analyses with longer time horizons. CONCLUSION ESG is a cost-effective treatment option for people living with obesity and should be considered in commercial health plans as an additional treatment option for clinically eligible patients.
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Affiliation(s)
- Reem Z Sharaiha
- Division of Gastroenterology & Hepatology, Weill Cornell Medicine, 1283 York Avenue, 9 Floor, New York, NY, 10021, USA.
| | - Erik B Wilson
- Department of Surgery, The University of Texas Health Science Center, Houston, TX, 77030, USA
| | - Natan Zundel
- Department of Surgery, University at Buffalo, Buffalo, NY, 14203, USA
| | - Michael B Ujiki
- Department of Surgery, North Shore University Health System, Evanston, IL, 60201, USA
| | - Barham K Abu Dayyeh
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
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Crompvoets PI, Nieboer AP, van Rossum EFC, Cramm JM. The relationship between person-centred care and well-being and satisfaction with care of patients living with obesity. Int J Qual Health Care 2024; 36:mzae078. [PMID: 39119734 PMCID: PMC11363957 DOI: 10.1093/intqhc/mzae078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/21/2024] [Accepted: 08/12/2024] [Indexed: 08/10/2024] Open
Abstract
Person-centred care (PCC) is associated with improved patient well-being and higher levels of satisfaction with care but its impact on individuals living with obesity is not well-established. The main aim of this study was to assess the relationship between PCC and the physical and social well-being of patients living with obesity, as well as their satisfaction with care. This study is based on a cross-sectional, web-based survey administered among a representative panel of Dutch individuals living with obesity. The primary outcomes were physical and social well-being and satisfaction with care. The primary exposure was a rating of overall PCC, encompassing its eight dimensions. In addition, covariates considered in the analyses included sex, age, marital status, education level, body mass index, and chronic illness. The data from a total of 590 participants were analysed using descriptive statistics, correlation analyses, and multiple regression analyses. Among PCC dimensions, participants rated 'access to care' the highest (M 4.1, SD 0.6), while 'coordination of care' (M 3.5, SD 0.8) was rated lower than all other dimensions. Participants' overall PCC ratings were positively correlated with their physical (r = 0.255, P < .001) and social well-being (r = 0.289, P < .001) and their satisfaction with care (r = 0.788, P < .001), as were the separate dimension scores. After controlling for sex, age, marital status, education level, body mass index, and chronic illness in the regression analyses, participants' overall PCC ratings were positively related to their physical (β = 0.24, P < .001) and social well-being (β = 0.26, P < .001), and satisfaction with care (β = 0.79, P < .001). PCC holds promise for improved outcomes among patients living with obesity, both in terms of physical and social well-being, as well as satisfaction with care. This is an important finding, particularly when considering the profound physical, social, and psychological consequences associated with obesity. In addition to highlighting the potential benefits of PCC in the healthcare of individuals living with obesity, the findings offer valuable insights into strategies for further refining the provision of PCC to meet the specific needs of these patients.
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Affiliation(s)
- Paige I Crompvoets
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam P.O. Box 1738, The Netherlands
| | - Anna P Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam P.O. Box 1738, The Netherlands
| | - Elisabeth F. C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam P.O. Box 2040, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam P.O. Box 2040, The Netherlands
| | - Jane M Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam P.O. Box 1738, The Netherlands
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Ter Bogt MJJ, Te Riele YZ, Kooijman PGC, Heszler AN, van der Meer S, van Roon R, Molleman GRM, van den Muijsenbergh M, Fransen GAJ, Bevelander KE. Citizens' perspectives on healthy weight approaches in low SEP neighborhoods: a qualitative study from a systems perspective. BMC Public Health 2024; 24:2137. [PMID: 39112968 PMCID: PMC11304654 DOI: 10.1186/s12889-024-19595-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 07/26/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The physical and the social environment are important predictors of healthy weight, especially in low socioeconomic position (SEP) neighborhoods. Many Dutch municipalities have implemented a healthy weight approach (HWA). Yet, there is room for improvement. This system science study examined what influences the utilization of HWA facilities and activities, and what aspects can help to achieve a desired systems change (also called leverage point themes (LPTs)) in the HWA system as perceived by citizens living in low SEP neighborhoods. METHOD All research phases were performed with four citizens co-researchers. Forty-seven citizens living in low SEP neighborhoods were semi-structurally interviewed about the neighborhood HWA facilities and municipal HWA activities. A rapid coding qualitative analysis approach was applied per topic. The topics were citizens' healthy living description, personal circumstances, and satisfaction with foot and cycle paths, sports facilities, playgrounds, green spaces, museums and theaters, community centers, churches, healthcare, school, food supplies, contact with neighborhood, unfamiliar and/or unused activities, familiar and used activities, unavailable but desired (lacking) activities, and reaching citizens. RESULTS The utilization of HWA facilities and activities was influenced by the overarching themes of social cohesion, familiarity, reaching citizens, maintenance, safety, physical accessibility, financial accessibility, social accessibility, fit with personal context, and fit with the neighborhood's specific needs. Different overarching themes stood out across different facilities and activities. LPTs indicated the overarching themes needed in combination with one another for a specific activity or facility to increase utilization. For example, the LPT regarding foot and cycle paths was "accessible, safe, and maintained foot and cycle paths". The LPTs regarding familiar and used activities were "customized activities; information provision (e.g., about possibilities to join without paying); social contact, meeting others, and everyone feels included". CONCLUSION Conducting inclusive qualitative research from a systems perspective among citizens living in low SEP neighborhoods has contributed valuable insights into their needs. This enables practical implementation of HWAs by providing a deeper understanding of the LPTs within the HWA system. LPTs can help HWA stakeholders to further develop current HWAs toward systems approaches. Future research could study the leverage points that may contribute to LPT implementation.
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Affiliation(s)
- Maud J J Ter Bogt
- AMPHI Academic Collaborative Centre, Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands.
- Municipal Health Service Gelderland-Zuid, Nijmegen, TV, 6524, The Netherlands.
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands.
| | - Yentl Z Te Riele
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
| | - Piet G C Kooijman
- Municipal Health Service Gelderland-Zuid, Nijmegen, TV, 6524, The Netherlands
| | - Anita N Heszler
- Municipal Health Service Gelderland-Zuid, Nijmegen, TV, 6524, The Netherlands
| | - Saskia van der Meer
- Municipal Health Service Gelderland-Zuid, Nijmegen, TV, 6524, The Netherlands
| | - Rob van Roon
- Municipal Health Service Gelderland-Zuid, Nijmegen, TV, 6524, The Netherlands
| | - Gerard R M Molleman
- AMPHI Academic Collaborative Centre, Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
| | - Maria van den Muijsenbergh
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
- Pharos, The Dutch Centre of Expertise on Health Disparities, Utrecht, LH, 3507, The Netherlands
| | - Gerdine A J Fransen
- AMPHI Academic Collaborative Centre, Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
- Municipal Health Service Gelderland-Zuid, Nijmegen, TV, 6524, The Netherlands
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
| | - Kirsten E Bevelander
- AMPHI Academic Collaborative Centre, Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, EZ, 6525, The Netherlands
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Rikken QGH, Aalders MB, Dahmen J, Sierevelt IN, Stufkens SAS, Kerkhoffs GMMJ. Ten-Year Survival Rate of 82% in 262 Cases of Arthroscopic Bone Marrow Stimulation for Osteochondral Lesions of the Talus. J Bone Joint Surg Am 2024; 106:1268-1276. [PMID: 38728384 DOI: 10.2106/jbjs.23.01186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND The long-term sustainability of arthroscopic bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLT) remains a matter of debate. The primary aim of the present study was to assess the 10-year survival free from revision in ankles that had undergone arthroscopic BMS for an OLT. The secondary aim was to evaluate the influence of baseline patient and lesion characteristics on survival. METHODS Patients who underwent arthroscopic BMS for a symptomatic OLT and had a minimum follow-up of 10 years were included to assess procedure survival. The primary outcome, the 10-year cumulative survival rate, was analyzed by the Kaplan-Meier survival method. Secondary outcomes were the median time to revision and the effects of baseline factors (lesion size, primary or non-primary lesion type, preoperative cysts, and obesity as defined by a body mass index [BMI] of ≥30 kg/m 2 ) on survival, analyzed with a Cox regression model and reported using hazard ratios (HRs). RESULTS The 262 included patients had a mean follow-up of 15.3 ± 4.8 years. The 10-year cumulative survival rate of the arthroscopic BMS procedures was 82% (95% confidence interval [CI]: 77% to 87%). At 15 years of follow-up, the cumulative survival rate was 82% (95% CI: 76% to 86%). The median time to revision was 2.4 years (interquartile range: 1.3 to 5.1 years). Of the baseline factors, obesity (HR: 3.0 [95% CI: 1.44 to 6.43], p < 0.01) was associated with decreased survival. Lesion size (HR: 0.9 [95% CI: 0.5 to 1.8], p = 0.8), non-primary lesion type (HR: 1.8 [95% CI: 0.9 to 3.4], p = 0.1), and the presence of preoperative cysts (HR: 1.0 [95% CI: 0.6 to 1.9], p = 0.9) were not significantly associated with survival. CONCLUSIONS At a minimum follow-up of 10 years, the survival rate of arthroscopic BMS for OLT was 82%. At 15 and 20 years of follow-up, survival appeared to remain stable. Obesity (BMI ≥ 30 kg/m 2 ) was associated with a higher likelihood of revision surgery. This risk factor should be incorporated into the treatment algorithm for OLT when counseling patients regarding surgery. LEVEL OF EVIDENCE Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Quinten G H Rikken
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Sports and Musculoskeletal Health Programs, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | - Margot B Aalders
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Sports and Musculoskeletal Health Programs, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jari Dahmen
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Sports and Musculoskeletal Health Programs, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | - Inger N Sierevelt
- Orthopedic Department, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands
| | - Sjoerd A S Stufkens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Sports and Musculoskeletal Health Programs, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Centre, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Sports and Musculoskeletal Health Programs, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Centre, Amsterdam UMC, Amsterdam, The Netherlands
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Scott IC, Bajpai R, Hider SL, Helliwell T, Mallen CD, Muller S. The relationship between obesity and patient-reported outcome measures in people with polymyalgia rheumatica. Rheumatol Adv Pract 2024; 8:rkae081. [PMID: 39006539 PMCID: PMC11239789 DOI: 10.1093/rap/rkae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/29/2024] [Indexed: 07/16/2024] Open
Abstract
Objective To examine the association between obesity and patient-reported outcome measures (PROMs) in a primary care-based cohort of people with PMR. Methods The PMR Cohort Study recruited people with incident PMR from 382 general practices. Self-completed questionnaires (0, 12, 24 months) captured a range of PROMs for pain, stiffness, anxiety, depression, fatigue, function and quality of life, alongside data on BMI. People were categorized as underweight/normal weight (BMI < 25kg/m2), overweight (25-29.99 kg/m2) or obese (≥30 kg/m2). Piecewise, multilevel, linear mixed-effects regression models examined relationships between BMI categories and PROMs over time, adjusting for confounding variables. Chi-squared tests examined the relationship between obesity and glucocorticoid persistence. Results 644 people with PMR were included. At baseline, 33.9% were normal/underweight, 40.6% overweight and 25.5% obese. Compared with normal/underweight people, those with obesity had significantly worse scores for the following: pain and stiffness at 12 months; fatigue at 12 and 24 months; depression at baseline; physical function at all time points; and quality of life at baseline and 12 months. They also had significantly smaller improvements in stiffness (1.13 units on an 11-point numeric rating scale; P = 0.001) and physical function (0.14 units measured using the modified Health Assessment Questionnaire; P = 0.025) between 0 and 12 months. BMI categories did not relate to persistent glucocorticoid use at 12 months (P = 0.110) or 24 months (P = 0.166). Conclusion Obesity associates with poorer outcomes for a range of PROMs in people with PMR. Consideration should be given to providing weight management support to people with PMR and obesity.
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Affiliation(s)
- Ian C Scott
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Ram Bajpai
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Samantha L Hider
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Toby Helliwell
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Centre for Academic Social Care, Public Health, Community and Primary Care (COSMIC), Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Christian D Mallen
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership University NHS Foundation Trust, Staffordshire, UK
| | - Sara Muller
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
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11
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Orioli L, Samaras S, Sawadogo K, de Barsy M, Lause P, Deswysen Y, Navez B, Thissen JP, Loumaye A. Circulating myostatin as a biomarker of muscle mass and strength in individuals with cancer or obesity. Clin Nutr 2024; 43:1800-1808. [PMID: 38861892 DOI: 10.1016/j.clnu.2024.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/22/2024] [Accepted: 05/28/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND & AIMS Our study aims to determine whether myostatin (MSTN) is associated with muscle mass and strength in individuals with cancer or obesity, as well as with cancer cachexia (CC) or sarcopenic obesity (SO). METHODS The ACTICA study included individuals with CC (n = 70) or without CC (NC, n = 73). The MYDIASECRET study included individuals with obesity evaluated before (T0) and 3 months (T3) after bariatric surgery (n = 62). Body composition was assessed using bioelectrical impedance analysis (BIA). Skeletal muscle mass (SMM) and appendicular SMM (ASMM) were calculated from Janssen's and Sergi's equations, respectively, and expressed as indexes (SMMI and ASMMI). Handgrip strength (HGS) was assessed using a Jamar hand-held dynamometer. MSTN plasma levels were measured using ELISA. Spearman's coefficient was used to correlate MSTN with muscle mass and strength. Receiver operating characteristic (ROC) curve analysis was performed to identify an optimal MSTN cutoff level for the prediction of CC or SO. RESULTS In the ACTICA study, muscle mass and strength were lower in CC individuals than in NC individuals (SMMI: 8.0 kg/m2vs 9.0 kg/m2, p = 0.004; ASMMI: 6.2 kg/m2vs 7.2 kg/m2, p < 0.001; HGS: 28 kg vs 38 kg, p < 0.001). MSTN was also lower in CC individuals than in NC individuals (1434 pg/mL vs 2149 pg/mL, p < 0.001). Muscle mass and strength were positively correlated with MSTN (SMMI: R = 0.500, p < 0.001; ASMMI: R = 0.479, p < 0.001; HGS: R = 0.495, p < 0.001). ROC curve analysis showed a MSTN cutoff level of 1548 pg/mL (AUC 0.684, sensitivity 57%, specificity 75%, p < 0.001) for the prediction of CC. In the MYDIASECRET study, muscle mass and strength were reduced at T3 (SMMI: -8%, p < 0.001; ASMMI: -12%, p < 0.001; HGS: -6%, p = 0.005). MSTN was also reduced at T3 (1773 pg/mL vs 2582 pg/mL, p < 0.001). Muscle mass and strength were positively correlated with MSTN at T0 and T3 (SMMI-T0: R = 0.388, p = 0.002; SMMI-T3: R = 0.435, p < 0.001; HGS-T0: R = 0.337, p = 0.007; HGS-T3: R = 0.313, p = 0.013). ROC curve analysis showed a MSTN cutoff level of 4225 pg/mL (AUC 0.835, sensitivity 98%, specificity 100%, p = 0.014) for the prediction of SO at T3. CONCLUSIONS MSTN is positively correlated with muscle mass and strength in individuals with cancer or obesity, suggesting its potential use as a biomarker of muscle mass and strength. The ROC curve analysis suggests the potential use of MSTN as a screening tool for CC and SO.
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Affiliation(s)
- Laura Orioli
- Research Laboratory of Endocrinology, Diabetes, and Nutrition, Institute of Experimental and Clinical Research, Université Catholique de Louvain, 55 Avenue Hippocrate, 1200 Brussels, Belgium; Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Sofia Samaras
- Research Laboratory of Endocrinology, Diabetes, and Nutrition, Institute of Experimental and Clinical Research, Université Catholique de Louvain, 55 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Kiswendsida Sawadogo
- Statistical Support Unit, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Marie de Barsy
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Pascale Lause
- Research Laboratory of Endocrinology, Diabetes, and Nutrition, Institute of Experimental and Clinical Research, Université Catholique de Louvain, 55 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Yannick Deswysen
- Department of Oeso-gastro-duodenal and Bariatric Surgery, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Benoit Navez
- Department of Oeso-gastro-duodenal and Bariatric Surgery, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Jean-Paul Thissen
- Research Laboratory of Endocrinology, Diabetes, and Nutrition, Institute of Experimental and Clinical Research, Université Catholique de Louvain, 55 Avenue Hippocrate, 1200 Brussels, Belgium; Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
| | - Audrey Loumaye
- Research Laboratory of Endocrinology, Diabetes, and Nutrition, Institute of Experimental and Clinical Research, Université Catholique de Louvain, 55 Avenue Hippocrate, 1200 Brussels, Belgium; Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
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Cesanelli L, Cesanelli F, Degens H, Satkunskiene D. Obesity-related reduced spirometry and altered breathing pattern are associated with mechanical disadvantage of the diaphragm. Respir Physiol Neurobiol 2024; 325:104267. [PMID: 38679308 DOI: 10.1016/j.resp.2024.104267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/12/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024]
Abstract
The aim of this study was to characterize the breathing patterns of individuals with obesity during routine activities such as sitting and standing, and to identify potential contributors to alterations in these patterns. Measurements performed in 20 male subjects with obesity (BMI, 31.8±1.5 kg/m2) and 20 controls (BMI, 23.5±1.4 kg/m2) included anthropometric parameters, breathing-patterns in sitting and standing positions, spirometry, maximal respiratory pressures, and diaphragm B-mode ultrasonography. Individuals with obesity exhibited lower tidal volume and increased respiratory rate to maintain a similar minute-ventilation (p<0.05). Subjects with obesity demonstrated impaired spirometry and respiratory muscle strength, with inspiratory functions being notably compromised (p<0.05). Individuals with obesity had a greater diaphragm thickness at end inspiration but lower thickening-fraction at end quiet and forced breathings and reduced diaphragmatic displacement and excursion during maximal breaths (p<0.05). BMI was negatively associated with all respiratory function markers (p<0.05). Individuals with obesity exhibit a higher respiratory rate but lower tidal volume, likely to accommodate decreased compliance and excess thoracic and abdominal fat, further hindering inspiratory function. Moreover, increased adiposity is associated with a thicker but weaker diaphragm, primarily due to the diaphragm's mechanical disadvantage rather than its intrinsic inability to generate force.
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Affiliation(s)
- Leonardo Cesanelli
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania; Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania.
| | - Federico Cesanelli
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Hans Degens
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania; Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Danguole Satkunskiene
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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13
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Luah XW, Holst-Hansen T, Lübker C. The association between body mass index and health-related quality of life in the 2017 and 2018 health survey of England data: A cross-sectional observational analysis. Diabetes Obes Metab 2024; 26:2318-2328. [PMID: 38499493 DOI: 10.1111/dom.15546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
AIM To provide an updated estimate of the association between body mass index (BMI) and health-related quality of life (HRQoL) among the general population in England and to identify population subgroups with the highest potential utility gains from obesity interventions. MATERIALS AND METHODS The sample included 12 158 adults with valid HRQoL and BMI data from the 2017 and 2018 Health Survey for England. Robust standard error linear regression, controlling for demographic and socioeconomic characteristics, lifestyle behaviours and obesity-related comorbidities, was used for the baseline analysis. Robustness checks assessed the impact of (a) estimator selection; (b) model specifications; (c) statistical outliers at high BMI; (d) potential BMI measurement error; and (e) data pooling. RESULTS The study found a significant association between HRQoL and BMI, which exhibited an inverted U-shaped relationship. The mean HRQoL peaked at 25.7 kg/m2 in men and 22.6 kg/m2 in women and was reduced in the underweight, overweight and obesity BMI ranges. Sensitivity analyses reported similar coefficients, suggesting a robust model specification. CONCLUSIONS Reduced HRQoL beyond optimal BMI underlines the importance of maintaining a normal BMI range for overall health. The rising prevalence of class III obesity is a major public health concern given its disproportionate impact on health, health care utilization and costs. Obesity management is key to preventing the reduction in HRQoL associated with obesity-related comorbidities, and this analysis supports the development of targeted policies and population health initiatives for people with class III obesity.
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Affiliation(s)
- Xiao Wen Luah
- Department of Economics and Related Studies, University of York, York, UK
- Novo Nordisk A/S, Søborg, Denmark
| | | | - Christopher Lübker
- Novo Nordisk A/S, Søborg, Denmark
- Department of Health Sciences, University of York, York, UK
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Minaya DM, Kim JS, Kirkland R, Allen J, Cullinan S, Maclang N, de Lartigue G, de La Serre CB. Transfer with microbiota from lean donors prevents excessive weight gain and restores gut-brain vagal signaling in obese rats maintained on a high fat diet. RESEARCH SQUARE 2024:rs.3.rs-4438240. [PMID: 38853960 PMCID: PMC11160927 DOI: 10.21203/rs.3.rs-4438240/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background The collection of microorganisms, mainly bacteria, which live in the gastrointestinal (GI) tract are collectible known as the gut microbiota. GI bacteria play an active role in regulation of the host's immune system and metabolism, as well as certain pathophysiological processes. Diet is the main factor modulating GI microbiota composition and recent studies have shown that high fat (HF) diets induce detrimental changes, known as dysbiosis, in the GI bacterial makeup. HF diet induced microbiota dysbiosis has been associated with structural and functional changes in gut-brain vagally mediated signaling system, associated with overeating and obesity. Although HF-driven changes in microbiota composition are sufficient to alter vagal signaling, it is unknown if restoring normal microbiota in obesity can improve gut-brain signaling and metabolic outcomes. In this study, we evaluated the effect of lean gut microbiota transfer in obese, vagally compromised, rats on gut-brain communication, food intake, and body weight. Male Sprague-Dawley rats were maintained on regular chow, or 45% HF diet for nine weeks followed by three weeks of microbiota depletion using an antibiotic cocktail. The animals were then divided into four groups (n=10 each): LF - control group on regular chow, LF-LF - chow fed animals that received antibiotics and microbiota from chow fed animals, HF-LF - HF fed animals that received microbiota from chow fed animals, and HF-HF - HF fed animals that received microbiota from HF fed animals. Animals were gavaged with donor microbiota for three consecutive days on week one and once a week thereafter for three more weeks. HF-LF animals received inulin as a prebiotic to aid the establishment of the lean microbiome. Results We found that transferring a LF microbiota to HF fed animals (HF-LF) reduced caloric intake during the light phase when compared with HF-HF rats and prevented additional excessive weight gain. We did not observe significant changes in the density of vagal afferents terminating in the brainstem among the groups, however, HF-LF animals displayed an increase in postprandial activation of both primary sensory neurons innervating the GI tract and brainstem secondary neurons. Conclusions We concluded from these data that normalizing microbiota composition in obese rats improves gut-brain communication and restores normal feeding patterns which was associated with a reduction in weight gain.
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Affiliation(s)
- Dulce M. Minaya
- Department of Nutritional Science, University of Georgia, Athens, GA
| | | | - Rebecca Kirkland
- Department of Nutritional Science, University of Georgia, Athens, GA
| | - Jillian Allen
- Department of Nutritional Science, University of Georgia, Athens, GA
| | - Sitara Cullinan
- Department of Nutritional Science, University of Georgia, Athens, GA
| | - Neil Maclang
- Department of Nutritional Science, University of Georgia, Athens, GA
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Holt MF, Holmen S, Rolid K, Englund KVB, Østby CM, Ravnestad H, Andreassen AK, Gullestad L, Gude E, Broch K. The association between body mass index, exercise capacity, and health-related quality of life in heart transplant recipients. FRONTIERS IN TRANSPLANTATION 2024; 3:1379695. [PMID: 38993775 PMCID: PMC11235288 DOI: 10.3389/frtra.2024.1379695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 07/13/2024]
Abstract
Introduction Pre-transplant obesity and weight gain after heart transplantation are both associated with increased risk of poor clinical outcomes. We aimed to assess the association between overweight or obesity, exercise capacity, and health-related quality of life in heart transplant recipients. Methods This study is based on baseline data from the IronIC trial, in which we randomized 102 heart transplant recipients with iron deficiency to ferric derisomaltose or placebo. We performed cardio pulmonary exercise testing in all participants. To assess quality of life, we used the SF-36v2 questionnaire, using two sum scores: the physical component summary and the mental component summary. A minimal clinically important difference was defined as ≥2 and ≥3 for the physical and the mental component summary, respectively. Results 24/102 heart transplant recipients (24%) had a body mass index (BMI) ≥30 kg/m2. Peak oxygen consumption was 17.3 ± 4.6 ml/kg/min in the obese group vs. 24.7 ± 6.4 ml/kg/min in the group with a BMI <30 for a between-group difference of 7.4 (95% confidence interval 4.7-10.2) ml/kg/min: p < 0.001. The physical component summary score was on average 5.2 points lower in the patients with a body mass index ≥30 than in the lower weight group (p = 0.04). Conclusion Almost a quarter of our heart transplant recipients in long-term follow-up had a BMI ≥30 kg/m2. These patients had substantially lower exercise capacity and lower quality of life in the physical domain.
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Affiliation(s)
- Margrethe Flesvig Holt
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Stine Holmen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Innlandet Hospital Trust, Hamar, Norway
| | - Katrine Rolid
- Department of Health and Public Sector, The Research Council of Norway, Oslo, Norway
| | | | - Charlotte M. Østby
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Håvard Ravnestad
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Arne K. Andreassen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Lars Gullestad
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Einar Gude
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kaspar Broch
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
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16
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Janet R, Smallwood J, Hutcherson CA, Plassmann H, Mckeown B, Tusche A. Body mass index-dependent shifts along large-scale gradients in human cortical organization explain dietary regulatory success. Proc Natl Acad Sci U S A 2024; 121:e2314224121. [PMID: 38648482 PMCID: PMC11067012 DOI: 10.1073/pnas.2314224121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/14/2024] [Indexed: 04/25/2024] Open
Abstract
Making healthy dietary choices is essential for keeping weight within a normal range. Yet many people struggle with dietary self-control despite good intentions. What distinguishes neural processing in those who succeed or fail to implement healthy eating goals? Does this vary by weight status? To examine these questions, we utilized an analytical framework of gradients that characterize systematic spatial patterns of large-scale neural activity, which have the advantage of considering the entire suite of processes subserving self-control and potential regulatory tactics at the whole-brain level. Using an established laboratory food task capturing brain responses in natural and regulatory conditions (N = 123), we demonstrate that regulatory changes of dietary brain states in the gradient space predict individual differences in dietary success. Better regulators required smaller shifts in brain states to achieve larger goal-consistent changes in dietary behaviors, pointing toward efficient network organization. This pattern was most pronounced in individuals with lower weight status (low-BMI, body mass index) but absent in high-BMI individuals. Consistent with prior work, regulatory goals increased activity in frontoparietal brain circuits. However, this shift in brain states alone did not predict variance in dietary success. Instead, regulatory success emerged from combined changes along multiple gradients, showcasing the interplay of different large-scale brain networks subserving dietary control and possible regulatory strategies. Our results provide insights into how the brain might solve the problem of dietary control: Dietary success may be easier for people who adopt modes of large-scale brain activation that do not require significant reconfigurations across contexts and goals.
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Affiliation(s)
- Rémi Janet
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Jonathan Smallwood
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Cendri A. Hutcherson
- Department of Psychology, University of Toronto, Toronto, ONM5S 2E5, Canada
- Department of Marketing, Rotman School of Management, University of Toronto, Toronto, ONM5S 3E6, Canada
| | - Hilke Plassmann
- Marketing Area, INSEAD, FontainebleauF-77300, France
- Control-Interoception-Attention Team, Paris Brain Institute (ICM), Sorbonne University, Paris75013, France
| | - Bronte Mckeown
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
| | - Anita Tusche
- Department of Psychology, Queen’s University, Kingston, ONK7L 3N6, Canada
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA91125
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Benton MJ, Hutchins AM. The relationship between resting metabolic rate and quality of life is moderated by age and body composition in women: a cross-sectional study. BMC Womens Health 2024; 24:235. [PMID: 38615006 PMCID: PMC11015637 DOI: 10.1186/s12905-024-03085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) is related to body composition, which is also related to resting metabolic rate (RMR). RMR can be increased by exercise and diet interventions that are not dependent on changes in body composition, so a link between RMR and HRQOL may provide interventions that directly improve HRQOL in women. METHODS One hundred twenty women (median age 63.5 [IQR: 53.0-71.0] years) completed one-time measurement of body composition (multi-frequency bioelectrical impedance), RMR (handheld calorimetry), and HRQOL (RAND-36). Physical (PCS) and mental (MCS) composite scores were calculated for the RAND-36. Pearson correlations were used to identify relationships between RMR, body composition, and HRQOL. Variables at the p < .01 level were entered into multiple regression models. RESULTS Median body mass index was 26.1 [IQR: 23.2-30.9] kg/m2 and median lean mass index was 16.1 [IQR: 14.6-17.3] kg/m2. Body composition consisted of fat mass (median 27.2 [IQR: 20.3-34.7] kg) and lean mass (median 42.7 [IQR: 38.2-46.9] kg). Median RMR was 1165.0 [IQR: 1022.5-1380.0] kcal/day. Median HRQOL scores were PCS (84.0 [IQR: 74.0-93.0]) and MCS (85.0 [IQR: 74.3-90.0]). RMR was not directly related to PCS, but was directly and negatively related to MCS (p = .002). RMR was significantly and positively related to body composition (lean mass: p < .001; fat mass: p < .001), body mass index (p = .005), and lean mass index (p < .001); but only fat mass (PCS: p < .001; MCS: p < .001) and body mass index (PCS: p < .001; MCS: p < .001) were related to HRQOL, although the relationship was negative. In addition, age was found to be significantly negatively related to RMR (p < .001) and PCS (p = .003). Regression models confirmed the moderating influence of age and body composition on the relationship between RMR and HRQOL. RMR, age, fat mass, and body mass index explained 24% (p < .001) of variance in PCS; and RMR, fat mass, and body mass index explained 15% (p < .001) of variance in MCS. CONCLUSION In women, the relationship between RMR and HRQOL is moderated by age and body composition. Understanding these pathways will allow clinicians and researchers to direct interventions more effectively.
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Affiliation(s)
- Melissa J Benton
- Department of Nursing, University of Colorado Colorado Springs, Colorado Springs, CO, USA.
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO, 80918, USA.
| | - Andrea M Hutchins
- Department of Human Physiology & Nutrition, University of Colorado Colorado Springs, Colorado Springs, CO, USA
- Helen & Arthur E. Johnson Beth-El College of Nursing & Health Sciences, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO, 80918, USA
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Cherrington AL, Tripputi MT, Younes N, Herman WH, Katona A, Groessl EJ, Craig J, Gonzalez JS, Garg R, Casula S, Kuo S, Florez HJ. Impact of Glucose-Lowering Medications on Health-Related Quality of Life in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care 2024; 47:603-609. [PMID: 38190625 PMCID: PMC10973906 DOI: 10.2337/dc23-1648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/26/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Diabetes is associated with reduced health-related quality of life (HRQoL). Information on the relationship between HRQoL and glucose-lowering medications in recently diagnosed type 2 diabetes (T2D) is limited. We assessed changes in HRQoL in participants with T2D receiving metformin plus one of four glucose-lowering medications in Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). RESEARCH DESIGN AND METHODS A total of 5,047 participants, baseline mean age 57 years, with <10 years T2D duration and glycated hemoglobin level 6.8-8.5% and taking metformin monotherapy, were randomly assigned to glargine, glimepiride, liraglutide, or sitagliptin. HRQoL was evaluated at baseline for 4,885 participants, and at years 1, 2, and 3, with use of the self-administered version of the Quality of Well-being Scale (QWB-SA) and SF-36 physical (PCS) and mental (MCS) component summary scales. Linear models were used to analyze changes in HRQoL over time in intention-to-treat analyses. RESULTS None of the medications worsened HRQoL. There were no differences in QWB-SA or MCS by treatment group at any time point. PCS scores improved with liraglutide versus other groups at year 1 only. Greater weight loss during year 1 explained half the improvement in PCS scores with liraglutide versus glargine and glimepiride. Liraglutide participants in the upper tertile of baseline BMI showed the greatest improvement in PCS scores at year 1. CONCLUSIONS Adding liraglutide to metformin in participants within 10 years of T2D diagnosis showed improvement in the SF-36 PCS in comparisons with the other medications at 1 year, which was no longer significant at years 2 and 3. Improvement was related to weight loss and baseline BMI.
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Affiliation(s)
- Andrea L. Cherrington
- Divisions of Preventive and General Internal Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Mark T. Tripputi
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Naji Younes
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - William H. Herman
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Aimee Katona
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Erik J. Groessl
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA
| | | | - Jeffrey S. Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Endocrinology, Department of Medicine, and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Rajesh Garg
- Department of Medicine, University of Miami, Miami, FL
| | - Sabina Casula
- Endocrinology, Diabetes, and Metabolism, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL
| | - Shihchen Kuo
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Hermes J. Florez
- Department of Medicine, University of Miami, Miami, FL
- Geriatric Research, Education, and Clinical Center, Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL
- Medical University of South Carolina, Charleston, SC
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19
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Lovan P, Saez-Clarke E, Graefe B, Messiah SE, Prado G. Parent childhood experiences, parenting strategies, and youth health-related outcomes in Hispanic families with unhealthy weight: An intergenerational study. Eat Behav 2024; 53:101870. [PMID: 38460202 PMCID: PMC11144088 DOI: 10.1016/j.eatbeh.2024.101870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/06/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
We aimed to examine whether (a) parents' childhood family mealtime experiences (CFM) (e.g., mealtime communication-based stress) and parents' socio-demographic characteristics (e.g., education level) predict parents' health-related parenting strategies (e.g., discipline), (b) health-related parenting strategies for eating and physical activity predict youth's health-related outcomes (e.g., dietary intake), (c) parenting strategies mediate the relationship between CFM and youth outcomes. A path model was used to examine the above-mentioned relationships. Data were obtained from the baseline assessment of a randomized clinical trial evaluating the efficacy of a family-based intervention to promote quality diet and increase physical activity. Participants were 280 Hispanic youth (52.1 % female, Mage = 13.01 ± 0.83) with unhealthy weight (MBody Mass Index %tile = 94.55 ± 4.15) and their parents (88.2 % female, Mage = 41.87 ± 6.49). Results indicated that childhood mealtime communication-based stress and mealtime structure were positively associated with control. Appearance weight control was positively associated with monitoring, discipline, limit-setting, and reinforcement. Parental mealtime control had positive associations with discipline, control, and limit-setting. Emphasis on mother's weight was positively associated with reinforcement. We also found positive associations between parental monitoring and youth's physical QOL and between parental discipline and fruits and vegetables intake. No mediating effect was found. Findings demonstrated significant effects of parents' childhood experience on parenting strategies, which in turn was associated with the youths' health-related outcomes. These results suggest the intergenerational effects of parent's childhood experience on their youth's health-related outcomes.
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Affiliation(s)
- Padideh Lovan
- School of Nursing and Health Studies, University of Miami, Miami, FL 33146, United States; Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33146, United States.
| | - Estefany Saez-Clarke
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL 33146, United States; Department of Psychology, University of Miami, Miami, FL 33146, United States.
| | - Beck Graefe
- Department of Educational and Psychological Studies, University of Miami, Miami, FL 33146, United States.
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Science, The University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX 75207, United States; Center for Pediatric Population Health, University of Texas Health Science Center, School of Public Health, Dallas, TX 75207, United States; Department of Pediatrics, McGovern Medical School, Houston, TX 77030, United States.
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Miami, FL 33146, United States.
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Kouba I, Del Pozzo J, Lesser ML, Shahani D, Gulersen M, Bracero LA, Blitz MJ. Socioeconomic and clinical factors associated with excessive gestational weight gain. Arch Gynecol Obstet 2024; 309:1295-1303. [PMID: 36930325 PMCID: PMC10021048 DOI: 10.1007/s00404-023-07000-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Excessive gestational weight gain (EGWG) is associated with adverse maternal and offspring outcomes but efforts to identify women at high risk for EGWG have been limited. The objective of this study is to identify socioeconomic and clinical factors associated with EGWG. METHODS This retrospective cohort included pregnant patients who delivered live, term, singleton newborns between January 2018 and February 2020 at seven hospitals within a large health system in New York. Patients were stratified by pre-pregnancy body mass index and then classified based on whether they exceeded the Institute of Medicine guidelines for gestational weight gain (GWG) and whether they gained more than 50 pounds in pregnancy. RESULTS A total of 44,872 subjects were included for analysis: 48% had EGWG and 17% had GWG exceeding 50 pounds. Patients with EGWG were more likely to be Black race, English speakers, overweight or obese pre-pregnancy, and have a mood disorder diagnosis. Patients who were underweight, multiparous, and those with gestational diabetes were less likely to have EGWG. CONCLUSION Sociodemographic and clinical findings associated with GWG > 50 pounds were similar but only overweight and not obese patients were at increased risk. Patients at risk for EGWG may benefit from early nutrition counseling and education on lifestyle changes.
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Affiliation(s)
- Insaf Kouba
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
- Division of Maternal-Fetal Medicine, South Shore University Hospital, 376 E Main St, Suite 202, Bay Shore, NY, 11706, USA.
| | - Jaclyn Del Pozzo
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Martin L Lesser
- Biostatistics Unit, Office of Academic Affairs, New Hyde Park, NY, USA
| | - Disha Shahani
- Biostatistics Unit, Office of Academic Affairs, New Hyde Park, NY, USA
| | - Moti Gulersen
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Luis A Bracero
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Matthew J Blitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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21
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Jeong SM, Jung JH, Yang YS, Kim W, Cho IY, Lee YB, Park KY, Nam GE, Han K. 2023 Obesity Fact Sheet: Prevalence of Obesity and Abdominal Obesity in Adults, Adolescents, and Children in Korea from 2012 to 2021. J Obes Metab Syndr 2024; 33:27-35. [PMID: 38531533 PMCID: PMC11000515 DOI: 10.7570/jomes24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 03/28/2024] Open
Abstract
Background The 2023 Obesity Fact Sheet aims to present an updated overview of obesity prevalence across all age groups, including children and adolescents. Methods This study included individuals aged ≥20 years (n=16,941,423 in 2021) who underwent health checkups provided by the Korean National Health Insurance Service between 2012 and 2021. The prevalence of obesity and abdominal obesity was standardized by age and sex using data from the 2010 population and housing census. For children and adolescents (6 to 18 years) (n=884 in 2021), we used the Korea National Health and Nutrition Examination Survey (2012 to 2021), and obesity was defined by the corresponding sex- and age-specific body mass index percentile of 95th or greater based on the 2017 Korean National Growth Chart for Children and Adolescents. Results The overall prevalence of obesity in 2021 is 38.4% (49.2% in men and 27.8% in women), which is a 1.27-fold increase from 30.2% in 2012. The prevalence of obesity has increased across all age groups, particularly among those aged 20, 30, and 80 years. The prevalence of class III obesity substantially increased from 0.35% (men) and 0.42% (women) in 2012 to 1.21% and 0.97% in 2021, with 3.46- and 2.31-fold increases, respectively. This increase was particularly pronounced in young adults. The prevalence of obesity in children and adolescents has surged from 9.7% in 2012 to 19.3% in 2021, with a greater increase among boys. Conclusion Our study provides information on the current status of obesity prevalence based on the 2023 Obesity Fact Sheet, emphasizing the urgency of implementing timely strategies to reverse this increasing trend.
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Affiliation(s)
- Su-Min Jeong
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Family Medicine, Seoul National University Health Service Center, Seoul, Korea
| | - Jin-Hyung Jung
- Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Ye Seul Yang
- Department of Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Wonsock Kim
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - In Young Cho
- Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
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22
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Grant D, Smith J, Bottoms L. Assessing the role of biomarker feedback in a 12-week community weight management programme among overweight men: A pilot study. PLoS One 2024; 19:e0299636. [PMID: 38547224 PMCID: PMC10977703 DOI: 10.1371/journal.pone.0299636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/10/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The primary objective of this study was to examine the feasibility of recruitment, retention, and delivery of biomarker feedback among men partaking in Shape Up, a physical activity for health programme. Secondarily, it explored the potential effects of biomarker feedback on participants' adherence and motivation levels. METHODS In this two-arm non-randomised pilot study, 46 men (mean±SD age 46.0±8.6 years) participating in the 12-week Shape Up programme were assigned to a control group or biomarker feedback group. Biomarker feedback consisted of 3 blood test panels: at baseline, 12 weeks, and 24 weeks (follow-up), each with a doctor's report. Both groups completed questionnaires (Short Active Lives Survey [SALS], Treatment Self-Regulation Questionnaire [TSRQ], and EQ-5D-5L) to gauge levels of motivation and engagement. The mean difference was calculated between baseline and programme end. Recruitment, retention, and attendance rates were determined. RESULTS Mean recruitment (approach-to-consent), retention, and attendance rates were 96.3%, 92.3%, and 83.7% in the control group, and 85.2%, 86.2%, and 81.5% in the biomarker feedback group, respectively. Of biomarker feedback group participants, 86.4% attended their 12-week blood test and 45.5% attended their follow-up blood test. The mean 12-week differences (95% CI) for the control group and biomarker feedback group were 138.1 (2.7, 273.5) and 467.3 (249.4, 685.2) for active minutes per week, 0.2 (-0.8, 1.2) and 0.4 (0.0, 0.8) for autonomous TSRQ domains, 0.2 (-0.3, 0.8) and 0.8 (0.1, 1.4) for controlled TSRQ domains, and 19 (12.7, 26.5) and 27.2 (19.8, 34.6) for EQ-5D-5L scores, respectively. CONCLUSION Biomarker feedback was well-received by participants and deemed feasible, with high recruitment and retention rates for the duration of the 12-week programme. Biomarker feedback may affect aspects of motivation but did not appear to influence adherence to the programme. Biomarker data may provide additional evidence of programme efficacy. Important design considerations are provided for definitive larger-scale trials.
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Affiliation(s)
- Daniel Grant
- Medichecks, Ranch House, Chapel Lane, Bingham, Nottingham, United Kingdom
| | - Joshua Smith
- Medichecks, Ranch House, Chapel Lane, Bingham, Nottingham, United Kingdom
| | - Lindsay Bottoms
- Centre for Research in Psychology and Sport Sciences, University of Hertfordshire, Hatfield, United Kingdom
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23
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Al Ali RE, Alrowaishd SA, Abu Thyab EZ, Almarzuqi RK, Al Awaji MI, Aldhahi MI, Ibrahim ZM. Enhancing the quality of life for physical therapists: insights from a cross-sectional study. Front Public Health 2024; 12:1286727. [PMID: 38566797 PMCID: PMC10986363 DOI: 10.3389/fpubh.2024.1286727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
Background Physical Therapy profession is known for its demanding physical requirements. This increases the risk of attrition and work-related accidents and disorders that affect physical therapists' quality of life and work performance. This study aimed to evaluate the effect of physical activity level and other contributing factors on quality of life of physical therapists. Methods A cross-sectional study was conducted among practicing physical therapists (n = 258). The International Physical Activity Questionnaires-Short Form was used to measure physical activity levels and the World Health Organization Quality of Life Questionnaire short form was used to measure the quality of life among physical therapists. Data was collected through a self-administered online survey using Microsoft Forms. Results The eligible participants were 258 out of 297. The highest percentage of physical therapists had a moderate physical activity level (45.35%) and the median for overall quality of life score was 63.27(52.73-73.59). There was a significant positive correlation between physical activity and age with overall quality of life score (rs = 0.41, p < 0.001; rs = 0.13, p < 0.036) respectively and a significant negative correlation between body mass index and overall quality of life score (rs = -0.13, p < 0.04). Conclusion The results obtained revealed that physical therapists mostly have moderate physical activity level and relatively good perceived quality of Life. Furthermore, our study identified significant correlations between physical activity, age, body mass index, and the overall quality of life among practicing physical therapists.
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Affiliation(s)
- Rahaf Eid Al Ali
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Sahab A. Alrowaishd
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Elaf Z. Abu Thyab
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Raghad K. Almarzuqi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Manal I. Al Awaji
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Lad SU, Sinopoli J, Khong B, Conroy B, Perzynski AT, Del Rincon JP. Clinical and sociodemographic characteristics as predictors for quality of life in transmasculine and transfeminine individuals receiving gender-affirming hormone therapy. Soc Sci Med 2024:116734. [PMID: 38490912 DOI: 10.1016/j.socscimed.2024.116734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/17/2024]
Abstract
Healthcare systems and providers have increasingly acknowledged the role and impact of social determinants in overall health. However, gender-diverse individuals face persistent health disparities due to their identities. There is limited research on the impact of clinical and sociodemographic characteristics on mood and quality of life (QoL) for transgender (TG) individuals. Our study aims to understand and better elucidate social and clinical characteristics of transmasculine (TM) and transfeminine (TF) individuals and their impact on quality of life and depressive symptoms. In this cross-sectional study, 298 TF and TM individuals on gender-affirming hormone therapy (GAHT) were surveyed about their demographic characteristics (age, gender identity, body mass index (BMI), and education), social needs, mood, and quality of life. Multivariable regression modelling was performed to assess the effect of each variable listed above on three domains of QoL (psychological, environmental, and physical) as well as depressive symptoms. We find that QoL scores are similar between TM and TF individuals, with scores in the psychological domain particularly low in both cohorts. TM individuals report higher rates of stress and restroom avoidance than TF individuals. In particular, psychological well-being (measured by the psychological domain of QoL and depressive symptoms) is significantly associated with increased BMI, financial instability, and stress in TM individuals while for TF individuals, psychological well-being is associated with stress and social integration. These data suggest that social circumstances are key drivers of QoL and psychological well-being among gender-diverse individuals receiving GAHT with specific differences between TF and TM individuals. This information may be utilized by healthcare providers and policymakers to address and improve clinical care and social policies to improve health equity for gender-diverse individuals.
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Affiliation(s)
- Saloni U Lad
- Cleveland Clinic Lerner College of Medicine, 9501 Euclid Ave., Cleveland, OH, 44195, USA.
| | - Jacob Sinopoli
- The Chester Summer Scholars Program, MetroHealth Medical System, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA; Case Western Reserve University, Cleveland, OH, USA.
| | - Brian Khong
- Department of Medicine, MetroHealth System, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
| | - Britt Conroy
- Case Western Reserve University, Cleveland, OH, USA; Department of Urology and Family Medicine & Community Health, University Hospitals Cleveland Medical Center, 11100 Euclid Ave., Cleveland, OH, 44106, USA.
| | - Adam T Perzynski
- Center for Healthcare Research and Policy, Case Western Reserve University at MetroHealth, 10900 Euclid Ave., Cleveland, OH, 44106, USA.
| | - Juan P Del Rincon
- Case Western Reserve University, Cleveland, OH, USA; Department of Medicine, MetroHealth System, Cleveland, OH, USA; Endocrinology and Metabolism Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA.
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25
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Obi-Nwosu AL, Nwosu BO, Ezemenahi SI, Obi-Nwosu DI, Nwosu CS, Azudialu BC, Ojiakor CS, Umeh UM, Izuchukwu EC, Ofiaeli CI, Ulochukwu CM. Anthropometric Predictors of Health-Related Quality of Life in Obese Patients Attending a Tertiary Hospital in Nnewi, South-East Nigeria: A Cross-Sectional Study. Niger J Clin Pract 2024; 27:376-382. [PMID: 38528359 DOI: 10.4103/njcp.njcp_396_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/07/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Obesity as a disorder with excess body fat directly decreases quality of life. While Body Mass Index (BMI) has been used largely in health studies as a measure of obesity, it is largely unable to differentiate between body fat and lean body mass, hence other anthropometric measures can be used to assess body fat. OBJECTIVE To determine the association of anthropometric indicators with health-related quality of life (HRQoL) in obese adults. MATERIALS AND METHODS A cross-sectional study of obese adults (BMI ≥30kg/m2) attending the general outpatient clinic was conducted over four months. The quality of life was assessed using the short form-36 (SF-36) questionnaire. The anthropometric indicators used were BMI, waist circumference (WC), waist hip ratio (WHR), and waist-height ratio (WHtR). RESULTS Physical component summary (PCS) was significantly related to BMI, WHtR, and WC. After adjusting for co-variables (gender, age, occupation, and marital status), they remained significantly associated with PCS. Mental component summary (MCS) was significantly related to BMI, WHtR, and WC. After adjusting for the known determinants of HRQoL, only BMI remained significantly associated with MCS (P = -0.004; r = -0.146). When all the indicators were included in the same regression model, no anthropometric indicator was significantly related to MCS while only WHtR was significantly associated with PCS (P = 0.001; r = -0.465). CONCLUSION HRQoL in obese patients is related to measures of body fat. The physical and mental components of health-related quality of life are correlated differently with the various anthropometric measures of obesity. The WHtR was found to be an independent predictor of the physical component of HRQoL.
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Affiliation(s)
- Amaka L Obi-Nwosu
- Department of Family Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Betrand O Nwosu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Sylvia I Ezemenahi
- Department of Family Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Daniella I Obi-Nwosu
- Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Chinekwu S Nwosu
- Department of Radiology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Bede C Azudialu
- Department of Family Medicine, Federal Medical Centre Owerri, Imo State, Nigeria
| | - Chukwudi S Ojiakor
- Department of Anaesthesia, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Uche M Umeh
- Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka, Nigeria
| | - Emeka C Izuchukwu
- Department of Chemical Pathology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Chika I Ofiaeli
- Department of Family Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
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Mansour S, Alkhaaldi SMI, Sammanasunathan AF, Ibrahim S, Farhat J, Al-Omari B. Precision Nutrition Unveiled: Gene-Nutrient Interactions, Microbiota Dynamics, and Lifestyle Factors in Obesity Management. Nutrients 2024; 16:581. [PMID: 38474710 DOI: 10.3390/nu16050581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Obesity is a complex metabolic disorder that is associated with several diseases. Recently, precision nutrition (PN) has emerged as a tailored approach to provide individualised dietary recommendations. AIM This review discusses the major intrinsic and extrinsic components considered when applying PN during the management of obesity and common associated chronic conditions. RESULTS The review identified three main PN components: gene-nutrient interactions, intestinal microbiota, and lifestyle factors. Genetic makeup significantly contributes to inter-individual variations in dietary behaviours, with advanced genome sequencing and population genetics aiding in detecting gene variants associated with obesity. Additionally, PN-based host-microbiota evaluation emerges as an advanced therapeutic tool, impacting disease control and prevention. The gut microbiome's composition regulates diverse responses to nutritional recommendations. Several studies highlight PN's effectiveness in improving diet quality and enhancing adherence to physical activity among obese patients. PN is a key strategy for addressing obesity-related risk factors, encompassing dietary patterns, body weight, fat, blood lipids, glucose levels, and insulin resistance. CONCLUSION PN stands out as a feasible tool for effectively managing obesity, considering its ability to integrate genetic and lifestyle factors. The application of PN-based approaches not only improves current obesity conditions but also holds promise for preventing obesity and its associated complications in the long term.
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Affiliation(s)
- Samy Mansour
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Saif M I Alkhaaldi
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Ashwin F Sammanasunathan
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Saleh Ibrahim
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
- Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Joviana Farhat
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Basem Al-Omari
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi P.O. Box 127788, United Arab Emirates
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Nakanishi H, Mosleh KA, Al-Kordi M, Farsi S, Chaudhry S, Marrero K, Scott Davis S, Kermansaravi M, Parmar C, Clapp B, Ghanem OM. One Anastomosis Gastric Bypass as Revisional Surgery Following Sleeve Gastrectomy: A Systematic Review and Meta-Analysis. Obes Surg 2024; 34:429-441. [PMID: 38198098 DOI: 10.1007/s11695-024-07056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Although sleeve gastrectomy (SG) is the most performed metabolic and bariatric surgery (MBS) worldwide, some patients require conversional procedures due to weight recurrence or late complications. Recently, one-anastomosis gastric bypass (OAGB) gained popularity as a viable option to address those problems. The aim of this meta-analysis is to assess the safety and efficacy of conversional OAGB after primary SG in the management of patients with obesity. METHODS Cochrane, Embase, PubMed, Scopus, and Web of Science were searched for articles from their inception to February 2023 by two independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42023403528). RESULTS From 1,117 studies screened, twenty studies met the eligibility criteria, with a total of 1,057 patients with obesity undergoing conversional OAGB after primary SG. The mean age ranged from 28.2 to 49.5 years, and 744 patients (75.2%) were women. At one year after revisional OAGB, the pooled mean percent excess weight loss (%EWL) was 65.2% (95%CI: 56.9, 73.4, I2 = 97%). The pooled mean %EWL after conversional OAGB was 71.1% (95%CI: 62.2, 80.0, I2 = 90%) at two years and 71.6% (95%CI: 61.0, 82.2, I2 = 50%) at five years. Additionally, resolution rates of diabetes and hypertension were 65.4% (95%CI: 0.522, 0.785, I2 = 65%) and 58.9% (95%CI: 0.415, 0.762, I2 = 89%), respectively. CONCLUSIONS Our meta-analysis demonstrated OAGB as an effective conversional procedure after primary SG in terms of weight loss and obesity-associated medical problems for selected patients. Despite the promising results, further randomized controlled studies with larger sample sizes and more extended follow-up periods are necessary to determine if the OAGB is the best conversional surgery after SG.
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Affiliation(s)
- Hayato Nakanishi
- St George's University of London, London, SW17 0RE, UK
- University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus
| | | | | | - Soroush Farsi
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Shahrukh Chaudhry
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Katie Marrero
- Carle Foundation Hospital General Surgery Residency, Champaign, IL, USA
| | - S Scott Davis
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital NHS Trust, London, UK
- University College London, London, UK
| | - Benjamin Clapp
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Omar M Ghanem
- Department of Surgery, Mayo Clinic, Rochester, MN, USA.
- Division of Metabolic and Abdominal Wall Reconstructive Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
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Rokhman MR, Arifin B, Broggi B, Verhaar AF, Zulkarnain Z, Satibi S, Perwitasari DA, Boersma C, Cao Q, Postma MJ, van der Schans J. Impaired health-related quality of life due to elevated risk of developing diabetes: A cross-sectional study in Indonesia. PLoS One 2023; 18:e0295934. [PMID: 38117810 PMCID: PMC10732360 DOI: 10.1371/journal.pone.0295934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/04/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND This study investigated the association between elevated risk of developing diabetes and impaired health-related quality of life (HRQoL) in the Indonesian population. METHODS A cross-sectional study was conducted on 1,336 Indonesians from the general population who had no previous diagnosis of diabetes. Utility score to represent HRQoL was measured using the EuroQol 5-dimension, while the risk for developing diabetes was determined using the Finnish Diabetes Risk Score (FINDRISC) instrument. All participants underwent a blood glucose test after fasting for 8 hours. The association between FINDRISC score and HRQoL adjusted for covariates was analysed using multivariate Tobit regression models. Minimal clinically important differences were used to facilitate interpretation of minimal changes in utility score that could be observed. RESULTS The median (interquartile range) of the overall FINDRISC score was 6 (7), while the mean (95% confidence intervals) of the EQ-5D utility score was 0.93 (0.93-0.94). Once adjusted for clinical parameters and socio-demographic characteristics, participants with a higher FINDRISC score showed a significantly lower HRQoL. No significant association was detected between fasting blood glucose level categories and HRQoL. A difference of 4-5 points in the FINDRISC score was considered to reflect meaningful change in HRQoL in clinical practice. CONCLUSION An elevated risk of developing diabetes is associated with a lower HRQoL. Therefore, attention should be paid not only to patients who have already been diagnosed with diabetes, but also to members of the general population who demonstrate an elevated risk of developing diabetes. This approach will assist in preventing the onset of diabetes and any further deterioration of HRQoL in this segment of the Indonesian population.
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Affiliation(s)
- M. Rifqi Rokhman
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Institute of Science in Healthy Ageing & HealthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bustanul Arifin
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Pharmacy, Universitas Hasanuddin, Makassar, Indonesia
- Disease Prevention and Control Division, Banggai Laut Regency Health, Population Control and Family Planning Service, Central Sulawesi, Indonesia
- Unit of Pharmaco Therapy, Epidemiology and Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Benedetta Broggi
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne-Fleur Verhaar
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Zulkarnain Zulkarnain
- Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Thyroid Center, Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | - Satibi Satibi
- Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Cornelis Boersma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Management Sciences, Open University, Heerlen, The Netherlands
| | - Qi Cao
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maarten J. Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Institute of Science in Healthy Ageing & HealthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Unit of Pharmaco Therapy, Epidemiology and Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Jurjen van der Schans
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
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Chantzaras A, Yfantopoulos J. Association between medication adherence and health-related quality of life of patients with hypertension and dyslipidemia. Hormones (Athens) 2023; 22:665-676. [PMID: 37493942 DOI: 10.1007/s42000-023-00471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE Τo evaluate the association between medication adherence and health-related quality of life (HRQoL) of patients with hypertension and dyslipidemia in Greece. METHODS In a multicenter, cross-sectional, non-interventional study, a total of 721 hypertensive and 463 dyslipidemic adult outpatient patients were recruited during the COVID-19 pandemic using consecutive sampling. The EQ-5D-5L instrument was used to measure HRQoL, and medication adherence was assessed with the Adherence Starts with Knowledge 20 questionnaire. Multiple linear stepwise regressions using robust standard errors were employed. RESULTS Approximately 28% of hypertensive and 16% of dyslipidemic patients had not been fully adherent during the previous week, while the estimates were 49 and 34%, respectively when the previous month was considered. The HRQoL domain with the highest prevalence of problems was anxiety/depression, followed by mobility and usual activities for both conditions; HRQoL was lower in dyslipidemic patients. Higher medication non-adherence was independently associated with lower EQ-VAS in hypertension and a lower EQ-5D index in dyslipidemia. Other significant risk factors of impaired HRQoL and general health were lack of exercise, longer duration of disease, and multimorbidity, while a curvilinear effect of BMI and age was observed. Also, female gender, employment, and marriage worked as protective factors for hypertensive patients and education for dyslipidemic participants. CONCLUSION Medication adherence is suboptimal in patients with hypertension and, in particular, with dyslipidemia in Greece. Moreover, poor medication adherence has a detrimental impact on patients' HRQoL. Therefore, improving treatment outcomes and patients' HRQoL in a sustainable way requires a better understanding of the factors influencing medication adherence.
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Affiliation(s)
- Athanasios Chantzaras
- National and Kapodistrian University of Athens MBA, Sofokleous 1 & Aristeidou Str., 105 59, Athens, Greece.
| | - John Yfantopoulos
- National and Kapodistrian University of Athens MBA, Sofokleous 1 & Aristeidou Str., 105 59, Athens, Greece
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30
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Obekpa EO, McCurdy SA, Schick V, Markham CM, Gallardo KR, Wilkerson JM. Health-related quality of life and recovery capital among recovery residents taking medication for opioid use disorder in Texas. Front Public Health 2023; 11:1284192. [PMID: 38054070 PMCID: PMC10694473 DOI: 10.3389/fpubh.2023.1284192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Background Recovery from opioid use disorder (OUD) includes improvements in health-related quality of life (HRQOL) and is supported by recovery capital (RC). Little is known about RC and HRQOL among recovery residents taking medication for OUD. We described HRQOL and RC and identified predictors of HRQOL. Methods Project HOMES is an ongoing longitudinal study implemented in 14 recovery homes in Texas. This is a cross-sectional analysis of data from 358 participants' on HRQOL (five EQ-5D-5L dimensions-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and RC (Assessment of Recovery Capital scores) collected from April 2021 to June 2023. Statistical analyses were conducted using T-, Chi-squared, and Fisher's exact tests. Results Most participants were 35 years/older (50.7%), male (58.9%), non-Hispanic White (68.4%), heterosexual (82.8%), and reported HRQOL problems, mainly anxiety/depression (78.4%) and pain/discomfort (55.7%). Participants who were 35 years/older [mean (SD) = 42.6 (7.3)] were more likely to report mobility and pain/discomfort problems than younger participants. Female participants were more likely to report pain/discomfort problems than male participants. Sexual minorities were more likely to report anxiety/depression problems than heterosexual participants. Married participants and those in committed relationships were more likely to report problems conducting self-care than single/never-married participants. Comorbid conditions were associated with mobility, pain/discomfort, and usual activities problems. Most participants reported high social (65.4%), personal (69.0%), and total (65.6%) RC. Low personal RC was associated with mobility (aOR = 0.43, CI = 0.24-0.76), self-care (aOR = 0.13, CI = 0.04-0.41), usual activities (aOR = 0.25, CI = 0.11-0.57), pain/discomfort (aOR = 0.37, CI = 0.20-0.68), and anxiety/depression (aOR = 0.33, CI = 0.15-0.73) problems. Low total RC was associated with problems conducting self-care (aOR = 0.20, CI = 0.07-0.60), usual activities (aOR = 0.43, CI = 0.22-0.83), pain/discomfort problems (aOR = 0.55, CI = 0.34-0.90), and anxiety/depression (aOR = 0.20, CI = 0.10-0.41) problems. Social RC was not associated with HRQOL. Conclusion Personal and total RC and comorbid conditions predict HRQOL. Although the opioid crisis and the increasing prevalence of comorbidities have been described as epidemics, they are currently being addressed as separate public health issues. Our findings underscore the importance of ensuring residents are provided with interprofessional care to reduce the burden of comorbidities, which can negatively impact their OUD recovery. Their RC should be routinely assessed and enhanced to support their recovery and improve HRQOL.
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Affiliation(s)
- Elizabeth O. Obekpa
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Sheryl A. McCurdy
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Vanessa Schick
- Department of Management, Policy, and Community Health, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Christine M. Markham
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Kathryn R. Gallardo
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
| | - Johnny Michael Wilkerson
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center Houston, School of Public Health, Houston, TX, United States
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Cheng Q, Bajis S, Cunningham E, Shih STF, Schulz M, Marshall AD, Martin NK, Miners A, Hajarizadeh B, Wiseman V, Dore GJ, Grebely J. Health-related quality of life among people who inject drugs in Australia. Qual Life Res 2023; 32:3195-3207. [PMID: 37351701 PMCID: PMC10522523 DOI: 10.1007/s11136-023-03465-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE There is limited research on health-related quality of life (HRQoL) among people who inject drugs (PWID). We aimed to evaluate factors associated with HRQoL among a cohort of PWID in Australia. METHODS Participants were enrolled in an observational cohort study (the LiveRLife Study) between 2014 and 2018 at 15 sites in Australia. They provided fingerstick whole-blood samples for point-of-care HCV RNA testing and underwent transient elastography to assess liver disease. Participants completed the EQ-5D-3L survey at enrolment. Regression models were used to assess the impact of clinical and socioeconomic characteristics on the EQ-5D-3L scores. RESULTS Among 751 participants (median age, 43 years; 67% male), 63% reported injection drug use in the past month, 43% had current HCV infection, and 68% had no/mild liver fibrosis (F0/F1). The mean EQ-5D-3L and EQ-VAS scores were 0.67 and 62, respectively, for the overall study population. There was no significant difference in the EQ-5D-3L scores among people with and without recent injecting drug use (mean: 0.66 vs. 0.68, median: 0.73 vs. 0.78, P = 0.405), and among people receiving and not receiving opioid agonist therapy (mean: 0.66 vs. 0.68, median: 0.73 vs. 0.76, P = 0.215). Participants who were employed were found to have the highest mean EQ-5D-3L (0.83) and EQ-VAS scores (77). The presence of current HCV infection, liver fibrosis stage, and high-risk alcohol consumption had little impact on HRQoL. CONCLUSIONS The study findings provide important HRQoL data for economic evaluations, useful for guiding the allocation of resources for HCV elimination strategies and interventions among PWID.
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Affiliation(s)
- Qinglu Cheng
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia.
| | - Sahar Bajis
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Evan Cunningham
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Sophy T F Shih
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Marcel Schulz
- St Vincent's Clinical School, UNSW Medicine, Sydney, NSW, Australia
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Alison D Marshall
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Alec Miners
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Behzad Hajarizadeh
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Virginia Wiseman
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
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Kelly J, Menon V, O'Neill F, Elliot L, Combe E, Drinkwater W, Abbott S, Hayee B. UK cost-effectiveness analysis of endoscopic sleeve gastroplasty versus lifestyle modification alone for adults with class II obesity. Int J Obes (Lond) 2023; 47:1161-1170. [PMID: 37674032 PMCID: PMC10599990 DOI: 10.1038/s41366-023-01374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure that has been demonstrated in the MERIT randomised, controlled trial to result in substantial and durable additional weight loss in adults with obesity compared with lifestyle modification (LM) alone. We sought to conduct the first cost-effectiveness analysis of ESG versus LM alone in adults with class II obesity (BMI 35.0-39.9 kg/m2) from a national healthcare system perspective in England based on results from this study. METHODS A 6-state Markov model was developed comprising 5 BMI-based health states and an absorbing death state. Baseline characteristics, utilities, and transition probabilities were informed by patient-level data from the subset of patients with class II obesity in MERIT. Adverse events (AEs) were based on the MERIT safety population. Mortality was estimated by applying BMI-specific hazard ratios from the published literature to UK general population mortality rates. Utilities for the healthy weight and overweight health states were informed from the literature; disutility associated with increasing BMI in the class I-III obesity health states was estimated using MERIT utility data. Disutility due to AEs and the prevalence of obesity-related comorbidities were based on the literature. Costs included intervention costs, AE costs, and comorbidity costs. RESULTS ESG resulted in higher overall costs than LM alone but led to an increase in quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) for ESG vs LM alone was £2453/QALY gained. ESG was consistently cost effective across a wide range of sensitivity analyses, with no ICER estimate exceeding £10,000/QALY gained. In probabilistic sensitivity analysis, the mean ICER was £2502/QALY gained and ESG remained cost effective in 98.25% of iterations at a willingness-to-pay threshold of £20,000/QALY. CONCLUSION Our study indicates that ESG is highly cost effective versus LM alone for the treatment of adults with class II obesity in England.
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Affiliation(s)
- Jamie Kelly
- University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Vinod Menon
- University Hospitals Coventry & Warwickshire NHS Foundation Trust, Coventry, UK
- University of Warwick, Coventry, UK
| | | | | | | | | | - Sally Abbott
- University Hospitals Coventry & Warwickshire NHS Foundation Trust, Coventry, UK
- Research Centre for Healthcare and Communities, Institute of Health and Wellbeing, Coventry University, Coventry, UK
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Mumena WA, Owaidhah LH, Alsaadi RA, Aljuhani NM, Almehmadi LS, Kutbi HA. Behaviors Related to Limiting Fat Intake among Young Adults in Saudi Arabia. Nutrients 2023; 15:4540. [PMID: 37960193 PMCID: PMC10649438 DOI: 10.3390/nu15214540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Young adults tend to frequently consume foods that are high in fat. Efforts to limit the consumption of fat among the Saudi population have been initiated; however, data concerning current behaviors related to limiting fat intake are lacking. We aimed to explore behaviors related to limiting fat intake and to investigate the association with fat intake among young adults in Saudi Arabia. In this cross-sectional study, a total of 305 students aged ≥19 years were recruited from Taibah University, Madinah. Face-to-face interviews were conducted to collect data concerning sociodemographic status, behaviors related to limiting fat intake, and fat intake. The median score of behaviors related to limiting fat intake was significantly higher among females and supplement users compared to other groups. Healthy weight, overweight, and obese students reported a significantly higher score of behaviors related to limiting fat intake, compared to underweight students. Males who reported making an effort to limit the consumption of fatty foods consumed less total fat, saturated fat, monounsaturated fat, and polyunsaturated fat, while those who reported reading the nutrition fact labels of food products consumed more polyunsaturated fat. Females who reported reading nutrition fact labels consumed less saturated fat. Efforts to limit fat intake have been noted especially among females; however, these efforts were not linked to fat intake among young adults in Saudi Arabia.
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Affiliation(s)
- Walaa Abdullah Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah 42353, Saudi Arabia
| | - Lamar Haitham Owaidhah
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah 42353, Saudi Arabia
| | - Ruba Abdulrahman Alsaadi
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah 42353, Saudi Arabia
| | - Nada Mohammed Aljuhani
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah 42353, Saudi Arabia
| | - Laila Sulaiman Almehmadi
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, P.O. Box 344, Madinah 42353, Saudi Arabia
| | - Hebah Alawi Kutbi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah 21589, Saudi Arabia;
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Vetrani C, Verde L, Colao A, Barrea L, Muscogiuri G. The Mediterranean Diet: Effects on Insulin Resistance and Secretion in Individuals with Overweight or Obesity. Nutrients 2023; 15:4524. [PMID: 37960178 PMCID: PMC10648830 DOI: 10.3390/nu15214524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
High adherence to the Mediterranean Diet (MD) is associated with a lower risk of type 2 diabetes. However, it is less clear whether the different MD food items might influence specific biological functions related to glucose tolerance, i.e., insulin resistance (IR) and/or secretion (IS). Thus, this cross-sectional study aimed to investigate the relationship between adherence to MD and IR, insulin sensitivity, and IS in individuals with overweight/obesity. Participants (62 individuals; 7M/55F; mean age 49 ± 15 years; mean BMI 35.8 ± 6.7 kg/m²) underwent a 75 g oral glucose tolerance test (OGTT) to assess plasma glucose and insulin concentrations. These parameters were used for the calculation of validated IR indices (Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), Homeostatic Model Assessment for β-cell function (HOMA-β)), as well as insulin sensitivity indices (insulin sensitivity index (ISI), oral glucose insulin sensitivity (OGIS)). MD adherence was gauged using the PREDIMED questionnaire. Bivariate correlations were used to highlight the association between OGTT-derived indices and MD adherence (PREDIMED score) or specific foodstuffs related to MD. Despite there being no significant differences in BMI, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT), the high MD adherence group presented lower HOMA-IR (p = 0.022) and higher ISI (p = 0.033) compared to other groups. High MD adherence was inversely correlated with HOMA-IR (r = -0.400; p = 0.004) and directly correlated with ISI (r = 0.296, p = 0.039). Fish consumption, a key component of MD, exhibited significant associations: it was directly correlated to ISI (r = 0.394, p = 0.005) and inversely related to HOMA-IR (r = -0.327, p = 0.019) and β-cell function (r = -0.489, p < 0.001). In conclusion, a high MD adherence, and in particular the consumption of fish, is associated with a decreased IR in individuals with overweight/obesity.
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Affiliation(s)
- Claudia Vetrani
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale, Via Porzio, Isola F2, 80143 Naples, Italy;
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples “Federico II”, 80131 Naples, Italy; (L.V.); (A.C.); (G.M.)
| | - Ludovica Verde
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples “Federico II”, 80131 Naples, Italy; (L.V.); (A.C.); (G.M.)
- Department of Public Health, University of Naples “Federico II”, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Annamaria Colao
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples “Federico II”, 80131 Naples, Italy; (L.V.); (A.C.); (G.M.)
- Dipartimento di Medicina Clinica e Chirurgia, Diabetologia ed Andrologia, Unità di Endocrinologia, Università Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione Alla Salute E Allo Sviluppo Sostenibile”, Università Federico II, 80131 Naples, Italy
| | - Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale, Via Porzio, Isola F2, 80143 Naples, Italy;
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples “Federico II”, 80131 Naples, Italy; (L.V.); (A.C.); (G.M.)
| | - Giovanna Muscogiuri
- Centro Italiano Per La Cura E Il Benessere del Paziente Con Obesità (C.I.B.O), University of Naples “Federico II”, 80131 Naples, Italy; (L.V.); (A.C.); (G.M.)
- Dipartimento di Medicina Clinica e Chirurgia, Diabetologia ed Andrologia, Unità di Endocrinologia, Università Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
- Cattedra Unesco “Educazione Alla Salute E Allo Sviluppo Sostenibile”, Università Federico II, 80131 Naples, Italy
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Alsannan B, Alharmi J, Alrahal F, Al Mansoor S, Tulandi T. Prevalence and Quality of Life among Overweight and Obese Women with Different Severity and Types of Urinary Incontinence. Med Princ Pract 2023; 33:47-55. [PMID: 37848009 PMCID: PMC10896612 DOI: 10.1159/000534651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/08/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Urinary incontinence (UI) is an involuntary leakage of urine and affects the social, physical, and psychological aspects of many individuals worldwide. The purpose of our study was to examine the prevalence, quality of life (QoL), severity, and different types of UI in overweight and obese women. METHODS We conducted a cross-sectional study of 1,351 consecutive patients, who were recruited between June 2021 and May 2022. RESULTS The mean age of the patients was 39.7 ± 14.2 years with less than a half in the 19-35-year age group (46.9%); 65% of the subjects were overweight or obese. The overall prevalence of UI was 61.2%. Overweight and obesity accounted to 70.2% of patients with mild to very severe UI. The risk estimates to have UI were 1.84 in overweight and 5.4 in obese group. The risk estimate for severe and very severe UI was 2.33 in overweight and 10.34 in obese group. When considering all subtypes, 67.9% of women with overweight and obesity had any of the subtypes, urge UI, stress UI, and mixed UI. Overweight and obesity were significantly associated with poor QoL in women with UI (p < 0.0001). Among 36.1% of all patients with poor QoL, 79.9% were overweight and obese. CONCLUSIONS Overweight and obesity are important risk factors of UI affecting daily activity and QOL considerably. As the number of people with obesity is increasing, the prevalence of UI with increased severity is likely to increase in young to mid-aged women. Weight loss should be considered as first-line treatment for this patient population.
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Affiliation(s)
- Baydaa Alsannan
- Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Jehad Alharmi
- Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | | | - Togas Tulandi
- Department of Obstetrics and Gynecology, Mcgill University, Montreal, QC, Canada
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Lin S, Cienfuegos S, Ezpeleta M, Pavlou V, Chakos K, McStay M, Runchey MC, Alexandria SJ, Varady KA. Effect of Time-Restricted Eating versus Daily Calorie Restriction on Mood and Quality of Life in Adults with Obesity. Nutrients 2023; 15:4313. [PMID: 37892388 PMCID: PMC10609268 DOI: 10.3390/nu15204313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
The purpose of this secondary analysis is to compare the effects of two popular weight loss regimens, time-restricted eating (TRE) and daily calorie restriction (CR), on mood and quality-of-life measures in adults with obesity. Ninety participants were randomized to one of three interventions for 12 months: 8 h TRE (eating only between 12:00 and 8:00 p.m., with no calorie counting); CR (25% energy restriction daily); or no-intervention control group. Questionnaires were administered to measure mood (Beck Depression Inventory-II (BDI-II), and Profile of Mood States (POMS)) and quality of life (Rand 36-Item Short Form) at baseline and month 12. Body weight decreased in the TRE group (-4.87%, 95%CI: -7.61, -2.13) and CR group (-5.30%, 95%CI: -9.06, -1.54) versus controls, with no difference between TRE and CR. The BDI-II depression score did not change in the TRE or CR group, versus controls, by month 12. Likewise, there were no changes in any of the POMS subscales (tension, depression, anger, fatigue, anger, confusion, or vigor) or the total mood disturbance score in the TRE or CR group versus controls. As for quality of life, there were no significant changes in the SF-36 constructs of mental health, bodily pain, and general physical health in the TRE or CR group versus controls. However, there was a trend towards increased vitality in the TRE group (7.77 [95% CI: 0.15, 15.39] p = 0.05) relative to controls. There were no associations between changes in body weight, physical activity, mood, and quality of life in any group by the end of the study. These findings suggest that TRE and CR produce similar degrees of weight loss, but impact neither mood nor quality of life in adults with obesity over 12 months. Future well-powered studies will be needed to confirm these findings.
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Affiliation(s)
- Shuhao Lin
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Sofia Cienfuegos
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Mark Ezpeleta
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Vasiliki Pavlou
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Kaitlin Chakos
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Mara McStay
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Mary-Claire Runchey
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
| | - Shaina J. Alexandria
- Department of Preventative Medicine (Biostatistics), Northwestern University, Chicago, IL 60612, USA
| | - Krista A. Varady
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 West Taylor Street, Room 532, Chicago, IL 60612, USA
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Shishehgar F, Tehrani FR, Vahidi S. The effects of weight loss on health-related quality of life in obese women with PCOS and controls. BMC Womens Health 2023; 23:532. [PMID: 37817138 PMCID: PMC10566153 DOI: 10.1186/s12905-023-02682-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complicated endocrine disorder with widespread symptoms that reduce women's quality of life. The adverse effect of associated obesity on this reduction is unclear, therefore the impact of weight loss on health-related quality of life (HRQOL) in obese women with PCOS is unknown. This study aimed to compare the impact of weight loss following a 24-week dietary intervention on HRQOL in obese women with and without PCOS. METHODS In a 24-week hypocaloric LGI (low glycemic index) diet intervention study, 286 women were recruited (140 PCOS, 146 controls) and 216 participants (PCOS = 105, non-PCOS = 111) completed the study. HRQOL was assessed using the SF-36 questionnaire (Short Form Health Survey). Physical activity was measured using the short form of the International Physical Activity Questionnaire (IPAQ). Anthropometric assessments, dietary intake, physical activity levels, and HRQOL scores, according to the Iranian version of SF-36, were compared at baseline and 24 weeks with intervention. RESULTS At the end of the intervention, there was no significant difference in the percentages of weight loss between the two groups (PCOS: 6.29 ± 3.32% vs. non-PCOS: 7 ± 3.62%, p = 0.1). At baseline, women with PCOS had lower mean scores in aspects of physical function (PF), general health perception (GH), role limitation due to emotional problem (RE), vitality (VT), mental health (MH), physical (PCS) and mental component summary scales (MCS), compared to non-PCOS (P < 0.01). At 24 weeks, the percentage of improvement in HRQOL in the non-PCOS group was higher compared to the PCOS group but this difference didn't reach statistical significance except for PCS. In both groups, greater weight loss was associated with further improvement in the physical aspects of HRQOL and vitality. In the non-PCOS group, with trivial exception, greater weight loss was associated with greater improvement in the mental aspects of HRQOL. CONCLUSIONS Both obese PCOS and non-PCOS women achieved nearly similar levels of improvement in HRQOL due to weight loss induced by a hypocaloric LGI diet. TRIAL REGISTRATION This study is registered in the Iranian Randomized Clinical Trials Registry (IRCT, code: IRCT2016092129909N1).
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Affiliation(s)
- Farnaz Shishehgar
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Setareh Vahidi
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Ahmad AM, Mahmoud AM, Serry ZH, Mohamed MM, Abd Elghaffar HA. Effects of low-versus high-volume high-intensity interval training on glycemic control and quality of life in obese women with type 2 diabetes. A randomized controlled trial. J Exerc Sci Fit 2023; 21:395-404. [PMID: 37954548 PMCID: PMC10632101 DOI: 10.1016/j.jesf.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/26/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023] Open
Abstract
Background/objective Comparison between different training volumes of high-intensity interval training (HIIT) is understudied in type 2 diabetes. This study aimed to compare the effects of low- and high-volume HIIT on glycemic control, blood lipids, blood pressure, anthropometric adiposity measures, cardiorespiratory fitness, and health-related quality of life (HRQoL) in women with type 2 diabetes. Methods Seventy-two obese women with type 2 diabetes aged 36-55 were randomly assigned to a low-volume HIIT group (i.e., 2 × 4-min high-intensity treadmill exercise at 85%-90% of peak heart rate, with a 3-min active recovery interval in between), a high-volume HIIT group (i.e., 4 × 4-min high-intensity treadmill exercise at 85%-90% of peak heart rate, with three 3-min active recovery intervals in between), and a non-exercising control group. Patients in HIIT groups exercised three days a week for 12 weeks. All patients received oral hypoglycemic medications with no calorie restrictions. The outcome measures were glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2-hr PPBG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC), waist-to-hip ratio, time to maximal exhaustion determined from a maximal treadmill exercise test (i.e., a measure of cardiorespiratory fitness), and HRQoL assessed by the 12-item Short Form (SF-12) Health Survey. Results The low- and high-volume HIIT groups showed significant improvements in all outcome measures compared to the baseline and the non-exercising group (P < 0.05), except for DBP in the low-volume HIIT group (p > 0.05). Also, both low- and high-volume HIIT groups showed similar improvements in TC, HDL, SBP, DBP, BMI, WC, waist-to-hip ratio, and the SF-12 scores, with no significant between-groups difference (p > 0.05). The high-volume HIIT group, however, showed more significant improvements in HbA1c, FBG, 2-hr PPBG, TG, LDL, and treadmill time to maximal exhaustion than the low-volume HIIT group (p < 0.05). The non-exercising group showed non-significant changes in all outcome measures (p > 0.05). Conclusion Low-volume HIIT could be equally effective as high-volume HIIT for improving TC, HDL, blood pressure, anthropometric adiposity measures, and HRQoL in obese women with type 2 diabetes. Nevertheless, high-volume HIIT could have a greater impact on glycemic control, TG, LDL, and cardiorespiratory fitness in these patients. Trial registration ClinicalTrials.gov, NCT05110404.
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Affiliation(s)
- Ahmad Mahdi Ahmad
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | | | - Zahra Hassan Serry
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Mohamed Mady Mohamed
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Heba Ali Abd Elghaffar
- Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Kemp JVA, Kumar V, Saleem A, Hashman G, Hussain M, Taylor VH. Examining Associations Between Women's Mental Health and Obesity. Psychiatr Clin North Am 2023; 46:539-549. [PMID: 37500249 DOI: 10.1016/j.psc.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Obesity is a common comorbidity associated with mental illness. It is important to understand the many ways weight gain and obesity can impact the cause and course of mental illness in women, with a special focus on vulnerable life stages. Women seem disproportionally impacted by the weight gain side effects of medications, and issues such as weight gain are more likely to impact symptoms of mental illness, impacting self-esteem. This article summarizes the existing literature on the associations between women's mental health and obesity. Understanding this association will lead to better health outcomes.
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Affiliation(s)
- Jennifer V A Kemp
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - Vivek Kumar
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - April Saleem
- Department of Pathology and Molecular Medicine, Gastrointestinal Disease Research Unit, Queen's University, 76 Stuart Street, Sheth Lab (Floor 3), Kingston, Ontario K7L 2V7, Canada
| | - Gabrielle Hashman
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada; Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mashael Hussain
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada; Matheson Centre for Mental Health Research & Education, University of Calgary, Foothills Campus, 3280 Hospital Drive Northwest, 1D-57, Calgary, Alberta T2N 4Z6, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, Foothills Campus, Calgary, Alberta, Canada.
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Zhu T, Yang S, Mauro TM, Man MQ. Association of Epidermal Biophysical Properties with Obesity and Its Implications. Skin Pharmacol Physiol 2023; 36:165-173. [PMID: 37640014 DOI: 10.1159/000533587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Obesity is a condition defined by an excess amount of body fat, with body mass index (BMI) of 30 and higher. It is associated with a number of other medical conditions, including insulin resistance, diabetes mellitus, and cardiovascular diseases, as well as dyslipidemia, and it is also associated with several cutaneous disorders such as atopic dermatitis, psoriasis, intertriginous dermatitis, acanthosis nigricans and skin infections. SUMMARY Evidence suggests a link between obesity and epidermal dysfunction. Generally, individuals with obesity display higher transepidermal water loss rate and lower stratum corneum hydration levels, although no association of obesity with epidermal dysfunction has been documented. Results of skin surface pH are controversial. But study demonstrated a positive correlation of BMI with skin surface pH on both the forearm and the shin in males, suggesting that the changes in epidermal function vary with gender in individuals with obesity. KEY MESSAGES This review summarizes the association between obesity and epidermal function, and discusses possible underlying mechanisms. Individuals with obesity exhibit poor epidermal permeability barrier and lower stratum corneum hydration levels. Because of the pathogenic role of compromised epidermal function in inflammation, which is also linked to obesity, improvement in epidermal function could benefit individuals with obesity, particularly those with abnormalities in epidermal function.
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Affiliation(s)
- Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyun Yang
- Department of Dermatology, The People's Hospital of Baoshan, Baoshan, China
| | - Theodora M Mauro
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
| | - Mao-Qiang Man
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
- Dermatology Hospital, Southern Medical University, Guangzhou, China
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Chaves E, Jeffrey DT, Williams DR. Disordered Eating and Eating Disorders in Pediatric Obesity: Assessment and Next Steps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6638. [PMID: 37681777 PMCID: PMC10487955 DOI: 10.3390/ijerph20176638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/09/2023]
Abstract
While the exact prevalence of disordered eating in youth who are overweight and have obesity has not been determined, studies show that the odds of a young adult (18-24 years) with obesity engaging in disordered eating behaviors is 2.45 times more likely to occur than in young adults with Body Mass Indexes (BMI) in the normative range. The purpose of this review is to highlight the role that disordered eating and eating disorders may play in pediatric obesity and the importance of screening for these conditions. The ability to identify and assess disordered eating alters the course of treatment. Without an understanding of the intersection of obesity and disordered eating, medical providers may continue treatment-as-usual. Doing so may inadvertently contribute to internalized weight bias in patients with obesity and exacerbate their disordered eating symptoms and behaviors. In addition, understanding the spectrum of disordered eating in pediatric patients with obesity allows providers to tailor treatments, discuss food and physical activity differently, and know when to refer patients to eating-disorder-specific providers for continued treatment.
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Affiliation(s)
- Eileen Chaves
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Center of Healthy Weight and Nutrition, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - D. Thomas Jeffrey
- Psychology Department, The Ohio State University, Columbus, OH 43210, USA;
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Liqiang S, Fang-Hui L, Minghui Q, Haichun C. Threshold effect and sex characteristics of the relationship between chronic inflammation and BMI. BMC Endocr Disord 2023; 23:175. [PMID: 37582770 PMCID: PMC10428651 DOI: 10.1186/s12902-023-01396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/29/2023] [Indexed: 08/17/2023] Open
Abstract
Chronic inflammation is an important pathway for obesity to harm health, the aggravation of chronic inflammation occurs without clinical symptoms. BMI is closely related to chronic inflammation, and it is a predictive factor of chronic inflammation, but the following questions remain unanswered: Are the effects of chronic inflammation on different BMI intervals consistent? Are the effects of BMI on chronic inflammation consistent between male and female? This study aimed to explore the threshold effect, and sex characteristics of the relationship between chronic inflammation and BMI. METHODS People with normal weight, overweight, and obesity were selected as subjects for cross-sectional study. BMI, hs-CRP, adiponectin and irisin was tested. Multiple regression analysis and generalized additive models were used to examine the association between hs-CRP and BMI. RESULTS 119 adults were recruited (normal weight: n = 30, 28.1 ± 7.65 years, BMI: 22.04 ± 1.55; overweight: n = 29, 27.45 ± 7.47 years, BMI: 26.11 ± 1.22; and obesity: n = 60, 28.82 ± 6.05 years, BMI: 33.68 ± 3.57). After adjusting for age and sex, BMI was found to be positively associated with the chronic inflammatory marker hs-CRP (β = 0.45; P < 0.001), which had a threshold effect on hs-CRP. Positive correlation with hs-CRP was observed for BMI of > 24.6 (β = 0.54; P < 0.001) but not for BMI of 18.5-25.4 (β = -0.02; P > 0.05). The pro-inflammatory effect caused by BMI increase in female (β = 0.56; P < 0.001) was higher than that in male (β = 0.38; P < 0.001). When BMI was greater than 33, a positive correlation with hs-CRP was observed in female (β = 0.97; P < 0.001) but not in male (β = 0.14; P > 0.05). CONCLUSIONS BMI has a threshold effect on chronic inflammation, BMI greater than 24.3 is positively correlated with hs-CRP. BMI in 18.5-24.3 is not correlated with hs-CRP. Furthermore, when the BMI greater than 33, hs-CRP is not positively correlated with BMI in male, whereas the pro-inflammatory effect of BMI increase becomes greater in female. HIGHLIGHTS • BMI has a threshold effect on chronic inflammation. BMI in 18.5-24.3 is not correlated with chronic inflammation, and BMI greater than 24.3 is positively correlated with chronic inflammation. • The pro-inflammatory effect caused by BMI increase in female is higher than that in male. In particular, when the BMI is greater than 33, chronic inflammation is not positively correlated with BMI in male, whereas the pro-inflammatory effect of BMI increase becomes greater in female.
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Affiliation(s)
- Su Liqiang
- Physical Education College, Jiangxi Normal University, Nanchang, 330022, Jiangxi, China
| | - Li Fang-Hui
- School of Sport Sciences, Nanjing Normal University, Nanjing, 210023, Jiangsu, China
| | - Quan Minghui
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Chen Haichun
- Key Laboratory of Kinesiological Evaluation General Administration of Sport of China, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, 350108, Fujian, China.
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Linde S, Egede LE. Community Social Capital and Population Health Outcomes. JAMA Netw Open 2023; 6:e2331087. [PMID: 37624595 PMCID: PMC10457711 DOI: 10.1001/jamanetworkopen.2023.31087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Importance While the association between economic connectedness and social mobility has now been documented, the potential linkage between community-level economic connectedness and population health outcomes remains unknown. Objective To examine the association between community social capital measures (defined as economic connectedness, social cohesion, and civic engagement) and population health outcomes (defined across prevalence of diabetes, hypertension, high cholesterol, kidney disease, and obesity). Design, Setting, and Participants This cross-sectional study included communities defined at the zip code tabulation area (ZCTA) level in all 50 US states. Data were collected from January 2021 to December 2022. Main Outcomes and Measures Multivariable regression analyses were used to examine the association between population health outcomes and social capital. Adjusted analyses controlled for area demographic variables and county fixed effects. Heterogeneities within the associations based on the racial and ethnic makeup of communities were also examined. Results In this cross-sectional study of 17 800 ZCTAs, across 50 US states, mean (SD) economic connectedness was 0.88 (0.32), indicating friendship sorting on income; the mean (SD) support ratio was 0.90 (0.10), indicating that 90% of ties were supported by a common friendship tie; and the mean (SD) volunteering rate was 0.08 (0.03), indicating that 8% of individuals within a given community were members of volunteering associations. Mean (SD) ZCTA diabetes prevalence was 10.8% (2.9); mean (SD) high blood pressure prevalence was 33.2% (6.2); mean (SD) high cholesterol prevalence was 32.7% (4.2), mean (SD) kidney disease prevalence was 3.0% (0.7), and mean (SD) obesity prevalence was 33.4% (5.6). Regression analyses found that a 1% increase in community economic connectedness was associated with significant decreases in prevalence of diabetes (-0.63%; 95% CI, -0.67% to -0.60%); hypertension (-0.31%; 95% CI, -0.33% to -0.29%); high cholesterol (-0.14%; 95% CI, -0.15% to -0.12%); kidney disease (-0.48%; 95% CI, -0.50% to -0.46%); and obesity (-0.28%; 95% CI, -0.29% to -0.27%). Second, a 1% increase in the community support ratio was associated with significant increases in prevalence of diabetes (0.21%; 95% CI, 0.16% to 0.26%); high blood pressure (0.16%; 95% CI, 0.13% to 0.19%); high cholesterol (0.16%; 95% CI, 0.13% to 0.19%); kidney disease (0.17%; 95% CI, 0.13% to 0.20%); and obesity (0.08%; 95% CI, 0.06% to 0.10%). Third, a 1% increase in the community volunteering rate was associated with significant increases in prevalence of high blood pressure (0.02%; 95% CI, 0.01% to 0.02%); high cholesterol (0.03%; 95% CI, 0.02% to 0.03%); and kidney disease (0.02%; 95% CI, 0.01% to 0.02%). Additional analyses found that the strength of these associations varied based on the majority racial and ethnic population composition of communities. Conclusions and Relevance In this study, higher economic connectedness was significantly associated with better population health outcomes; however, higher community support ratios and volunteering rates were both significantly associated with worse population health. Associations also differed by majority racial and ethnic composition of communities.
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Affiliation(s)
- Sebastian Linde
- Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Milwaukee
- Center for Advancing Population Sciences, Medical College of Wisconsin, Milwaukee
| | - Leonard E. Egede
- Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Milwaukee
- Center for Advancing Population Sciences, Medical College of Wisconsin, Milwaukee
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Tan HC, Shumbayawonda E, Beyer C, Cheng LTE, Low A, Lim CH, Eng A, Chan WH, Lee PC, Tay MF, Kin S, Chang JPE, Bee YM, Goh GBB. Multiparametric Magnetic Resonance Imaging and Magnetic Resonance Elastography to Evaluate the Early Effects of Bariatric Surgery on Nonalcoholic Fatty Liver Disease. Int J Biomed Imaging 2023; 2023:4228321. [PMID: 37521027 PMCID: PMC10372298 DOI: 10.1155/2023/4228321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/05/2023] [Accepted: 07/08/2023] [Indexed: 08/01/2023] Open
Abstract
Background Bariatric surgery is the most effective treatment for morbid obesity and reduces the severity of nonalcoholic fatty liver disease (NAFLD) in the long term. Less is known about the effects of bariatric surgery on liver fat, inflammation, and fibrosis during the early stages following bariatric surgery. Aims This exploratory study utilises advanced imaging methods to investigate NAFLD and fibrosis changes during the early metabolic transitional period following bariatric surgery. Methods Nine participants with morbid obesity underwent sleeve gastrectomy. Multiparametric MRI (mpMRI) and magnetic resonance elastography (MRE) were performed at baseline, during the immediate (1 month), and late (6 months) postsurgery period. Liver fat was measured using proton density fat fraction (PDFF), disease activity using iron-correct T1 (cT1), and liver stiffness using MRE. Repeated measured ANOVA was used to assess longitudinal changes and Dunnett's method for multiple comparisons. Results All participants (Age 45.1 ± 9.0 years, BMI 39.7 ± 5.3 kg/m2) had elevated hepatic steatosis at baseline (PDFF >5%). In the immediate postsurgery period, PDFF decreased significantly from 14.1 ± 7.4% to 8.9 ± 4.4% (p = 0.016) and cT1 from 826.9 ± 80.6 ms to 768.4 ± 50.9 ms (p = 0.047). These improvements continued to the later postsurgery period. Bariatric surgery did not reduce liver stiffness measurements. Conclusion Our findings support using MRI as a noninvasive tool to monitor NAFLD in patient with morbid obesity during the early stages following bariatric surgery.
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Affiliation(s)
| | | | | | | | | | | | - Alvin Eng
- Singapore General Hospital, Singapore
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López-Olivares M, Fernández-Gómez E, Mohatar-Barba M, Luque-Vara T, Nestares T, López-Bueno M, Enrique-Mirón C. Adherence to the Mediterranean Diet Is Associated with Health-Related Quality of Life and Anthropometric Measurements in University Professors. Healthcare (Basel) 2023; 11:1928. [PMID: 37444762 PMCID: PMC10341359 DOI: 10.3390/healthcare11131928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
The main objective of this study was to assess the relationship between Mediterranean diet (MD) adherence and health-related quality of life (HRQOL) according to the anthropometric measurements of teaching and research staff (TRS) at the University of Granada (UGR), Spain. This diagnostic, non-experimental, cross-sectional, and observational study was performed on university lecturers (65 women and 62 men) using a correlational descriptive methodology. The lecturers' anthropometric measurements were taken, while MD adherence was determined using the PREvention with MEDiterranean diet (PREDIMED) questionnaire. The Short Form Health Survey (SF-36) was used for measuring HRQOL. Better results for body composition were associated with improvements in the physical and mental dimensions and MD adherence. Statistically significant differences were found between sexes, with men showing higher values for weight, height, waist circumference, BMI, waist/hip ratio (WHR), muscle mass, and systolic and diastolic pressure than women. Similarly, MD adherence was positively correlated with vitality (r = 0.233; p = 0.009), social functioning (r = 0.229; p = 0.008), and the mental component summary (r = 0.205; p = 0.021). The regression model determined that the mental component summary (β = 0.239, p = 0.041), diastolic pressure (PD) (β = -0.473, p < 0.000), fat percentage (FP) (β = -0.241, p = 0.004), and age (β = -0.231, p = 0.022) significantly predicted MD adherence. The results obtained in this study suggest that healthy dietary patterns such as the MD and an optimum body composition contribute to an improved HRQOL.
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Affiliation(s)
- María López-Olivares
- Department of Nutrition and Food Science, Faculty of Health Sciences, Melilla Campus, University of Granada, 52001 Melilla, Spain
| | - Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Miriam Mohatar-Barba
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
| | - Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Teresa Nestares
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology “José MataixVerdú” (INYTA), University of Granada, 18071 Granada, Spain
| | - Marta López-Bueno
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Carmen Enrique-Mirón
- Department of Inorganic Chemistry, HUM-613 Research Group, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
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Vecchiato M, Faggian S, Quinto G, Battista F, Foletto M, Di Vincenzo A, Bettini S, Gasperetti A, Busetto L, Ermolao A, Neunhaeuserer D. Analysis of Walking Economy after Sleeve Gastrectomy in Patients with Severe Obesity. BIOLOGY 2023; 12:biology12050746. [PMID: 37237558 DOI: 10.3390/biology12050746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/03/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Obesity is associated with a higher energy cost of walking which affects activities of daily living. Bariatric surgery with sleeve gastrectomy (SG) has beneficial effects on weight loss and comorbidities. PURPOSE The aim of this study was to analyze the impact of SG on walking economy in subjects with severe obesity. METHODS This observational cohort study included all patients with morbid obesity who were considered suitable candidates for SG between June 2017 and June 2019. Each patient underwent an incremental cardiopulmonary exercise test on a treadmill (modified Bruce protocol) one month before and six months after SG. Data on the energy cost of walking were recorded during three protocol stages (stage 0-slow flat walking: speed 2.7 km/h, slope 0%; stage ½-slow uphill walking: speed 2.7 km/h, slope 5%; stage 1-fast uphill walking: speed 4.0 km/h, slope 8%). RESULTS 139 patients with morbid obesity (78% women; age 44.1 ± 10.7 years; BMI 42.5 ± 4.7 kg/m2) were included in the study. At six months post-SG, patients presented with a significantly decreased body weight (-30.5 ± 17.2 kg; p < 0.05), leading to an average BMI of 31.6 ± 4.2 kg/m2. The net energy cost of walking (measured in J/m and J/kg/m) of the subjects was lower compared to pre-SG at all three protocol stages. This improvement was also confirmed when the subjects were grouped by gender and obesity classes. CONCLUSION After a significant weight loss induced by SG, regardless of the severity of obesity and gender, patients exhibited a lower energy expenditure and an improved walking economy. These changes make it easier to perform daily routines and may facilitate an increase in physical activity.
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Affiliation(s)
- Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
| | - Sara Faggian
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
| | - Giulia Quinto
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
| | - Mirto Foletto
- Bariatric Surgery Unit, University Hospital of Padova, 35131 Padova, Italy
| | - Angelo Di Vincenzo
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Silvia Bettini
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Andrea Gasperetti
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
| | - Luca Busetto
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
- Clinical Network of Sports and Exercise Medicine of the Veneto Region, 35131 Padova, Italy
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Vilugrón Aravena F, Cortés M, Valenzuela J, Rojas C, Gutiérrez P. [Obesity, weight-related stigma and its association with the perception of quality of life in Chilean university students]. NUTR HOSP 2023. [PMID: 37073745 DOI: 10.20960/nh.04338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION little attention has been paid to the effect of exposure to weight-related stigma on the quality of life of young Chileans with little obesity. OBJECTIVE to identify the prevalence of weight-related stigma and to analyze its association with obesity and the perception of quality of life in university students from Valparaíso, Chile. METHODS correlational type study and cross-sectional design. Two hundred and sixty-two university students participated, from 18 to 29 years old, matriculated in the Faculty of Health Sciences of a public university in Valparaíso, Chile. Quality of life was assessed with the WHOQOL-BREF scale, weight-related stigma with the Brief Stigmatizing Situations Inventory (SSI), and nutritional status with body mass index (BMI) classification. The application of the questionnaires was on-line and the answers were anonymous. Multiple logistic regression models were used to evaluate the association between the variables, adjusted for gender and age. RESULTS the prevalence of stigma related to weight was 13,2 % in eutrophic, 24,4 % in overweight and 68,0 % in obese. Weight-related stigma, rather than obesity itself, is associated with poorer perceived physical health (OR: 4.30; 95 % CI: 2.10-8.80), psychological health (OR: 4.51; 95 % CI: 2.20-9.26), social relationships (OR: 3.21; 95 % CI: 1.56-6.60) and environment (OR: 2.86; 95 % CI: 1.33-6.14). CONCLUSION students exposed to stigmatizing situations related to weight had a worse perception of their quality of life compared to those not stigmatized.
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Affiliation(s)
- Fabiola Vilugrón Aravena
- Departamento de Salud, Comunidad y Gestión. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Milenko Cortés
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Javiera Valenzuela
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Camila Rojas
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Paulina Gutiérrez
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
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Teli M, Thato R, Rias YA. Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review. SAGE Open Nurs 2023; 9:23779608231185921. [PMID: 37448972 PMCID: PMC10336768 DOI: 10.1177/23779608231185921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 05/10/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction One of the most important outcomes of diabetes care and treatment is an improvement in patients' health-related quality of life (HRQoL). Objective This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM). Methods To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included "type 2 diabetes" OR "T2DM" AND "health-related quality of life" OR "HRQoL" AND ("predicting factors" OR "influencing factors" OR "associated factors"). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229. Results The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL. Conclusion A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.
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Affiliation(s)
- Margareta Teli
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
- Nursing School, Polytechnic of Ministry of Health-Kupang, East Nusa Tenggara, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
| | - Yohane Andy Rias
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
- Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Jawa Timur, Indonesia
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Golmohammadi M, Kheirouri S, Ebrahimzadeh Attari V, Moludi J, Sulistyowati R, Nachvak SM, Mostafaei R, Mansordehghan M. Is there any association between dietary inflammatory index and quality of life? A systematic review. Front Nutr 2022; 9:1067468. [PMID: 36618692 PMCID: PMC9815464 DOI: 10.3389/fnut.2022.1067468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background The inflammatory potential of unhealthy diets can lead to the development of chronic diseases and also exacerbating their complications. Therefore, the present systematic review aimed to evaluate the association of dietary inflammatory index (DII) and quality of life (QOL) in human subjects. Methods A systematic search was conducted in PubMed, Web of Science, and Scopus databases, using the combination of all search terms related to DII and QOL until May 2022. All eligible human studies published in English were included. Results Three hundred twenty-seven studies were obtained from the first systematic search of the databases although, only eight studies were eligible for the evaluation. Seven studies reported that there was a significant reverse association between DII scores and overall QOL and/or its subscales in different populations including patients with asthma, osteoarthritis, hemodialysis patients, multiple sclerosis, obese women, and also in healthy subjects. While, one study on postmenopausal women found no evidence of this association. Conclusion This systematic review demonstrated that an anti-inflammatory diet might be associated with better QOL. However, future well-designed clinical trials can provide better conclusions especially regarding the quantifying of this relationship.
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Affiliation(s)
- Mona Golmohammadi
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sorayya Kheirouri
- Department of Community Medicine, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Jalal Moludi
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Seyed Mostafa Nachvak
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roghayeh Mostafaei
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Mansordehghan
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Henn RE, Elzinga SE, Glass E, Parent R, Guo K, Allouch AM, Mendelson FE, Hayes J, Webber-Davis I, Murphy GG, Hur J, Feldman EL. Obesity-induced neuroinflammation and cognitive impairment in young adult versus middle-aged mice. Immun Ageing 2022; 19:67. [PMID: 36550567 PMCID: PMC9773607 DOI: 10.1186/s12979-022-00323-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Obesity rates are increasing worldwide. Obesity leads to many complications, including predisposing individuals to the development of cognitive impairment as they age. Immune dysregulation, including inflammaging (e.g., increased circulating cytokines) and immunosenescence (declining immune system function), commonly occur in obesity and aging and may impact cognitive impairment. As such, immune system changes across the lifespan may impact the effects of obesity on neuroinflammation and associated cognitive impairment. However, the role of age in obesity-induced neuroinflammation and cognitive impairment is unclear. To further define this putative relationship, the current study examined metabolic and inflammatory profiles, along with cognitive changes using a high-fat diet (HFD) mouse model of obesity. RESULTS First, HFD promoted age-related changes in hippocampal gene expression. Given this early HFD-induced aging phenotype, we fed HFD to young adult and middle-aged mice to determine the effect of age on inflammatory responses, metabolic profile, and cognitive function. As anticipated, HFD caused a dysmetabolic phenotype in both age groups. However, older age exacerbated HFD cognitive and neuroinflammatory changes, with a bi-directional regulation of hippocampal inflammatory gene expression. CONCLUSIONS Collectively, these data indicate that HFD promotes an early aging phenotype in the brain, which is suggestive of inflammaging and immunosenescence. Furthermore, age significantly compounded the impact of HFD on cognitive outcomes and on the regulation of neuroinflammatory programs in the brain.
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Affiliation(s)
- Rosemary E Henn
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Sarah E Elzinga
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Emily Glass
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Molecular and Integrative Physiology, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Rachel Parent
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Molecular and Integrative Physiology, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kai Guo
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Adam M Allouch
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Faye E Mendelson
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA
| | - John Hayes
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ian Webber-Davis
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Geoffery G Murphy
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Molecular and Integrative Physiology, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Junguk Hur
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA.
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, 48109, USA.
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