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Rouhana S, Hallit S, Nicolas G. The association of maternal pre-pregnancy Body Mass Index and gestational weight gain with pregnancy and neonatal outcomes. Ir J Med Sci 2024; 193:303-312. [PMID: 37498477 DOI: 10.1007/s11845-023-03472-w] [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: 08/30/2022] [Accepted: 07/23/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Overweight and obesity epidemic is still expanding, and it is affecting women of childbearing age. Multiple studies have shown unmatched results concerning the effect of body mass index (BMI) besides gestational weight gain (GWG) on pregnancy and neonatal outcomes. This study aims to determine the effect of each of the two anthropometric indicators: pre-gestational BMI and gestational weight gain on the course of pregnancy, and neonatal outcomes. METHODS A retrospective study was conducted at Notre Dame de Secours University Hospital (CHU-NDS) Jbeil-Lebanon. The data was collected from the hospital archive. Out of 804 deliveries during 2020, 583 women were included after randomly choosing their files and eliminating those with exclusion criteria or incomplete data. RESULTS Underweight/healthy BMI mothers had a higher chance of having low GWG (45.5%), vaginal delivery (51.3%), and a baby of appropriate size (78.6%) or small size for gestational age (10.4%). Obese women had a higher risk of excessive GWG (49.3%), delivery via C-section. (69.3%), and large for gestational age babies (26.7%). Mothers who had low GWG were at a higher risk of having babies of appropriate size (80.1%) or small size for gestational age (13.1%). Mothers who had high GWG had a higher risk of having baby boys (58.9%), large for their gestational age (26.1%), with hypoglycemia at birth (20.6%). CONCLUSION Both extremes of BMI and GWG are linked to adverse neonatal outcomes. This highlights the importance of weight monitoring even during pregnancy to prevent its negative impact on neonates.
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Affiliation(s)
- Saly Rouhana
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, 11931, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal-Eddib, Lebanon.
| | - Georges Nicolas
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Pediatrics, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon
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Sheng BW, Zhang JQ, Chen M, Ma M. The inverse association between fasting blood glucose and the occurrence of gallbladder cancer in type 2 diabetes mellitus patients: a case-control study. J Cancer Res Clin Oncol 2023; 149:10387-10398. [PMID: 37273108 DOI: 10.1007/s00432-023-04944-3] [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: 03/20/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study aimed to explore the correlation between diabetes mellitus (DM) and gallbladder cancer (GBC) in an epidemiological setting. METHODS The study summarized the clinical and laboratory data of 2210 GBC Chinese patients in the authors' hospital. A total of 17 influencing factors for GBC, including gender, body mass index (BMI), fasting blood glucose (FBG), fasting insulin (FINS), the homeostasis model assessment of insulin resistance (HOMA-IR), retinol-binding protein 4 (RBP4), and lipid indexes were analyzed using unconditional logistic regression analysis. RESULTS Based on the results of univariate logistic regression, the risk of GBC was significantly and positively correlated with serum triglyceride, low-density lipoprotein, FINS, HOMA-IR, being female, BMI, DM, non-alcoholic fatty liver disease, and gallbladder stone disease (GSD), and significantly negatively correlated with high-density lipoprotein and FBG concentrations in serum, as well as hypertension. According to multivariate analysis, FINS was significantly positively associated with GBC risk, while DM showed an insignificant negative association; FBG was also not important. The most significant independent factor of GBC risk in patients with DM was HOMA-IR. Fasting blood glucose levels showed a significant negative relationship with GBC in patients with DM. In addition, this study indicated a significantly negative association between serum RBP levels and GBC. CONCLUSIONS The findings of the current study revealed that the efficient treatment of insulin resistance is an important approach for decreasing GBC risk, as opposed to lowering blood sugar only, particularly in patients with DM. Interestingly, FBG may have had an inverse association with the development of GBC in patients with type 2 DM. Of note, the study found that a dramatic initial drop in RBP may help predict the occurrence of GBC.
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Affiliation(s)
- Bin-Wu Sheng
- Department of Geriatric Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, China.
| | - Jian-Qin Zhang
- Shaanxi Nutrition Society, Medical School, of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Min Chen
- Biobank, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Mao Ma
- Department of Geriatric Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, China.
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Lee H, Koh DH. [Obesity and Pancreatobiliary Disease]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2021; 75:240-245. [PMID: 32448855 DOI: 10.4166/kjg.2020.75.5.240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/04/2023]
Abstract
Obesity has become a major medical and public health problem worldwide. Recent studies have shown that obesity is a chronic disease that is associated with many diseases, such as gallstone disease, acute pancreatitis, fatty liver, and digestive cancer. Obesity is also a risk factor for the formation of cholesterol gallstones. Clinical and epidemiological studies have suggested that obesity is positively associated with the risk of gallbladder cancer. Obesity may modulate the lipid and endogenous hormones metabolism, affect gallbladder motility, increase the risk of gallstones, and increased the risk of gallbladder cancer. In addition, obesity has been considered a risk factor for pancreatic diseases, including pancreatitis and pancreatic cancer. Obese patients develop systemic and local complications of acute pancreatitis more frequently. Several epidemiologic studies have suggested an association of pancreatic cancer with high body mass and lack of physical activity. This study reviewed the literature on obesity and pancreatobiliary disease in terms of epidemiology and mechanism.
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Affiliation(s)
- Hoongoo Lee
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Dong Hee Koh
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
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Lee YJ, Park YS, Park JH. Cholecystectomy is Feasible in Children with Small-Sized or Large Numbers of Gallstones and in Those with Persistent Symptoms Despite Medical Treatment. Pediatr Gastroenterol Hepatol Nutr 2020; 23:430-438. [PMID: 32953638 PMCID: PMC7481062 DOI: 10.5223/pghn.2020.23.5.430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE We investigated the clinical features and factors affecting the choice of treatment modality and the course of pediatric gallstone (GS) disease. METHODS We retrospectively analyzed the medical records of 65 patients diagnosed with GS using imaging studies between January 2009 and December 2017 were included. RESULTS This study included 65 patients (33 boys and 32 girls; mean age, 8.5±5.3 years; range, 0.2-18 years) who primarily presented with abdominal pain (34%), jaundice (18%), and vomiting (8%). Idiopathic GS occurred in 36 patients (55.4%). The risk factors for GS included antibiotic use, obesity, hemolytic disease, and chemotherapy in 8 (12.3%), 7 (10.8%), 6 (9.2%), and 4 patients (6.2%), respectively. We observed multiple stones (including sandy stones) in 31 patients (47.7%), a single stone in 17 (26.2%), and several stones in 17 (26.2%). GS with a diameter of <5 mm occurred in 45 patients (69.2%). Comorbidities included hepatitis, choledocholithiasis, cholecystitis, and acute pancreatitis in 20 (30.8%), 11 (16.9%), 11 (16.9%), and 4 patients (6.2%), respectively. Ursodeoxycholic acid (UDCA) was administered to 54 patients (83.1%), leading to stone dissolution in 22 patients (33.8%) within 6 months. Cholecystectomy was performed in 18 patients (27.7%) (mean age, 11.9±5.1 years). Most patients treated surgically had multiple stones (83%) and stones measuring <5 mm in size (89%), and 66.7% of patients had cholesterol stones. CONCLUSION Cholecystectomy is feasible in patients with small-sized or large numbers of GS and those with persistent abdominal pain and/or jaundice. UDCA administration with close follow-up is recommended in patients with uncomplicated GS.
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Affiliation(s)
- Yeoun Joo Lee
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Yeh Seul Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
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Abstract
BACKGROUND Cholecystitis and gallstones affect a large segment of the population in developed nations, and a small proportion of affected individuals subsequently develop cancer of the gallbladder. However, little is known about the possible beneficial effects of physical activity. OBJECTIVE Accordingly, a systematic review examined the influence of both acute and chronic exercise on gallbladder motility, and relationships were examined between habitual physical activity, gallbladder disease, and gallbladder cancer. METHODS A search of Ovid/MEDLINE from 1996 to November 2014 yielded 67 articles relating to physical activity and gallbladder function or disease; 18 of these relevant to the objectives of the review were supplemented by 22 papers from personal files and other sources. Because of the limited volume of material, all were considered, although note was taken of the quality of activity measurement, care in excluding covariates, and experimental design (cross-sectional, case-control or randomized controlled trial). RESULTS The impact of physical activity upon gallbladder function remains unclear; acute activity could augment emptying by stimulating cholecystokinin release, and one of two training experiments found a small increase in gallbladder motility. The largest and most recent cross-sectional and case-control trials show a reduced risk of gallbladder disease in active individuals. A small number of randomized controlled trials in humans and one animal study generally support these trends, although the number of cases of gallstones are too few for statistical significance. Three studies of gallbladder cancer also show a non-significant trend to benefit from physical activity. CONCLUSIONS Although there remains a need for further research, regular physical activity seems likely to reduce the risk of both gallstones and gallbladder cancer. A substantial number of individuals must be persuaded to exercise in order to avoid one case of gallbladder disease, but the attempt appears warranted because of the other health benefits of regular physical activity.
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Affiliation(s)
- Roy J Shephard
- Faculty of Kinesiology and Physical Education, University of Toronto, PO Box 521, Brackendale, BC, V90N 1H0, Canada.
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Hyun JJ, Lee HS, Kim CD, Dong SH, Lee SO, Ryu JK, Lee DH, Jeong S, Kim TN, Lee J, Koh DH, Park ET, Lee IS, Yoo BM, Kim JH. Efficacy of Magnesium Trihydrate of Ursodeoxycholic Acid and Chenodeoxycholic Acid for Gallstone Dissolution: A Prospective Multicenter Trial. Gut Liver 2016; 9:547-55. [PMID: 26087862 PMCID: PMC4478000 DOI: 10.5009/gnl15015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background/Aims Cholecystectomy is necessary for the treatment of symptomatic or complicated gallbladder (GB) stones, but oral litholysis with bile acids is an attractive alternative therapeutic option for asymptomatic or mildly symptomatic patients. This study was conducted to evaluate the efficacy of magnesium trihydrate of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) on gallstone dissolution and to investigate improvements in gallstone-related symptoms. Methods A prospective, multicenter, phase 4 clinical study to determine the efficacy of orally administered magnesium trihydrate of UDCA and CDCA was performed from January 2011 to June 2013. The inclusion criteria were GB stone diameter ≤15 mm, GB ejection fraction ≥50%, radiolucency on plain X-ray, and asymptomatic/mildly symptomatic patients. The patients were prescribed one capsule of magnesium trihydrate of UDCA and CDCA at breakfast and two capsules at bedtime for 6 months. The dissolution rate, response rate, and change in symptom score were evaluated. Results A total of 237 subjects were enrolled, and 195 subjects completed the treatment. The dissolution rate was 45.1% and the response rate was 47.2% (92/195) after 6 months of administration of magnesium trihydrate of UDCA and CDCA. Only the stone diameter was significantly associated with the response rate. Both the symptom score and the number of patients with symptoms significantly decreased regardless of stone dissolution. Adverse events necessitating discontinuation of the drug, surgery, or endoscopic management occurred in 2.5% (6/237) of patients. Conclusions Magnesium trihydrate of UDCA and CDCA is a well-tolerated bile acid that showed similar efficacy for gallstone dissolution and improvement of gallstone-related symptoms as that shown in previous studies.
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Affiliation(s)
- Jong Jin Hyun
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Hong Sik Lee
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Chang Duck Kim
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Seok Ho Dong
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seung-Ok Lee
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Ji Kon Ryu
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Don Haeng Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seok Jeong
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jin Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong Hee Koh
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Taek Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - In-Seok Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Moo Yoo
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Jin Hong Kim
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
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Dong J, Chen Y, Tang Y, Xu F, Yu C, Li Y, Pankaj P, Dai N. Body Mass Index Is Associated with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0144872. [PMID: 26658675 PMCID: PMC4684381 DOI: 10.1371/journal.pone.0144872] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/24/2015] [Indexed: 12/13/2022] Open
Abstract
Background Prior work suggested that patients with inflammatory bowel diseases (IBD) have lower body mass index (BMI) than controls and patients with lower BMI have more serious complications. Goal The study was aimed to find relationship between BMI in patients with and without IBD, investigate effects of medicine therapy and disease stages on patients’ BMI. Methods Potentially eligible studies were identified through searching PubMed, Cochrane and Embase databases. Outcome measurements of mean BMI and the number of patients from each study were pooled by a random-effect model. Publication bias test, sensitivity analysis and subgroup analysis were conducted. Results A total of 24 studies containing 1442 patients and 2059 controls were included. Main results were as follows: (1) BMI in Crohn’s disease (CD) patients was lower than that in health controls (-1.88, 95% CI -2.77 to -1.00, P< 0.001); (2) Medical therapy significantly improved BMI of CD patients (with therapy: -1.58, -3.33 to 0.16; without: -2.09, 95% CI -3.21 to -0.98) while on the contrary not significantly improving BMI of UC patients (with therapy: -0.24, 95% CI -3.68 to 3.20; without: -1.34, 95% CI -2.87 to 0.20, P = 0.57); (3) Both CD and UC patients in active phase showed significantly greater BMI difference compared with controls than those in remission (CD patients: remission: -2.25, 95% CI -3.38 to -1.11; active phase: -4.25, 95% CI -5.58 to -2.92, P = 0.03; UC patients: remission: 0.4, 95% CI -2.05 to 2.84; active phase: -5.38, -6.78 to -3.97, P = 0.001). Conclusions BMI is lower in CD patients; medical therapy couldn’t improve BMI of IBD patients; the state of disease affects BMI of CD patients and UC patients.
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Affiliation(s)
- Jie Dong
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yi Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuchen Tang
- Departments of Endocrinology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Fei Xu
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chaohui Yu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Youming Li
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Prasoon Pankaj
- Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ning Dai
- Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- * E-mail:
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Body mass index and biliary tract disease: a systematic review and meta-analysis of prospective studies. Prev Med 2014; 65:13-22. [PMID: 24721739 DOI: 10.1016/j.ypmed.2014.03.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 03/25/2014] [Accepted: 03/28/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the association between body mass index (BMI, kg/m(2)) and incidence of biliary tract disease. METHODS We performed a systematic review and a meta-analysis of prospective studies by searching the database of PubMed and EMBASE published up to December 31, 2013. Outcome of interest was disease of biliary tract system (gallbladder, extrahepatic bile duct and Ampullar of Vater). We used a random-effects model to combine the study-specific relative risks (RRs) and 95% confidence intervals (95% CIs) from 22 prospective studies. We examined whether BMI was associated with a higher risk of biliary tract disease in a combined analysis. RESULTS The positive association was stronger for non-cancer biliary tract disease than biliary tract cancer; combined RRs (95% CIs) comparing the top with bottom categories were 1.40 (1.15-1.65) for biliary tract cancer and 2.75 (2.35-3.15) for non-cancer biliary tract disease (P for difference<0.001). For non-cancer biliary tract disease, combined RRs (95% CIs) comparing the top with bottom categories were 3.21 (2.48-3.93) for women and 2.01 (1.66-2.37) for men (P for difference=0.04). CONCLUSION Obesity is associated with higher risks of biliary tract cancer and, to a greater extent, non-cancer biliary tract disease.
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Abstract
Obesity is a medical disease that is increasing significantly nowadays. Worldwide obesity prevalence doubled since 1980. Obese patients are at great risk for complications with physical and psychological burdens, thus affecting their quality of life. Obesity is well known to have higher risk for cardiovascular diseases, diabetes mellitus, musculoskeletal diseases and shorter life expectancy. In addition, obesity has a great impact on surgical diseases, and elective surgeries in comparison to general population. There is higher risk for wound infection, longer operative time, poorer outcome, and others. The higher the BMI (body mass index), the higher the risk for these complications. This literature review illustrates the prevalence of obesity as a diseases and complications of obesity in general as well as, in a surgical point of view, general surgery perioperative risks and complications among obese patients. It will review the evidence-based updates in these headlines.
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