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Suliburska J, Cholik R, Kocyłowski R, Bakinowska E. Relationship between prepregnancy BMI and the concentrations of iron, calcium, and magnesium in serum and hair during the first trimester of pregnancy in women. J Trace Elem Med Biol 2024; 83:127388. [PMID: 38262193 DOI: 10.1016/j.jtemb.2024.127388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND In women of childbearing age, a low dietary supply of iron, calcium, and magnesium is often observed. Minerals deficiency in pregnant women is often associated with abnormal body weight and may impact fetal development disorders. The aim of this study is to determine the relationship between prepregnancy body mass index (BMI) and the dietary intake of iron, calcium and magnesium and their concentrations in serum and hair in pregnant women. METHOD The study involved 97 Caucasian/white low-risk pregnant women at 12 weeks of gestation. The analysis of minerals in serum and hair samples was performed using atomic absorption spectrometry. Pre-pregnancy BMI was calculated based on self-reported weight. The study used a validated questionnaire and a 24-h recall nutrition interview, which were analyzed using Aliant software. RESULTS It was found that overweight and obese women exhibited higher magnesium concentration in serum, while iron content in serum and hair was markedly lower compared to women with normal body weight. The average total supply of iron was below the recommendation in pregnant women. Moreover, an inverse significant relationship was observed between BMI and iron concentration in hair and serum in the whole population. CONCLUSION In conclusion, being overweight or obese before pregnancy is associated with low dietary iron intake and low iron concentration in serum and hair during the first trimester of pregnancy in women.
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Affiliation(s)
- Joanna Suliburska
- Department of Human Nutrition and Dietetics, Poznan University of Life Science, ul. Wojska Polskiego 31, 60-624 Poznan, Poland.
| | - Rafsan Cholik
- Department of Human Nutrition and Dietetics, Poznan University of Life Science, ul. Wojska Polskiego 31, 60-624 Poznan, Poland
| | - Rafał Kocyłowski
- PreMediCAre NewMed Medical Centre, ul. Drużbickiego 13, 61-693 Poznań, Poland
| | - Ewa Bakinowska
- Institute of Mathematics, Poznan University of Technology, ul. Piotrowo 3A, 60-965 Poznan, Poland
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Vasilopoulos T, Drozda D, Vincent HK. Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index. Arch Gerontol Geriatr 2024; 120:105339. [PMID: 38340391 DOI: 10.1016/j.archger.2024.105339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931-1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0-5 scale) and Large Muscle Function (0-4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA; Department of Orthopaedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL 32611, USA.
| | - David Drozda
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
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Alsannan B, Laganà AS, Alhermi J, Almansoor S, Ayed A, Venezia R, Etrusco A. Prevalence of overactive bladder among overweight and obese women: A prospective cross-sectional cohort study. Eur J Obstet Gynecol Reprod Biol 2024; 295:59-64. [PMID: 38340591 DOI: 10.1016/j.ejogrb.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To evaluate the effect of body mass index (BMI) on the prevalence of overactive bladder syndrome (OAB), severity of symptoms, and quality of life in affected patients. METHODS We conducted a prospective cross-sectional study of 1351 consecutive patients who were recruited between June 2021 and May 2022. Patients were divided according to BMI (normal: <25.0, overweight: 25-29.9, obese: ≥30) and menopausal status. The latter were divided according to the presence or absence of urinary incontinence in the normal, wet-OAB and dry-OAB groups. A validated questionnaire, the International Consultation on Incontinence Questionnaire in Overactive Bladder (ICIQ-OAB), in the English and Arabic languages was used. RESULTS A total of 1351 patients were included. For women who were overweight, there was a greater prevalence of dry-OAB (p = 0.02), However, the prevalence of both dry and wet-OAB were higher in obese women (p < 0.00001). Compared to women with a normal BMI, women who were overweight or obese had a greater likelihood of developing abnormal daytime urine frequency and nocturia, with p values ≤ 0.01. The ORs of overweight and obese women were 3.1 and 5.3, respectively, for experiencing wet OAB in comparison to women with a normal BMI. Additionally, the odds of developing severe OAB in overweight and obese women were 5.8 and 18.6, respectively, which negatively affects their quality of life (QoL). CONCLUSION The risk of developing OAB symptomatology is significantly greater in overweight and obese patients. As BMI increases, the symptomatology, perceived discomfort and QoL of patients with OAB worsen.
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Affiliation(s)
- Baydaa Alsannan
- Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, 13110 Safat, Kuwait.
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Jehad Alhermi
- Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, 13110 Safat, Kuwait
| | | | - Amal Ayed
- Kuwait Ministry of Health, 13110 Safat, Kuwait
| | - Renato Venezia
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Andrea Etrusco
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
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Pan Q, Yang Y, Cao H, Xu Z, Tian Z, Zhan Y, Li Z, Lu M, Gu F, Lu Q, Gong L, Liu H, Li Y, Lu J, Chen Z. Contribution of Insulin Resistance and β Cell Dysfunction to Gestational Diabetes Stratified for Pre-pregnant Body Mass Index. Reprod Sci 2024; 31:1151-1158. [PMID: 37957467 DOI: 10.1007/s43032-023-01379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 10/03/2023] [Indexed: 11/15/2023]
Abstract
The objective of the study was to evaluate the contribution of insulin resistance and β cell dysfunction to gestational diabetes mellitus (GDM) in Chinese women stratified by pre-pregnant body mass index (BMI). A total of 847 pregnant women were enrolled. They were divided into low BMI and high BMI groups according to the median of pre-pregnancy BMI. The homeostasis model assessment of insulin resistance (HOMA-IR) and β cell function (HOMA-β), Matsuda index, and 60-min insulinogenic index (IGI60) were used to evaluate insulin resistance and β cell function. In all the participants, 150 (17.71%) were diagnosed with GDM. ROC analyses showed that in the low BMI group, the association of β cell dysfunction (IGI60 or HOMA-β) with GDM was stronger than that of insulin resistance (Matsuda index or HOMA-IR), while in the high BMI group, the association of β cell dysfunction with GDM was weaker than that of insulin resistance (all P < 0.05). Among all GDM patients, 47.33% demonstrated predominant insulin resistance (Matsuda index < 25th percentile), and 46% had predominant β cell defect (IGI60 < 25th percentile). In the low BMI group, 15.09% of GDM patients demonstrated predominant insulin resistance, and 62.26% of GDM patients had predominant β cell defect, whereas in the high BMI group, 64.95% of GDM patients demonstrated mainly insulin resistance and 36.08% of GDM patients had mainly β cell defect. In women with low BMI, β cell dysfunction is the major etiologic factor, whereas, in women with high BMI, insulin resistance is the predominant etiologic factor in the development of GDM.
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Affiliation(s)
- Qingrong Pan
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Yanna Yang
- Department of General Practice, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Emergency, Beijing Electric Power Hospital, Capital Medical University, Beijing, China
| | - Huawei Cao
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zibo Xu
- Department of Education, Second College of Clinical Medicine, Tianjin Medical University, Tianjin, China
| | - Zeyang Tian
- Department of General Practice, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of General Practice, Binhe Street Community Health Service Center, Pinggu District, Beijing, China
| | - Yuanyuan Zhan
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Zhan Li
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Menghan Lu
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Fang Gu
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Qi Lu
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Liyun Gong
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Hao Liu
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yanfang Li
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Junli Lu
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
| | - Zhe Chen
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China.
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Aly M, Ishihara T, Torii S, Kamijo K. Being underweight, academic performance and cognitive control in undergraduate women. Arch Womens Ment Health 2024; 27:249-258. [PMID: 38082003 DOI: 10.1007/s00737-023-01410-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/05/2023] [Indexed: 03/13/2024]
Abstract
The prevalence of underweight among young women is a serious international health issue. However, the evidence on how being underweight negatively affects brain health and cognition is still unclear. This study investigated the association between underweight status, academic performance, and neurocognitive control in young Japanese women using a cross-sectional design. We analyzed the academic performance of female undergraduates, comparing underweight and healthy-weight groups (n = 43; age 18-23 years, M = 21.1, SD = 1.3) based on their grade point average (GPA). We also analyzed their error-related negativity (ERN), an electrophysiological measure that potentially reflects academic performance, during an arrowhead version of the flanker task to assess cognitive control of action monitoring. Participants with a low body mass index were found to have lower GPAs. Furthermore, the underweight students exhibited smaller ERN amplitudes, which indicates decreased cognitive control in action monitoring. These findings suggest that a healthy weight status is essential for effective cognitive functioning and academic success in young adult women, among whom being underweight is a serious health problem.
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Affiliation(s)
- Mohamed Aly
- Faculty of Liberal Arts and Sciences, Chukyo University, Nagoya, Japan
- Department of Educational Sciences and Sports Psychology, Faculty of Physical Education, Assiut University, Assiut, Egypt
| | - Toru Ishihara
- Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Keita Kamijo
- Faculty of Liberal Arts and Sciences, Chukyo University, Nagoya, Japan.
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Allsbrook A, To JQ, Pulido OR, Morgan ME, Perea LL, Shin H, Muller A, Ong A, Butts CA, Braverman MA. Body Mass Index Does Not Predict Injury Pattern or Outcome After Motorcycle Crash. J Surg Res 2024; 296:88-92. [PMID: 38241772 DOI: 10.1016/j.jss.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 11/11/2023] [Accepted: 12/17/2023] [Indexed: 01/21/2024]
Abstract
INTRODUCTION The obesity epidemic plagues the United States, affecting approximately 42% of the population. The relationship of obesity with injury severity and outcomes has been poorly studied among motorcycle collisions (MCC). This study aimed to compare injury severity, mortality, injury regions, and hospital and intensive care unit length of stay (LOS) between obese and normal-weight MCC patients. METHODS Trauma registries from three Pennsylvania Level 1 trauma centers were queried for adult MCC patients (January 1, 2016, and December 31, 2020). Obesity was defined as adult patients with body mass index ≥ 30 kg/m2 and normal weight was defined as body mass index < 30 kg/m2 but > 18.5 kg/m2. Demographics and injury characteristics including injury severity score (ISS), abbreviated injury score, mortality, transfusions and LOS were compared. P ≤ 0.05 was considered significant. RESULTS One thousand one hundred sixty-four patients met the inclusion criteria: 40% obese (n = 463) and 60% nonobese (n = 701). Comparison of ISS demonstrated no statistically significant difference between obese and normal-weight patients with median ISS (interquartile range) 9 (5-14) versus 9 (5-14), respectively (P = 0.29). Obese patients were older with median age 45 (32-55) y versus 38 (26-54) y, respectively (P < 0.01). Comorbidities were equally distributed among both groups except for the incidence of hypertension (30 versus 13.8%, P < 0.01) and diabetes (11 versus 4.4%, P < 0.01). There was no statistically significant difference in Trauma Injury Severity Score or abbreviated injury score. Hospital LOS, intensive care unit LOS, and 30-day mortality among both groups were similar. CONCLUSIONS Obese patients experiencing MCC had no differences in distribution of injury, mortality, or injury severity, mortality, injury regions, and hospital compared to normal-weight adults. Our study differs from current data that obese motorcycle drivers may have different injury characteristics and increased LOS.
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Affiliation(s)
- Anthony Allsbrook
- Division of Acute Care Surgical Services, Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania
| | - Jennifer Q To
- Division of Acute Care Surgical Services, Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania
| | - Odessa R Pulido
- Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Madison E Morgan
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Lindsey L Perea
- Division of Trauma and Acute Care Surgery, Department of Surgery, Penn Medicine Lancaster General Health, Lancaster, Pennsylvania
| | - Hannah Shin
- Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Alison Muller
- Division of Trauma, Department of Surgery, Acute Care Surgery & Surgical Critical Care, Reading Hospital- Tower Health, West Reading, Pennsylvania
| | - Adrian Ong
- Division of Trauma, Department of Surgery, Acute Care Surgery & Surgical Critical Care, Reading Hospital- Tower Health, West Reading, Pennsylvania
| | - Christopher A Butts
- Division of Trauma, Department of Surgery, Acute Care Surgery & Surgical Critical Care, Reading Hospital- Tower Health, West Reading, Pennsylvania
| | - Maxwell A Braverman
- Division of Acute Care Surgical Services, Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania.
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Hoffman H, Cote JR, Wood J, Jalal MS, Draytsel DY, Gould GC. The Influence of Body Mass Index on Outcomes in Patients Undergoing Mechanical Thrombectomy for Anterior Circulation Large Vessel Occlusion: Institutional Experience and Meta-analysis. Neurocrit Care 2024; 40:654-663. [PMID: 37498460 DOI: 10.1007/s12028-023-01801-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND An obesity paradox, whereby patients with higher body mass index (BMI) experience improved outcomes, has been described for ischemic stroke. It is unclear whether this applies to patients undergoing mechanical thrombectomy (MT) for large vessel occlusion (LVO). METHODS Mechanical thrombectomies for anterior circulation LVO between 2015 and 2021 at a single institution were reviewed. Multivariable logistic regressions were used to determine the association between BMI and favorable functional outcome (90-day modified Rankin Scale 0-2), intracranial hemorrhage, and malignant middle cerebral infarction. A systematic review was performed to identify studies reporting the effect of BMI on outcomes among patients receiving MT for LVO. The data from the systematic review were combined with the institutional data by using a random effects model. RESULTS The institutional cohort comprised 390 patients with a median BMI of 27 kg/m2. Most patients were obese [36.7% (BMI ≥ 30 kg/m2)], followed by overweight [30.5% (BMI ≥ 25 and < 30 kg/m2)], normal [27.9% (BMI ≥ 18.5 and < 25 kg/m2)], and underweight [4.9% (BMI < 18.5 kg/m2)]. As a continuous variable, BMI was not associated with any of the outcomes. When analyzing BMI ordinally, obesity was associated with lower odds of favorable 90-day modified Rankin Scale (odds ratio 0.42, 95% confidence interval 0.20-0.86). The systematic review identified three eligible studies comprising 1,348 patients for a total of 1,738 patients. In the random effects model, there was no association between obesity and favorable outcome (odds ratio 0.89, 95% confidence interval 0.63-1.24). CONCLUSIONS Obesity is not associated with favorable outcomes in patients undergoing MT for LVO.
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Affiliation(s)
- Haydn Hoffman
- Department of Neurosurgery, State University of New York Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA.
| | - John R Cote
- Department of Neurosurgery, State University of New York Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Jacob Wood
- Department of Neurosurgery, State University of New York Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Muhammad S Jalal
- Department of Neurosurgery, State University of New York Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Dan Y Draytsel
- Department of Neurosurgery, State University of New York Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
| | - Grahame C Gould
- Department of Neurosurgery, State University of New York Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13210, USA
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Li W, Wang Z, Hua C, Zhang H, Liu X, Zheng S, Lv Q, Jiang C, Dong J, Ma C, Du X. Body mass index, frailty, and outcomes in heart failure with preserved ejection fraction. ESC Heart Fail 2024; 11:709-718. [PMID: 38131256 DOI: 10.1002/ehf2.14595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/10/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
AIMS Relationship between body mass index (BMI), frailty, and clinical adverse events remains unclear in patients with heart failure (HF) with preserved ejection fraction (HFpEF) in different patient populations. We aimed to compare the association of BMI, frailty, and clinical adverse events between a US cohort from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study and a Chinese cohort from the Heart Failure Registry of Patient Outcomes (HERO) study. METHODS AND RESULTS We used data of 1715 participants enrolled from America in the TOPCAT study and 1487 patients with HFpEF in the Chinese registry study, the HERO. We evaluated the relationship between BMI and frailty using multivariate restricted cubic spline logistic regression. Association between frailty and BMI categories and primary outcomes including HF hospitalization, aborted sudden death, and cardiovascular death, all-cause mortality, and HF hospitalization were analysed by Cox proportional hazards models. The patients' mean age was 72 ± 11 years for both study populations, with 50% and 46% female for the TOPCAT study and the HERO study, respectively. Patients in the TOPCAT study had a higher mean BMI (33.9 vs. 24 kg/m2), with 72.3% vs. 52.9% defined as moderately to severely frail (frailty index > 0.3). In the TOPCAT study, risk of frailty rose as BMI increased, but not in the HERO study. Patients with frailty were at significant higher risk for the primary composite outcomes [hazard ratio (HR) 1.84 (95% confidence interval: 1.46-2.32)], all-cause mortality [HR 1.73 (1.34-2.25)], and HF hospitalization [HR 1.83 (1.40-2.40)] in the TOPCAT study. The corresponding numbers in the HERO study were 1.26 (1.01-1.57), 2.21 (1.45-3.35), and 1.15 (0.81-1.37), respectively. The association of frailty with clinical outcomes did not vary with BMI categories in the two studies. CONCLUSIONS BMI distribution and association between BMI and frailty risk were different between the two study populations. Frailty was associated with clinical adverse events and this association was consistent across different BMI categories in both studies.
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Affiliation(s)
- Wenjie Li
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Zhiyan Wang
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Chang Hua
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Hao Zhang
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Xinru Liu
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Shiyue Zheng
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Qiang Lv
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Chao Jiang
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Jianzeng Dong
- Department of Cardiology, Anzhen Hospital, Beijing, China
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Changsheng Ma
- Department of Cardiology, Anzhen Hospital, Beijing, China
| | - Xin Du
- Department of Cardiology, Anzhen Hospital, Beijing, China
- Heart Health Research Center (HHRC), Beijing, China
- The George Institute for Global Health (Australia), The University of New South Wales, Sydney, Australia
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Chen Q, Chen J, Zeng R, Shi J. Path analysis to identify factors influencing osteoporosis: A cross-sectional study. Exp Gerontol 2024; 188:112392. [PMID: 38447925 DOI: 10.1016/j.exger.2024.112392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Osteoporosis is characterized by low bone mass and deterioration of bone tissue, which is influenced by both environmental factors and nutritional metabolism. The relationship between biochemical indicators and bone mineral density (BMD) is intricate and involves complex mechanisms. Path analysis, a statistical method that investigates causal relationships and the strength of associations among multiple factors, can be valuable in elucidating the connection between biochemical indicators and BMD. METHODS In this study, we employed advanced statistical techniques, specifically structural equation modeling (SEM) to investigate the intricate interrelationships among a myriad of factors that exert influence on BMD. This analytical approach facilitated not only the identification of the direct relationships between specific variables and BMD but also the exploration of the intricate of indirect pathway through which other variables contribute to the oval impact on BMD. By delving into the direct and indirect effects, we aimed to unravel the complex influences that collectively shape the state of bone health, providing a nuanced understanding of the multifaceted nature of the factors affecting BMD. RESULTS Our findings revealed that lipid levels had a significant indirect influence on BMD, which was mediated by body mass index (BMI). BMI exhibited both direct and indirect effects on BMD. Uric acid (UA) exerted a significant direct and indirect influence on BMD, with glomerular filtration rate (GFR) acting as the mediator. However, the total effect of UA on BMD was not significant due to the cancellation of positive effect UA on BMD but negative indirect effects of UA through GFR. For females, albumin had a significant direct effect on BMD, whereas this effect was not observed in males. The path analysis models generated results that demonstrated an acceptable fit for both female data (χ2 = 9.63, df = 7, p = 0.21, comparative fit index (CFI) = 0.98, root mean square error of approximation (RMSEA) = 0.05) and male data (χ2 = 6.26, df = 4, p = 0.18, CFI = 0.97, RMSEA = 0.06). CONCLUSIONS Nutritional metabolism plays a crucial role in maintaining BMD in elderly females and males.
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Affiliation(s)
- Qiaofeng Chen
- Department of Orthopaedics, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Jie Chen
- University of Massachusetts Boston, Boston, MA, USA
| | - Rongdong Zeng
- Department of Orthopaedics, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China.
| | - Jianhui Shi
- Department of Orthopaedics, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China.
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Blanco-Ferreiro A, Candal-Pedreira C, Sendón B, Santiago-Pérez MI, Rey-Brandariz J, Varela-Lema L, Mourino N, Ruano-Ravina A, García G, Pérez-Ríos M. Self-perceived body weight and weight status: analysis of concordance by age group and sex. Public Health 2024; 229:160-166. [PMID: 38447299 DOI: 10.1016/j.puhe.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/29/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Previous studies suggest that there is discordance between actual weight status and body-weight perception. This fact has implications when it comes to designing public health interventions. The aim of this study was to estimate the prevalence of the different categories of weight status and body-weight perception and to analyse their concordance in a representative Spanish population sample. STUDY DESIGN Cross-sectional study. METHODS Data were sourced from the 2018 Galician Risk Behaviour Data System, with the target population being all persons aged 16 years and above. We collected data on self-perceived body weight and assessed weight status on the basis of body mass index (BMI). BMI was estimated using self-reported measures of weight and height. To estimate concordance, Cohen's kappa coefficient, both unweighted and weighted with Cicchetti weights, was calculated. RESULTS Data were obtained for 7853 individuals aged 16 years and above, whereas the overall unweighted concordance was 0.393 (95%CI: 0.377-0.409), with an agreement percentage of 61.6%, weighted concordance was 0.503 (0.490-0.517), with an agreement percentage of 86.6%. The highest concordance between self-perceived body weight and weight status was observed in women. By age group, the highest concordance was observed in the youngest group (16-24 years) for the BMI categories of underweight and overweight, and in the 45-64 age group for the category of obesity. CONCLUSIONS The results highlight the existence of differences between self-perceived body weight and weight status, according to sex and age.
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Affiliation(s)
- A Blanco-Ferreiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - C Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
| | - B Sendón
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - M I Santiago-Pérez
- Epidemiology Department, Directorate-General of Public Health, Santiago de Compostela, Spain
| | - J Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - L Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - N Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - A Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - G García
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - M Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
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11
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Cacciatore C, Cangiano B, Carbone E, Spagnoli S, Cid Ramirez MP, Polli N, Bonomi M, Persani L. Body weight variation is not an independent factor in the determination of functional hypothalamic amenorrhea in anorexia nervosa. J Endocrinol Invest 2024; 47:903-911. [PMID: 37812282 DOI: 10.1007/s40618-023-02207-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Functional hypothalamic amenorrhea (FHA) is one of the foremost manifestations in anorexia nervosa (AN), but a subset of patients have menses despite marked weight loss and underweight. The aim of our study was to investigate parameters potentially influencing FHA in AN. DESIGN AND METHODS In this observational retrospective study, we selected 114 female patients with AN who completed a 12 months semi-residential rehabilitation program and a subsequent 12 months outpatient follow-up. We divided our sample into three groups: "Group 0" patients who experienced FHA and recovered their menses, "Group 1" persistent FHA, "Group 2" never experienced FHA, and looked for clinical and hormonal correlations. RESULTS At the enrollment, the BMI was higher in Group 2 than in Group 1 (p = 0.0202), but the last follow-up weight was higher in Group 1 (p < 0.0001) despite persistent amenorrhea. At logistic regression, the higher BMI at which patients experienced amenorrhea was the main prediction factor for persistent FHA. Notwithstanding comparable leptin levels at admission, they improved significantly at discharge only in Groups 0 and 2 (p = 0.0054 and p = 0.0104, respectively). FT3 at admission was significantly higher in Group 2 than in Group 0 (p = 0.0249). CONCLUSIONS FHA does not correlate strictly with body weight variations in AN patients, indicating a multifactorial origin, likely including an individual predisposition. Higher FT3 levels identify patients who continue having menses at extremely low BMI. AN patients with persistent FHA constitute a subgroup in whom estroprogestins should be considered after significant weight recovery to prevent prolonged tissue hypoestrogenism.
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Affiliation(s)
- C Cacciatore
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - B Cangiano
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20100, Milan, Italy
| | - E Carbone
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - S Spagnoli
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - M P Cid Ramirez
- Secciòn Endocrinologia y Diabetes, Hospital Clìnico Universidad del Chile, Santiago, Chile
| | - N Polli
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
| | - M Bonomi
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20100, Milan, Italy
| | - L Persani
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, Italy.
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20100, Milan, Italy.
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12
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Du M, Qiu M, Qian Y, Wang T, Chen X. Serum Copper/Zinc Ratio in Overweight and Obese Children: a Cross-Sectional Study. Biol Trace Elem Res 2024; 202:1539-1549. [PMID: 37505435 DOI: 10.1007/s12011-023-03790-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
To assess the association between serum copper/zinc ratio (CZR) and overweight/obesity in children. Sociodemographic and clinical data of children aged 8-18 years old were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. These associations were explored using weighted univariate and multivariate logistic regression analyses with the odds ratios (ORs) and 95% confidence intervals (CIs). High serum CZR level was related to higher odds of overweight (OR = 1.74), obesity (OR = 5.26), and central obesity (OR = 2.99). Subgroup analyses showed that high serum CZR levels were associated with high odds of overweight in children aged ≥ 12 years old (OR = 2.19) and females (OR = 2.02), while the increased odds of obesity and central obesity were found in children aged ≥ 12 years old and both male and female. Elevated serum CZR level was linked to high odds of childhood overweight, obesity, and central obesity, and this relationship was also found in children with different age and gender.
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Affiliation(s)
- Mu Du
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Mingfang Qiu
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Ye Qian
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Tianqi Wang
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China
| | - Xiaobo Chen
- Department of Endocrinology, Children's Hospital of Capital Institute of Pediatrics, No. 2 Yabao Road, Chaoyang District, 100020, Beijing, People's Republic of China.
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13
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Ben H, Kholinne E, Guo J, Kim D, Je MG, Koh KH, Jeon IH. Does body mass index affect outcomes following arthroscopic superior capsular reconstruction using fascia lata autograft for massive irreparable rotator cuff tear? Int Orthop 2024; 48:1079-1088. [PMID: 38147071 DOI: 10.1007/s00264-023-06065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/10/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE This study aimed to evaluate the effect of increased body mass index (BMI) on patient-reported outcomes (PROs) and clinically significant outcomes (CSOs) obtained > two years postoperatively following arthroscopic superior capsular reconstruction (ASCR). METHODS A retrospective study was conducted on patients who underwent ASCR with a minimum two year follow-up. All patients were divided into normal (BMI < 25.0), overweight (BMI 25-30.0), and obese (BMI ≥ 30) according to preoperative BMI. Patients were assessed using the PROs preoperatively and at six months, one year, and two years postoperatively, including the visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and Constant-Murley scores. The time required to achieve each CSO was analyzed and compared. Multivariate analyses evaluated the predictor variables and time required to achieve CSOs. RESULTS This study included 63 patients with a mean age of 64.8 ± 8.6 years, including 31 normal BMI, 25 overweight, and seven obese patients. Significant improvements in VAS and ASES scores after ASCR were observed in all three groups. Normal and overweight patients had significant improvements in the Constant score; however, no difference was observed in obese patients. No significant difference was observed in the probability distributions of CSOs between the BMI groups. Similarly, no significant differences were observed in the probability distributions of the CSOs, ASES, and Constant scores at each time point, among the BMI groups. CONCLUSION Patients in the normal and overweight groups had significant improvements in the VAS, ASES, and Constant scores after ASCR. Patients in the obese group had a significant improvement in VAS score; however, there is no difference for the ASES and Constant scores in the obese group. However, no differences were observed in all PROMs and the likelihood of achieving CSOs among the different BMI groups.
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Affiliation(s)
- Hui Ben
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05535, Korea
| | - Erica Kholinne
- Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St. Carolus Hospital, Jakarta, Indonesia
| | - Jia Guo
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05535, Korea
| | - Dohun Kim
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05535, Korea
| | - Min Geol Je
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05535, Korea
| | - Kyoung Hwan Koh
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05535, Korea
| | - In Ho Jeon
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05535, Korea.
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14
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Von Holle A, Adami HO, Baglietto L, Berrington de Gonzalez A, Bertrand KA, Blot W, Chen Y, DeHart JC, Dossus L, Eliassen AH, Fournier A, Garcia-Closas M, Giles G, Guevara M, Hankinson SE, Heath A, Jones ME, Joshu CE, Kaaks R, Kirsh VA, Kitahara CM, Koh WP, Linet MS, Park HL, Masala G, Mellemkjaer L, Milne RL, O'Brien KM, Palmer JR, Riboli E, Rohan TE, Shrubsole MJ, Sund M, Tamimi R, Tin Tin S, Visvanathan K, Vermeulen RC, Weiderpass E, Willett WC, Yuan JM, Zeleniuch-Jacquotte A, Nichols HB, Sandler DP, Swerdlow AJ, Schoemaker MJ, Weinberg CR. BMI and breast cancer risk around age at menopause. Cancer Epidemiol 2024; 89:102545. [PMID: 38377945 PMCID: PMC10942753 DOI: 10.1016/j.canep.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND A high body mass index (BMI, kg/m2) is associated with decreased risk of breast cancer before menopause, but increased risk after menopause. Exactly when this reversal occurs in relation to menopause is unclear. Locating that change point could provide insight into the role of adiposity in breast cancer etiology. METHODS We examined the association between BMI and breast cancer risk in the Premenopausal Breast Cancer Collaborative Group, from age 45 up to breast cancer diagnosis, loss to follow-up, death, or age 55, whichever came first. Analyses included 609,880 women in 16 prospective studies, including 9956 who developed breast cancer before age 55. We fitted three BMI hazard ratio (HR) models over age-time: constant, linear, or nonlinear (via splines), applying piecewise exponential additive mixed models, with age as the primary time scale. We divided person-time into four strata: premenopause; postmenopause due to natural menopause; postmenopause because of interventional loss of ovarian function (bilateral oophorectomy (BO) or chemotherapy); postmenopause due to hysterectomy without BO. Sensitivity analyses included stratifying by BMI in young adulthood, or excluding women using menopausal hormone therapy. RESULTS The constant BMI HR model provided the best fit for all four menopausal status groups. Under this model, the estimated association between a five-unit increment in BMI and breast cancer risk was HR=0.87 (95% CI: 0.85, 0.89) before menopause, HR=1.00 (95% CI: 0.96, 1.04) after natural menopause, HR=0.99 (95% CI: 0.93, 1.05) after interventional loss of ovarian function, and HR=0.88 (95% CI: 0.76, 1.02) after hysterectomy without BO. CONCLUSION The BMI breast cancer HRs remained less than or near one during the 45-55 year age range indicating that the transition to a positive association between BMI and risk occurs after age 55.
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Affiliation(s)
- Ann Von Holle
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinksa Institutet, Stockholm, Sweden
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - William Blot
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Jessica Clague DeHart
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Agnes Fournier
- Centre for Research in Epidemiology and Statistics, Paris, France
| | - Montse Garcia-Closas
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Graham Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Marcela Guevara
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Alicia Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg, Germany
| | | | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Hannah Lui Park
- Department of Pathology and Laboratory Medicine, Department of Epidemiology, UC Irvine School of Medicine, Irvine, CA, USA
| | - Giovanna Masala
- Institute for the Study and Prevention of Cancer, Florence, Italy
| | - Lene Mellemkjaer
- Diet, Cancer and Health, Danish Cancer Institute, Copenhagen, Denmark
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Julie R Palmer
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | | | - Malin Sund
- Department of Surgical and perioperative Sciences/Surgery, Umea University, Sweden
| | - Rulla Tamimi
- Department of Population Health Sciences, Weill Cornell Medical College, NY, USA
| | - Sandar Tin Tin
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, United Kingdom
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roel Ch Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jian-Min Yuan
- Division of Cancer Control and Population Science, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom; Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom
| | | | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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Wang H, Yee D, Potter D, Jewett P, Yau C, Beckwith H, Watson A, O'Grady N, Wilson A, Brain S, Pohlmann P, Blaes A. Impact of body mass index on pathological response after neoadjuvant chemotherapy: results from the I-SPY 2 trial. Breast Cancer Res Treat 2024; 204:589-597. [PMID: 38216819 PMCID: PMC10959799 DOI: 10.1007/s10549-023-07214-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/05/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE Increased body mass index (BMI) has been associated with poor outcomes in women with breast cancer. We evaluated the association between BMI and pathological complete response (pCR) in the I-SPY 2 trial. METHODS 978 patients enrolled in the I-SPY 2 trial 3/2010-11/2016 and had a recorded baseline BMI prior to treatment were included in the analysis. Tumor subtypes were defined by hormone receptor and HER2 status. Pretreatment BMI was categorized as obese (BMI ≥ 30 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and normal/underweight (< 25 kg/m2). pCR was defined as elimination of detectable invasive cancer in the breast and lymph nodes (ypT0/Tis and ypN0) at the time of surgery. Logistic regression analysis was used to determine associations between BMI and pCR. Event-free survival (EFS) and overall survival (OS) between different BMI categories were examined using Cox proportional hazards regression. RESULTS The median age in the study population was 49 years. pCR rates were 32.8% in normal/underweight, 31.4% in overweight, and 32.5% in obese patients. In univariable analysis, there was no significant difference in pCR with BMI. In multivariable analysis adjusted for race/ethnicity, age, menopausal status, breast cancer subtype, and clinical stage, there was no significant difference in pCR after neoadjuvant chemotherapy for obese compared with normal/underweight patients (OR = 1.1, 95% CI 0.68-1.63, P = 0.83), and for overweight compared with normal/underweight (OR = 1, 95% CI 0.64-1.47, P = 0.88). We tested for potential interaction between BMI and breast cancer subtype; however, the interaction was not significant in the multivariable model (P = 0.09). Multivariate Cox regression showed there was no difference in EFS (P = 0.81) or OS (P = 0.52) between obese, overweight, and normal/underweight breast cancer patients with a median follow-up time of 3.8 years. CONCLUSION We found no difference in pCR rates by BMI with actual body weight-based neoadjuvant chemotherapy in this biologically high-risk breast cancer population in the I-SPY2 trial.
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Affiliation(s)
- Haiyun Wang
- Cancer Care Associates of York, York, PA, USA
| | - Douglas Yee
- Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware St SE, MMC 480, Minneapolis, MN, 55455, USA
| | - David Potter
- Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware St SE, MMC 480, Minneapolis, MN, 55455, USA
| | - Patricia Jewett
- Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware St SE, MMC 480, Minneapolis, MN, 55455, USA
| | - Christina Yau
- University of California San Francisco, San Francisco, USA
| | - Heather Beckwith
- Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware St SE, MMC 480, Minneapolis, MN, 55455, USA
| | | | | | - Amy Wilson
- Quantum Leap Healthcare Collaborative, San Francisco, USA
| | - Susie Brain
- University of California San Francisco, San Francisco, USA
| | - Paula Pohlmann
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Anne Blaes
- Division of Hematology, Oncology and Transplantation, University of Minnesota, 420 Delaware St SE, MMC 480, Minneapolis, MN, 55455, USA.
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Ma Y, Wei S, Dang L, Gao L, Shang S, Hu N, Peng W, Zhao Y, Yuan Y, Zhou R, Wang Y, Gao F, Wang J, Qu Q. Association between the triglyceride-glucose index and cognitive impairment in China: a community population-based cross-sectional study. Nutr Neurosci 2024; 27:342-352. [PMID: 36976719 DOI: 10.1080/1028415x.2023.2193765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Insulin resistance (IR) is a feature of metabolic syndrome and plays an important role in cognitive impairment (CI). The triglyceride-glucose (TyG) index is a convenient and cost-effective surrogate for assessing IR. This study aimed to assess the association between the TyG index and CI. METHODS This community population-based cross-sectional study used a cluster-sampling methodology. All participants underwent the education-based Mini-Mental State Examination (MMSE), and those with CI were identified using standard thresholds. The fasting blood triglyceride and glucose levels were measured in the morning, and the TyG index was calculated as ln (½ fasting triglyceride level [mg/dL] × fasting blood glucose level [mg/dL]). Multivariable logistic regression and subgroup analysis were used to assess the relationship between the TyG index and CI. RESULTS This study included 1484 subjects, of which 93 (6.27%) met the CI criteria. Multivariable logistic regression showed that CI incidence increased by 64% per unit increase in the TyG index (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.02-2.63, p = 0.042). CI risk was 2.64-fold higher in the highest TyG index quartile compared to the lowest TyG index quartile (OR = 2.64, 95% CI: 1.19-5.85, p = 0.016). Finally, interaction analysis showed that sex, age, hypertension, and diabetes did not significantly affect the association between the TyG index and CI. CONCLUSION The present study suggested that an elevated TyG index was associated with a higher CI risk. Subjects with a higher TyG index should manage and treat at an early stage to alleviate the cognitive decline.
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Affiliation(s)
- Yimeng Ma
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Shan Wei
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Liangjun Dang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Ling Gao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Suhang Shang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Ningwei Hu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Wei Peng
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yi Zhao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Ye Yuan
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Rong Zhou
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yanyu Wang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Fan Gao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Jin Wang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
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17
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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Fu Y, Yu Y, Wang Y, Sun Y, Zhang K, Xu F, Wang N, Wang B, Lu Y. Nonlinear relationship between body mass index and serum uric acid: An observational and Mendelian randomization study among Chinese adults. Nutr Metab Cardiovasc Dis 2024; 34:998-1007. [PMID: 38218712 DOI: 10.1016/j.numecd.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/10/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS Conflicting evidence exists on the relationship between body mass index (BMI) and serum uric acid (SUA), and importantly, the causal role of BMI in SUA remains unclear. We aimed to evaluate the BMI-SUA relationship and its causality among Chinese adults using observational and Mendelian randomization (MR) analyses. METHODS AND RESULTS Study included 6641 adults from East China. A genetic risk score based on 14 BMI-associated East Asian variants was formulated. One-sample MR and non-linear MR analyses assessed the causal link between BMI_GRS and SUA levels. Mean BMI levels were 24.8 (SD 3.4) and 24.3 (SD 3.6) kg/m2 in men and women, respectively. Spline models revealed gender-specific BMI-SUA associations: a reverse J-shape for men and a J-shape for women (P-values for nonlinearity <0.05). In men, BMI showed a positive correlation with SUA levels when BMI was below 29.6 kg/m2 (beta coefficient 19.1 [95 % CI 15.1, 23.0] μmol/L per 1-SD increase in BMI), while in women, BMI exhibited a negative correlation with SUA levels when the BMI was less than 21.7 kg/m2 (beta coefficient -12.9 [95 % CI -21.6, -4.1] μmol/L) and a positive correlation when BMI exceeded 21.7 kg/m2 (beta coefficient 13.3 [95 % CI 10.9, 15.8] μmol/L). Furthermore, MR analysis suggested non-linear BMI-SUA link in women but not men. CONCLUSION Our study indicates a non-linear correlation between BMI and SUA in both genders. It is noteworthy that in women, this correlation may have a causal nature. Nevertheless, further longitudinal investigations are required to authenticate our findings.
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Affiliation(s)
- Yanqi Fu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuefeng Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Xu
- iHuman Institute, School of Life Science and Technology, Shanghai Tech University, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Bin Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Cao Q, Fan C, Fei Y, Zhang S, Shen T, Meng H. Waist-to-height ratio is a better predictor of hypertension in women during recovery from anesthesia compared to BMI, waist-to-hip ratio, and waist circumference. Heliyon 2024; 10:e28297. [PMID: 38533001 PMCID: PMC10963644 DOI: 10.1016/j.heliyon.2024.e28297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
This was an observational study of patients with benign breast tumors intended to investigate and compare the predictive value of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) for hypertension in the recovery room. Logistic regression analysis was used to determine the association between these body fat anthropometric indices and hypertension. Receiver operating characteristic curve (ROC) analysis was performed to assess the comparative predictive ability. A total of 689 women were evaluated. Patients with BMI ≥28 (kg/m2), WC > 85 cm, WHR ≥0.82, and WHtR ≥0.5 had a significantly higher probability of increased systolic blood pressure (SBP) and diastolic blood pressure (DBP) than patients with less than threshold values (all P < 0.05). The areas under the ROC curve (AUC) of BMI, WC, and WHtR where all modestly significant (all AUC ≥0.65) and nearly identical at 0.6592, 0.65, and 0.6724, respectively. Conclusion: body fat anthropometric indices are useful predicting hypertension during recovery from general anesthesia in patients with benign breast tumors undergoing day surgery; WHtR outperformed the other indices and nearly identical.
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Affiliation(s)
- Qinqin Cao
- Department of Anesthesiology, Affiliated Hospital of Jining Medical University, China
| | - Chengjuan Fan
- Department of Nephrology, Affiliated Hospital of Jining Medical University, China
| | - Yufen Fei
- Department of Anesthesiology, Affiliated Hospital of Jining Medical University, China
| | - Shouxin Zhang
- Department of Anesthesiology, Affiliated Hospital of Jining Medical University, China
| | - Tong Shen
- Department of Anesthesiology, Affiliated Hospital of Jining Medical University, China
| | - Haihong Meng
- Department of Anesthesiology, Affiliated Hospital of Jining Medical University, China
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20
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Li LX, Socinski MA, Kichenadasse G, Karapetis CS, Shahnam A, McKinnon RA, Rowland A, Hopkins AM, Sorich MJ. A lack of association between BMI and chemoimmunotherapy efficacy in advanced non-small cell lung cancer: Secondary analysis of the IMpower150 and IMpower130 clinical trials. BMC Cancer 2024; 24:379. [PMID: 38528478 DOI: 10.1186/s12885-024-12132-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/17/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Multiple studies have indicated that patients with high body mass index (BMI) may have favourable survival outcomes following treatment with an immune checkpoint inhibitor (ICI). However, this evidence is limited by several factors, notably the minimal evidence from randomised controlled trials (RCTs), the use of categorised BMI with inconsistent cut point definitions, and minimal investigation of contemporary combination ICI therapy. Moreover, whether overweight and obese patients gain a larger benefit from contemporary frontline chemoimmunotherapy in non-small cell lung cancer (NSCLC) is unclear. METHODS This secondary analysis pooled individual patient data from the intention-to-treat population of the IMpower130 and IMpower150 RCTs comparing chemoimmunotherapy versus chemotherapy. Co-primary outcomes were overall survival (OS) and progression-free survival (PFS). The potentially non-linear relationship between BMI and chemoimmunotherapy treatment effect was evaluated using Multivariable Fractional Polynomial Interaction (MFPI). As a sensitivity analysis, chemoimmunotherapy treatment effect (chemoimmunotherapy versus chemotherapy) on survival was also estimated for each BMI subgroup defined by World Health Organisation classification. Exploratory analyses in the respective chemoimmunotherapy and chemotherapy cohort were undertaken to examine the survival outcomes among BMI subgroups. RESULTS A total of 1282 patients were included. From the MFPI analysis, BMI was not significantly associated with chemoimmunotherapy treatment effect with respect to either OS (p = 0.71) or PFS (p = 0.35). This was supported by the sensitivity analyses that demonstrated no significant treatment effect improvement in OS/PFS among overweight or obese patients compared to normal weight patients (OS: normal BMI HR = 0.74 95% CI 0.59-0.93, overweight HR = 0.78 95% CI 0.61-1.01, obese HR = 0.84 95% CI 0.59-1.20). Exploratory analyses further highlighted that survival outcomes were not significantly different across BMI subgroups in either the chemoimmunotherapy therapy cohort (Median OS: normal BMI 19.9 months, overweight 17.9 months, and obese 19.5 months, p = 0.7) or the chemotherapy cohort (Median OS: normal 14.1 months, overweight 15.9 months, and obese 16.7 months, p = 0.7). CONCLUSION There was no association between high BMI (overweight or obese individuals) and enhanced chemoimmunotherapy treatment benefit in front-line treatment of advanced non-squamous NSCLC. This contrasts with previous publications that showed a superior treatment benefit in overweight and obese patients treated with immunotherapy given without chemotherapy.
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Affiliation(s)
- Lee X Li
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, SA, Australia.
| | | | - Ganessan Kichenadasse
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Christos S Karapetis
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
- Flinders Medical Centre, Adelaide, Australia
| | - Adel Shahnam
- Department of Medical Oncology, Peter McCallum Cancer Centre, Melbourne, Australia
| | - Ross A McKinnon
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, SA, Australia
| | - Andrew Rowland
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, SA, Australia
| | - Ashley M Hopkins
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, SA, Australia
| | - Michael J Sorich
- College of Medicine and Public Health, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, SA, Australia
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21
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Choe Y. Obesity and Upper Gastrointestinal Diseases. Korean J Gastroenterol 2024; 83:81-86. [PMID: 38522850 DOI: 10.4166/kjg.2024.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Abstract
Obesity increases gastroesophageal reflux disease through several factors. As a result, Barrett's esophagus, esophageal adenocarcinoma, and gastroesophageal junctional gastric cancer are increasing. Existing studies usually defined obesity by body mass index and analyzed the correlation. Recently, more studies have shown that central obesity is a more important variable in upper gastrointestinal diseases related to gastroesophageal reflux. Studies have reported that weight loss is effective in reducing gastroesophageal reflux symptoms. Obesity also affects functional gastrointestinal diseases. A significant correlation was shown in upper abdominal pain, reflux, vomiting, and diarrhea rather than lower abdominal diseases.
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Affiliation(s)
- Younghee Choe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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22
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Ambreen S, Yazdani N, Alvi AS, Qazi MF, Hoodbhoy Z. Association of maternal nutritional status and small for gestational age neonates in peri-urban communities of Karachi, Pakistan: findings from the PRISMA study. BMC Pregnancy Childbirth 2024; 24:214. [PMID: 38519904 PMCID: PMC10958913 DOI: 10.1186/s12884-024-06420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Early pregnancy nutritional status can be associated with adverse birth outcomes such as small-for-gestational age (SGA) and low birth weight (LBW). BMI (Body Mass Index) and MUAC (Mid-upper arm circumference) are easy to use assessments and are indicative of the pre-pregnancy nutritional status if obtained in the first trimester. This study primarily assesses the association of maternal nutritional status using BMI and MUAC with SGA in a community-based cohort of Pakistani women. It also aims to determine the predictive ability of MUAC and BMI in predicting SGA. Secondarily, we assessed the association between maternal nutrition and large for gestational age (LGA) and LBW. METHODS This study is a secondary analysis of an ongoing pregnancy cohort "Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA)"in Ibrahim Hyderi and Rehri Goth, Karachi. PRISMA participants who were enrolled between January 2021 to August 2022 were included given they had a gestational age < 14 weeks confirmed via ultrasound, MUAC and BMI measurements were available and birth weight was captured within 72 hours. Multivariable logistic regression was used to determine an association between maternal nutritional status and SGA. The PRISMA study was approved by the Aga Khan University Ethics Review Committee (2021-5920-15,518). RESULTS Of 926 women included in the analysis, 26.6% (n = 247) had a low MUAC (< 23 cm) while 18.4% (n = 171) were underweight (BMI < 18.5 kg/m2). Nearly one third of low MUAC and underweight women delivered SGA infants (34.4 and 35.1% respectively). Underweight women and women with low MUAC had a statistically significant association with SGA (Underweight: OR 1.49, 95% CI 1.1,2.4; Low MUAC-OR 1.64, 95% CI 1.2,2.3) as well as LBW (Underweight: OR-1.63, 95% CI 1.1,2.4; Low MUAC-OR-1.63, 95% CI 1.2,2.3). ROC curves showed that MUAC and BMI had modest predictability for SGA (AUC < 0.7). CONCLUSION Maternal nutritional status as indicated by BMI and MUAC are strongly associated with adverse pregnancy outcomes including SGA, LGA and LBW. Although MUAC and BMI are widely used to determine maternal nutritional status, they have poor predictive ability for newborn size. Further research is needed to identify other tools or a combination of tools to better predict adverse birth outcomes in resource-limited settings and plan interventions.
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Affiliation(s)
| | - Nida Yazdani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | - Zahra Hoodbhoy
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
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23
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Hidestrand P, Svensson B, Simpson P, Liuba P, Weismann CG. Impact of Underweight, Overweight, and Obesity on Health-Related Quality of Life in Children with Tetralogy of Fallot Variants. Pediatr Cardiol 2024:10.1007/s00246-024-03416-w. [PMID: 38506963 DOI: 10.1007/s00246-024-03416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/10/2024] [Indexed: 03/22/2024]
Abstract
Traditional cardiovascular risk factors put patients with congenital heart disease (CHD) at increased risk for cardiovascular morbidity and mortality. The aim of this study was to evaluate whether body mass index (BMI) is associated with health-related quality of life (HRQoL) in patients with variants of Tetralogy of Fallot (TOF). Patients and parents of children with variants of TOF-CHD were asked to fill out the PedsQL 4.0 questionnaire and provide weight and length. Patients were categorized into low, normal, and high BMI percentiles. Other demographic data were obtained from the Swedish national registry for congenital heart disease (SWEDCON). Statistical analyses included non-parametric Mann-Whitney U test, Fisher exact, and Chi-square tests. Eighty-five patients were included. Twelve were overweight or obese, 57 had a normal BMI, and 16 were underweight. There was a significant difference in age and gender between the groups. Comparing overweight/obese children to those with normal BMI, physical and social functioning were impaired, while emotional and school function were comparable between the groups. This applied to both child and parental assessment. When comparing underweight to normal weight children, school functioning assessed by the parent was the only domain significantly different from patients with a normal BMI. Children with variants of TOF and overweight/obesity have lower HRQoL, particularly in physical and social functioning, while underweight children may have impaired school functioning. We suggest that preventive measures aimed at maintaining a normal weight should be taken early in life to reduce long-term cardiovascular risk in the CHD population.
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Affiliation(s)
- Pip Hidestrand
- Department of Pediatric Cardiology, Skåne University Hospital, Lund University, Lund, Sweden.
- Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Birgitta Svensson
- Department of Pediatric Cardiology, Skåne University Hospital, Lund University, Lund, Sweden
- Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Pippa Simpson
- Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Petru Liuba
- Department of Pediatric Cardiology, Skåne University Hospital, Lund University, Lund, Sweden
- Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Constance G Weismann
- Department of Pediatric Cardiology, Skåne University Hospital, Lund University, Lund, Sweden
- Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig Maximilian University, Munich, Germany
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24
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Kim KY, Hwang J, Park SH, Cho M, Kim YM, Kim HI, Hyung WJ. Superior lymph node harvest by fluorescent lymphography during minimally invasive gastrectomy for gastric cancer patients with high body mass index. Gastric Cancer 2024:10.1007/s10120-024-01482-w. [PMID: 38502275 DOI: 10.1007/s10120-024-01482-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/14/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Fluorescent lymphography (FL) using indocyanine green (ICG) allows for the visualization of all draining lymph nodes (LNs), thereby increasing LN retrieval. However, no studies have assessed the efficacy of FL in high body mass index (BMI) gastric cancer patients, even as LN yield decreases with increasing BMI in gastrectomy. This study aimed to investigate the influence of FL on LN retrieval in high BMI gastric cancer patients. METHODS Gastric cancer patients who underwent laparoscopic or robotic gastrectomies from 2013 to 2021 were included. Patients were classified into two groups, with FL (FL group) or without FL (non-FL group). The effect of FL on LN retrieval was assessed by BMI. Inverse probability of treatment weighting (IPTW) was used to ensure comparability between groups. RESULTS Retrieved LN number decreased as BMI increased regardless of FL application (P < 0.001). According to the IPTW analysis, the mean retrieved LN number was significantly higher in the FL group (48.4 ± 18.5) than in the non-FL group (39.8 ± 16.3, P < 0.001), irrespective of BMI. The FL group exhibited a significantly higher proportion of patients with 16 or more LNs (99.5%) than the non-FL group (98.1%, P < 0.001). The FL group also had a significantly higher proportion of patients with 30 or more LNs (86.6%) than the non-FL group (72.2%, P < 0.001). In both the normal and high-BMI patients, the FL group had a significantly larger percentage of patients with a higher nodal classification than the non-FL group. CONCLUSION FL resulted in more LN retrieval, even in high BMI patients. FL ensures accurate staging by maintaining the appropriate retrieved LN number in high BMI gastric cancer patients.
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Affiliation(s)
- Ki-Yoon Kim
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Jawon Hwang
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Sung Hyun Park
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Minah Cho
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Yoo Min Kim
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Hyoung-Il Kim
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, and Gastric Cancer Center, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea.
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25
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Wang Z, Li D, Zhang C. Ethnic‑specific associations between body mass index and gastric cancer: a Mendelian randomization study in European and Korean populations. Gastric Cancer 2024:10.1007/s10120-024-01491-9. [PMID: 38498241 DOI: 10.1007/s10120-024-01491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/10/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Zhe Wang
- Department of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, China
| | - Da Li
- Department of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, China
| | - Cheng Zhang
- Department of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, China.
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26
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Yang J, Chen Y, Li W. Association between body mass index and electrocardiogram indices: A Mendelian randomization study. J Electrocardiol 2024; 84:58-64. [PMID: 38520906 DOI: 10.1016/j.jelectrocard.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) remain a global health concern, and body mass index (BMI) is known to be associated with an increased risk of CVD, but the exact mechanisms underlying this relationship remain unclear. This study employs Mendelian randomization (MR) to investigate the causal association between BMI and electrocardiogram (ECG) indices, providing insights into potential pathways linking obesity to CVD. METHODS We conducted a comprehensive MR study utilizing large-scale genetic and ECG data from diverse populations. Instrumental variables were selected from genome-wide association studies, ensuring their relevance to BMI. Causal relationships between BMI and ECG indices, including P wave duration, PR interval, QRS duration, and QT interval, were assessed using various MR methods, with inverse variance weighted (IVW) considered as the primary analysis. RESULTS Our MR analysis revealed a significant positive causal association between higher BMI and P wave duration (β = 8.078, 95% CI: 5.322 to 10.833, p < 0.001), suggesting a potential mechanism through which higher BMI may contribute to arrhythmogenic risks. However, no significant causal associations were observed between BMI and PR interval, QRS duration, or QT interval (all p > 0.005). In addition, our study also found that there is no horizontal pleiotropy between BMI and P wave duration, PR interval, QRS duration, and QT interval, suggesting that the conclusions of this study are robust. CONCLUSION This study supports a causal relationship between elevated BMI and prolonged P wave duration, a marker of increased atrial arrhythmogenic risk. Further investigations are still needed to elucidate the underlying mechanisms.
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Affiliation(s)
- Jinfeng Yang
- Department of Electrophysiology, Guigang City People's Hospital, Guigang, Guangxi, China
| | - YiZhao Chen
- Department of Cardiology, Guigang City People's Hospital, Guigang, Guangxi, China.
| | - Wei Li
- Department of Cardiology, Guigang City People's Hospital, Guigang, Guangxi, China
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Son Y, Quiring ME, Dalton RM, Thomas B, Davidson N, DeVincentz D, Payne C, Parikh SH, Fink BA, Mueller T, Brown G. Renal mass imaging modalities: does body mass index (BMI) matter? Int Urol Nephrol 2024:10.1007/s11255-024-03962-5. [PMID: 38499727 DOI: 10.1007/s11255-024-03962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/22/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Accurate measurement of renal mass size is crucial in the management of renal cancer. With the burdensome cost of imaging yet its need for management, a better understanding of the variability among patients when determining mass size remains of urgent importance. Current guidelines on optimal imaging are limited, especially with respect to body mass index (BMI). The aim of this study is to discern which modalities accurately measure renal mass size and whether BMI influences such accuracy. METHODS A multi-institutional chart review was performed for adult patients undergoing partial or radical nephrectomy between 2018 and 2021, with 236 patients ultimately included. Patients were categorized by BMI (BMI 1: 18.5-24.9, BMI 2: 25-29.9, BMI 3: 30-34.9, and BMI 4: ≥ 35). The greatest mass lengths were compared between the pathology report and the following: computerized tomography (CT), renal ultrasound, and magnetic resonance imaging (MRI). RESULTS The difference between greatest length on CT with contrast and MRI were significantly different when compared to pathologic measurement. BMI groups 3 and 4 were found to have a significant difference in size estimates compared to BMI 2 for CT with contrast. No difference was found between size estimates by BMI group for any other imaging modality. CONCLUSION CT with contrast becomes less accurate at estimating mass size for patients with BMI > 30. While contrast-enhanced CT remains a vital imaging modality for tissue enhancement in the context of unknown renal masses, caution must be used for mass size estimation in the obese population.
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Affiliation(s)
- Young Son
- Department of Urology, Jefferson Health New Jersey, 18 E Laurel Rd, Stratford, NJ, 08084, USA.
| | - Mark E Quiring
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Raeann M Dalton
- School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Brian Thomas
- School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Noah Davidson
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Dayna DeVincentz
- College of Science and Mathematics, Rowan University, Glassboro, NJ, USA
| | - Collin Payne
- College of Osteopathic Medicine, Nova Southeastern University, Tampa Bay, FL, USA
| | - Sahil H Parikh
- School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Benjamin A Fink
- School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Thomas Mueller
- Department of Urology, Jefferson Health New Jersey, 18 E Laurel Rd, Stratford, NJ, 08084, USA
| | - Gordon Brown
- Department of Urology, Jefferson Health New Jersey, 18 E Laurel Rd, Stratford, NJ, 08084, USA
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Huffman N, Pasqualini I, Redfern RE, Murray TG, Deren ME, Israelite CL, Nelson CL, Van Andel D, Cholewa JM, Anderson MB, Klika AK, McLaughlin JP, Piuzzi NS. Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty. Eur J Orthop Surg Traumatol 2024:10.1007/s00590-024-03894-x. [PMID: 38488936 DOI: 10.1007/s00590-024-03894-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA. METHODS 1736 patients within a prospective observational study were categorized into BMI classes. Pre- and postoperative Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR), satisfaction, and pain scores were compared by BMI class using one-way ANOVA. RESULTS Healthy weight patients reported the highest preoperative HOOS JR (56.66 ± 13.35) compared to 45.51 ± 14.45 in Class III subjects. Healthy weight and Class III patients reported the lowest (5.65 ± 2.01) and highest (7.06 ± 1.98, p < 0.0001) preoperative pain, respectively. Changes in HOOS JR scores from baseline suggest larger improvements with increasing BMI class, where Class III patients reported an increase of 33.7 ± 15.6 points at 90 days compared to 26.1 ± 17.1 in healthy weight individuals (p = 0.002). Fewer healthy weight patients achieved the minimal clinically important difference (87.4%) for HOOS JR compared to Class II (96.5%) and III (94.7%) obesity groups at 90 days postoperatively. Changes in satisfaction and pain scores were largest in the Class III patients. Overall, no functional outcomes varied by BMI class postoperatively. CONCLUSION Patients of higher BMI class reported greater improvements following THA. While risk/benefit shared decision-making remains a personalized requirement of THA, this study highlights that utilization of BMI cutoff may not be warranted based on pain and functional improvement.
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Affiliation(s)
- Nickelas Huffman
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA
| | - Ignacio Pasqualini
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA
| | | | - Trevor G Murray
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA
| | - Matthew E Deren
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA
| | - Craig L Israelite
- Department of Orthopaedic Surgery, Penn Medicine, Philadelphia, PA, 19104, USA
| | - Charles L Nelson
- Department of Orthopaedic Surgery, Penn Medicine, Philadelphia, PA, 19104, USA
| | | | | | | | - Alison K Klika
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA
| | - John P McLaughlin
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic Foundation, Orthopedic and Rheumatology Institute, Cleveland, OH, 44195, USA.
- Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, OH, 44195, USA.
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Wang C, Yu Q, Chu T, Wang F, Dong F, Xin H, Wang D, Liu Y, Zhai J. Relationship of environmental exposure temperature and temperature extremes on sperm DNA fragmentation index in men with different BMI values and the indirect effect of DNA fragmentation index on semen parameters. Sci Total Environ 2024; 916:170292. [PMID: 38278223 DOI: 10.1016/j.scitotenv.2024.170292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
Prior studies have established a significant correlation between the DNA fragmentation index (DFI) and infertility. Additionally, certain investigations suggest that environmental exposure may serve as an etiological factor impacting semen quality. This study aimed to explore the impact of season, ambient temperature, and weather extremes on the DFI of sperm, along with other relevant parameters. Furthermore, it sought to assess how ambient temperature affects the DFI of sperm and other semen parameters in populations with varying BMI values. Additionally, the study analyzed the transient indirect effect of DFI on sperm parameters. This retrospective study analyzed semen samples from 11,877 men, selected based on female factor considerations, spanning from January 2016 to December 2021. Participants were grouped according to the season of semen collection. The results showed that samples collected in summer had a lower semen volume and sperm motility, while those collected in autumn had a lower DFI. We analyzed the exposure-response ratio between environmental exposure temperature and semen parameters using a generalized additive model. Results showed that the curve of the exposure-response relationship was U-shaped or inverted U-shaped; when the air temperature exposure was below the threshold, for each degree of temperature increase, the total sperm motility, sperm concentration, and progressive motility increased by 0.16 %, 0.29 × 10 (Levine, 1999)/ml and 0.14 %, respectively, while the DFI and inactivity rate decreased by 0.078 % and 0.15 %, respectively. When the air temperature exposure exceeded the threshold, for each degree of temperature increase, the sperm concentration, total sperm motility, semen volume and progressive motility decreased by 0.42 × 10 (Levine, 1999)/ml, 0.11 %, 0.0078 ml and 0.15 %, respectively, while the DFI and inactivity rate increased by 0.13 % and 0.12 %, respectively. Extremely cold weather during spermatogenesis was positively correlated with DFI, and extremely hot weather was negatively correlated with sperm motility. Subgroup analysis revealed that individuals classified as overweight / obese exhibited more pronounced changes in sperm parameters and the DFI in response to variations in environmental exposure temperature compared to those with a normal BMI. In the analysis of the relationship between DFI and sperm parameters, the results showed an inverted U-shape relationship between DFI and semen volume, and a negative correlation between DFI and sperm concentration and sperm motility. And we found that ambient temperature affects sperm parameters through DFI at low as well as average temperatures, whereas at high temperatures this indirect effect is no longer present.
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Affiliation(s)
- Chen Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Qiwei Yu
- Faculty of Geographical Science, Beijing Normal University, Beijing, China
| | - Ting Chu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Fang Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Fangli Dong
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Hang Xin
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Di Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Yaping Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Jun Zhai
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China.
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Turnquist BE, MacIver PH, Katzel LI, Waldstein SR. Interactive Relations of Body Mass Index, Cardiorespiratory Fitness, and Sex to Cognitive Function in Older Adults. Arch Clin Neuropsychol 2024:acae018. [PMID: 38486431 DOI: 10.1093/arclin/acae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE The course of cognitive aging is influenced by multiple health factors. This cross-sectional study investigated the interactive relations between body mass index (BMI), maximum oxygen consumption (VO2max), and sex on neuropsychological outcomes in community-dwelling predominantly older adults. METHODS Participants were 164 healthy adults [M (SD) = 64.6 (12.5) years, 56% men, 87% white] who participated in an investigation of cardiovascular risk factors and brain health. Multivariable regression analysis, adjusted for age, education, ethnicity, smoking, alcohol consumption, and depression, examined the interactive relations of BMI, VO2max, and sex to multiple neuropsychological outcomes. RESULTS Significant BMI*VO2max*sex interactions for Grooved Pegboard dominant (p = .019) and nondominant (p = .005) hands revealed that men with lower VO2max (l/min) displayed worse performance with each hand as BMI increased (p's < .02). A significant BMI*sex interaction for Logical Memory-Delayed Recall (p = .036) (after adjustment for blood glucose) showed that men, but not women, with higher BMI demonstrated worse performance (p = .036). Lastly, significant main effects indicated that lower VO2max was related to poorer logical memory, and higher BMI was associated with poorer Trail Making B and Stroop interference scores (p's < .05). CONCLUSIONS Among men, higher cardiorespiratory fitness may protect against the negative impact of greater BMI on manual dexterity and motor speed, making VO2max a target for intervention. Higher BMI is further associated with poorer executive function and verbal memory (in men), and lower VO2max is associated with poorer verbal memory.
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Affiliation(s)
- B Eric Turnquist
- Department of Psychology, University of Maryland, Baltimore, MD, USA
- Department of Psychology, American University, Washington, DC, USA
| | - Peter H MacIver
- Department of Psychology, University of Maryland, Baltimore, MD, USA
| | - Leslie I Katzel
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, USA
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore, MD, USA
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Gumilang RA, Fan YC, Wu SH, Bai CH. Adiposity indices and their higher predictive value for new-onset hypertension in metabolically healthy young women: findings from a population-based prospective cohort study. BMC Cardiovasc Disord 2024; 24:150. [PMID: 38475731 DOI: 10.1186/s12872-024-03817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND AIMS The present study aimed to investigate the predictive ability of selected adiposity indices, such as body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and waist-to-height ratio (WHtR), for new-onset hypertension in metabolically healthy Taiwanese adults. The study also sought to establish sex-specific cutoff points for these indices and to analyze the risk of new-onset hypertension, taking into account sex and age. METHODS This prospective cohort study utilized the Taiwan Biobank database to examine metabolically healthy participants aged between 20 and 65 at baseline. Four adiposity indices, namely BMI, WHR, WC, and WHtR, were calculated and used to predict new-onset hypertension over 4 years. Receiver operating characteristics (ROCs) and areas under the curve (AUCs) were used to evaluate the effectiveness of the parameters in predicting new-onset hypertension over 4 years. Sex-specific cutoff points were identified and used to assess the risk of new-onset hypertension. RESULTS This study analyzed 13,375 participants over 4.28 years. The incidence of new-onset hypertension was 17.65%. The new-onset rate of hypertension was 34.39% in men and 65.61% in women. Adiposity indices effectively predict new-onset hypertension, with WHtR having the highest predictive value (i.e., AUC) for both sexes. The classification of participants into low and high categories for each adiposity index was based on sex-specific cutoff points, and the risk of new-onset hypertension was assessed according to sex and age. This study found that high adiposity indices predicted a significantly higher risk of new-onset hypertension in metabolically healthy adults. The risk was equal for both sexes. Young women had a higher risk of new-onset hypertension than middle-aged women when they were further categorized. All risk ratios of the indices in young women were over two-fold and significant. CONCLUSION According to the sex-specific cutoff point, high adiposity indices had a higher predictive value for new-onset hypertension in metabolically healthy Taiwanese young women.
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Affiliation(s)
- Rizki Amalia Gumilang
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Faculty of Medicine, Public Health, and Nursing/Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yen-Chun Fan
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shang-Hao Wu
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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Ray S, Kapoor N, Deshpande N, Chatterjee S, Kumar J, Tantia O, Goyal G, Mukherjee JJ, Singh AK. Anti-obesity medications: current and futureAn overview of therapeutic options of obesity management in India: the Integrated Diabetes and Endocrinology Academy (IDEA) 2023 Congress update. Expert Rev Clin Pharmacol 2024. [PMID: 38471973 DOI: 10.1080/17512433.2024.2330468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/11/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION With newer anti-obesity medications (AOMs) being introduced at a rapid pace, it is prudent to make a concise and updated clinical practice document that may help busy clinicians in daily clinical practice. A group of metabolic physicians, diabetologists, endocrinologists, and bariatric surgeons assembled during the Integrated Diabetes and Endocrine Academy 2023 Congress (IDEACON, July 2023, Kolkata, India) to compile an update of pharmacotherapeutic options for managing people with obesity in India. AREAS COVERED After an extensive review of the literature by experts in different domains, this update provides all available information on the management of obesity, with a special emphasis on both currently available and soon-to-be-available AOMs, in people with obesity. EXPERT OPINION Several newer AOMs have been shown to reduce body weight significantly, thus poised to make a paradigm shift in the management of obesity. While the tolerability and key adverse events associated with these AOMs appear to be acceptable in randomized controlled trials, pharmacovigilance is vital in real-world settings, given the absence of sufficiently long-term studies. The easy availability and affordability of these drugs is another area of concern, especially in developing countries like India.
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Affiliation(s)
- Subir Ray
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India
- Non-Communicable disease Unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Neeta Deshpande
- Belgaum Diabetes Centre and CentraCare Institute of Diabetes, Obesity and Metabolic Health (CIDOM), Belgaum, Karnataka, India
| | - Sanjay Chatterjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
| | - Janardanan Kumar
- Department of Medicine, SRM Hospital & Research Centre, SRMIST, Kattankulathur, Tamil Nadu, India
| | - Om Tantia
- Department of Minimal Access and Bariatric Surgery, ILS Hospital, Kolkata, West Bengal, India
| | - Ghanshyam Goyal
- Department of Medicine, ILS Hospital, Salt Lake, Kolkata, West Bengal, India
| | - Jagat Jyoti Mukherjee
- Department of Medicine, Division of Diabetes & Endocrinology, Apollo Multi-Speciality Hospitals, Kolkata, West Bengal, India
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Dong D, Chen X, Li W, Gao X, Wang Y, Zhou F, Eickhoff SB, Chen H. Opposite changes in morphometric similarity of medial reward and lateral non-reward orbitofrontal cortex circuits in obesity. Neuroimage 2024; 290:120574. [PMID: 38467346 DOI: 10.1016/j.neuroimage.2024.120574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024] Open
Abstract
Obesity has a profound impact on metabolic health thereby adversely affecting brain structure and function. However, the majority of previous studies used a single structural index to investigate the link between brain structure and body mass index (BMI), which hinders our understanding of structural covariance between regions in obesity. This study aimed to examine the relationship between macroscale cortical organization and BMI using novel morphometric similarity networks (MSNs). The individual MSNs were first constructed from individual eight multimodal cortical morphometric features between brain regions. Then the relationship between BMI and MSNs within the discovery sample of 434 participants was assessed. The key findings were further validated in an independent sample of 192 participants. We observed that the lateral non-reward orbitofrontal cortex (lOFC) exhibited decoupling (i.e., reduction in integration) in obesity, which was mainly manifested by its decoupling with the cognitive systems (i.e., DMN and FPN) while the medial reward orbitofrontal cortex (mOFC) showed de-differentiation (i.e., decrease in distinctiveness) in obesity, which was mainly represented by its de-differentiation with the cognitive and attention systems (i.e., DMN and VAN). Additionally, the lOFC showed de-differentiation with the visual system in obesity, while the mOFC showed decoupling with the visual system and hyper-coupling with the sensory-motor system in obesity. As an important first step in revealing the role of underlying structural covariance in body mass variability, the present study presents a novel mechanism that underlies the reward-control interaction imbalance in obesity, thus can inform future weight-management approaches.
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Affiliation(s)
- Debo Dong
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Ximei Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Wei Li
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Yulin Wang
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China; Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Feng Zhou
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China; Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing 400715, China.
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Takehara K, Koga Y, Hachisu Y, Utsugi M, Sawada Y, Saito Y, Yoshimi S, Yatomi M, Tsurumaki H, Shin Y, Wakamatsu I, Kasahara N, Yamaguchi K, Umetsu K, Kouno S, Nakagawa J, Sunaga N, Maeno T, Hisada T. Glasgow prognostic score and body mass index predict short-term discontinuation of the antifibrotic agents pirfenidone and nintedanib. Respir Investig 2024; 62:388-394. [PMID: 38460356 DOI: 10.1016/j.resinv.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/19/2024] [Accepted: 02/17/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND The antifibrotic agents pirfenidone and nintedanib have been shown to be effective in patients with idiopathic pulmonary fibrosis (IPF). However, discontinuation of antifibrotic drugs is a major clinical concern because of the lack of alternative treatment options. Therefore, we identified factors that may be useful for predicting the termination of antifibrotic agents. METHODS We retrospectively recruited 280 IPF patients treated with antifibrotic drugs between 2009 and 2018 from seven regional core hospitals in Gunma prefecture, Japan. RESULTS At four months, the short-term discontinuation group exhibited a significantly worse prognosis in the pirfenidone group and a poorer prognosis in the nintedanib group compared to that in the continuation group. The discontinuation group of pirfenidone at 4 months exhibited lower albumin and higher C-reactive protein (CRP) levels in the sera compared to the group that continued treatment for more than 4 months. In multivariate analysis, the Glasgow prognostic score (GPS), well known as a predictor of cancer prognosis, which comprises serum CRP and albumin levels, predicted early discontinuation and prognosis in the pirfenidone group, whereas the body mass index (BMI) predicted early discontinuation of nintedanib. A high GPS, with both albumin <3.5 g/dL and CRP >1.0 mg/dL, was associated with a poorer prognosis in the pirfenidone group. CONCLUSION GPS and BMI were significant factors for short-term pirfenidone and nintedanib discontinuation, respectively. Initial evaluation of GPS and BMI prior to antifibrotic therapy may contribute to less interrupted IPF management, thus leading to better prognostic outcomes in patients with IPF.
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Affiliation(s)
- Kazutaka Takehara
- Department of Respiratory Medicine, Public Tomioka General Hospital, 2073-1, Tomioka, Tomioka, Gunma 370-2393, Japan; Department of Respiratory Medicine, Kiryu Kosei General Hospital, 6-3, Orihime-machi, Kiryu, Gunma 376-0024, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan.
| | - Yoshimasa Hachisu
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Mitsuyoshi Utsugi
- Department of Respiratory Medicine, Kiryu Kosei General Hospital, 6-3, Orihime-machi, Kiryu, Gunma 376-0024, Japan; Department of Respiratory Medicine, Gunma Saiseikai Maebashi Hospital, 564-1, Kamishindenmachi, Maebashi, Gunma, 371-0821, Japan
| | - Yuri Sawada
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Yasuyuki Saito
- Department of Respiratory Medicine, Isesaki Municipal Hospital, Tsunatorihonchou 12-1, Isesaki, Gunma 372-0817, Japan
| | - Seishi Yoshimi
- Department of Respiratory Medicine, Tone Chuo Hospital, 910-1 Numasu-machi, Numata, Gunma 378-0012, Japan
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Hiroaki Tsurumaki
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Yuki Shin
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi, Gunma, 371-0811, Japan
| | - Ikuo Wakamatsu
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Norimitsu Kasahara
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Koichi Yamaguchi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Kazue Umetsu
- Department of Respiratory Medicine, Fujioka General Hospital, 813-1, Nakakurisu Fujioka, Gunma 375-8503, Japan
| | - Shunichi Kouno
- Department of Respiratory Medicine, Fujioka General Hospital, 813-1, Nakakurisu Fujioka, Gunma 375-8503, Japan
| | - Junichi Nakagawa
- Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan
| | - Noriaki Sunaga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Takeshi Hisada
- Gunma University Graduate School of Health Sciences, 3-39-22 sho-wa machi Maebashi, Gunma 371-8514, Japan
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Fontanezi NM, Maximino P, Machado RHV, Ferrari G, Fisberg M. Association between parental feeding styles, body mass index, and consumption of fruits, vegetables and processed foods with mothers´ perceptions of feeding difficulties in children. BMC Pediatr 2024; 24:167. [PMID: 38459452 PMCID: PMC10921686 DOI: 10.1186/s12887-024-04657-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/20/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers' perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods. METHOD Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m2). RESULTS The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20-9.85), a high body mass index (OR: 1.35; 95% CI: 1.09-1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85-9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant. CONCLUSION This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs.
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Affiliation(s)
- Nathalia Moretti Fontanezi
- Sciences Applied to Pediatrics Postgraduate Program, Federal University of São Paulo, Rua Botucatu, 598, Vila Clementino, São Paulo, 04023-062, SP, Brazil.
| | - Priscila Maximino
- Center for Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Luis Egydio Setúbal Foundation, Sabará Children's Hospital, São Paulo. Av. Angelica 1968, conj 71a 74, São Paulo, 01239-040, SP, Brazil
| | | | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, Universidad de Santiago de Chile (USACH), el Deporte y la Salud, Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile
| | - Mauro Fisberg
- Sciences Applied to Pediatrics Postgraduate Program, Federal University of São Paulo, Rua Botucatu, 598, Vila Clementino, São Paulo, 04023-062, SP, Brazil
- Center for Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Luis Egydio Setúbal Foundation, Sabará Children's Hospital, São Paulo. Av. Angelica 1968, conj 71a 74, São Paulo, 01239-040, SP, Brazil
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Yang H, Kuang M, Qiu J, He S, Yu C, Sheng G, Zou Y. Relative importance of triglyceride glucose index combined with body mass index in predicting recovery from prediabetic state to normal fasting glucose: a cohort analysis based on a Chinese physical examination population. Lipids Health Dis 2024; 23:71. [PMID: 38459527 PMCID: PMC10921811 DOI: 10.1186/s12944-024-02060-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Prediabetes is a high-risk state for diabetes, and numerous studies have shown that the body mass index (BMI) and triglyceride-glucose (TyG) index play significant roles in risk prediction for blood glucose metabolism. This study aims to evaluate the relative importance of BMI combination with TyG index (TyG-BMI) in predicting the recovery from prediabetic status to normal blood glucose levels. METHODS A total of 25,397 prediabetic subjects recruited from 32 regions across China. Normal fasting glucose (NFG), prediabetes, and diabetes were defined referring to the American Diabetes Association (ADA) criteria. After normalizing the independent variables, the impact of TyG-BMI on the recovery or progression of prediabetes was analyzed through the Cox regression models. Receiver Operating Characteristic (ROC) curve analysis was utilized to visualize and compare the predictive value of TyG-BMI and its constituent components in prediabetes recovery/progression. RESULTS During the average observation period of 2.96 years, 10,305 individuals (40.58%) remained in the prediabetic state, 11,278 individuals (44.41%) recovered to NFG, and 3,814 individuals (15.02%) progressed to diabetes. The results of multivariate Cox regression analysis demonstrated that TyG-BMI was negatively associated with recovery from prediabetes to NFG and positively associated with progression from prediabetes to diabetes. Further ROC analysis revealed that TyG-BMI had higher impact and predictive value in predicting prediabetes recovering to NFG or progressing to diabetes in comparison to the TyG index and BMI. Specifically, the TyG-BMI threshold for predicting prediabetes recovery was 214.68, while the threshold for predicting prediabetes progression was 220.27. Additionally, there were significant differences in the relationship of TyG-BMI with prediabetes recovering to NFG or progressing to diabetes within age subgroups. In summary, TyG-BMI is more suitable for assessing prediabetes recovery or progression in younger populations (< 45 years old). CONCLUSIONS This study, for the first time, has revealed the significant impact and predictive value of the TyG index in combination with BMI on the recovery from prediabetic status to normal blood glucose levels. From the perspective of prediabetes intervention, maintaining TyG-BMI within the threshold of 214.68 holds crucial significance.
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Affiliation(s)
- Hongyi Yang
- Department of Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Maobin Kuang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Jiajun Qiu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Shiming He
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Changhui Yu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
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Cheng T, Fan J, Yuan F, Xie H, Zhang C, He Q. Association with pre-pregnancy BMI on early pregnancy loss in infertility patients in first HRT-FET cycles: A retrospective cohort study. Obes Res Clin Pract 2024:S1871-403X(24)00031-0. [PMID: 38453594 DOI: 10.1016/j.orcp.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To investigate the association between pre-pregnancy body mass index (BMI) and the early pregnancy loss rate in patients in first hormone replacement therapy-frozen-thawed embryo transfer (HRT-FET) cycles and find the threshold. METHODS A retrospective cohort study was conducted using a total of 14030 HRT-FET cycles at the Reproductive Center from January 2017 to December 2021. The association of pre-pregnancy BMI on early pregnancy loss rate in patients in HRT-FET cycles was assessed by performing univariate analysis, multivariable logistic regression, curve fitting and threshold effect analysis. RESULTS There were 2076 cycles of early pregnancy loss, and the pregnancy loss rate was 14.80%. After adjusting for confounding factors, the early pregnancy loss rate of the obese group was significantly higher than that of the normal weight group (P < 0.05). The threshold effect analysis showed that as the pre-pregnancy BMI ranged from 21.2 to 25.8 kg/m2, the early pregnancy loss rate came to the plateau phase at the low level. In addition, when the BMI was ≥ 25.8 kg/m2, the early pregnancy loss rate increased by 3% (aOR = 1.03, P = 0.01) with each 1 kg/m2 increment of BMI. CONCLUSION The early pregnancy loss rate might achieve a low level when the pre-pregnancy BMI was within the range of 21.2- 25.8 kg/m2. The early pregnancy loss rate would increase when pre-pregnancy BMI is more than 25.8 kg/m2. For patients in HRT-FET cycles, adjusting their pre-pregnancy BMI to the optimal level by following a healthy diet and daily exercise may help to reduce the early pregnancy loss.
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Affiliation(s)
- Tiantian Cheng
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Jingjing Fan
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Fang Yuan
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Huanhuan Xie
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Cuilian Zhang
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China
| | - Qiaohua He
- People's Hospital of Henan University, Henan Provincial People's Hospital Zhengzhou, 450003, China.
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Aoki J, Kimura K. The Body Mass Index as a Determinant of Acute Ischemic Location in Mild Non-cardioembolic Stroke Patients. Intern Med 2024:2926-23. [PMID: 38432968 DOI: 10.2169/internalmedicine.2926-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Objective Although the body mass index (BMI) is considered a meaningful parameter for evaluating obesity, the association between the BMI and acute non-cardioembolic stroke remains unclear. We investigated how the BMI was related to patients' background, type of infarction, and infarction location in patients with non-cardioembolic stroke using an acute dual study (ADS) cohort. Methods The ADS trial was conducted between May 2011 and June 2017 in Japan. The BMI classifications were those proposed by the World Health Organization classification: underweight, <18.5 kg/m2; normal weight, 18.5-24.9 kg/m2; overweight, 25-29.9 kg/m2; and obese, ≥30 kg/m2. Results Data from 1136 patients were analyzed. The median BMI was 23.6 kg/m2 (interquartile range: 21.6-25.8 kg/m2), with a BMI ≥30 kg/m2 in 63 patients (6%), 25-29.9 kg/m2 in 321 (28%), 18.5-24.9 kg/m2 in 692 (61%), and <18.5 kg/m2 in 60 (5%). The group with a BMI ≥30 kg/m2 was the youngest, and the group with a BMI <18.5 kg/m2 was the oldest (p<0.001). The proportion of patients with a history of hypertension (p<0.001), diabetes (p<0.001), dyslipidemia (p<0.001), and statin therapy (p=0.005) increased with increasing BMI. Pontine infarcts were frequent in the following order: obese, overweight, normal weight, and underweight (24%, 18%, 14%, and 13%, respectively; p=0.034). In contrast, cortical infarct were frequent in the order of underweight, normal weight, overweight, and obese at 20%, 19%, 14%, and 3%, respectively (p=0.007). Conclusion Acute stroke patients with a high BMI have more atherosclerosis-related factors in their backgrounds than those with lower BMIs. In addition, the BMI may be a determinant of infarct location in patients with acute stroke.
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Affiliation(s)
- Junya Aoki
- Department of Neurology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Kazumi Kimura
- Department of Neurology, Graduate School of Medicine, Nippon Medical School, Japan
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Altunok M, Çankaya E, Gözübüyük Kaplan H, Çınar E, Uyanık A, Sevinç C. The effect of body mass index on mortality, peritonitis, technique proficiency and residual renal function in peritoneal dialysis patients. Int Urol Nephrol 2024:10.1007/s11255-024-03988-9. [PMID: 38431535 DOI: 10.1007/s11255-024-03988-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The prevalence of obesity is increasing worldwide. Obesity is also increasing in the chronic kidney disease (CKD) population. There are conflicting data on complications such as mortality, peritonitis, and technique proficiency of peritoneal dialysis (PD) in underweight and obese patients according to body mass index (BMI). We aimed to present the data in our region to the literature by comparing the residual renal function (RRF), peritonitis, technique proficiency, and mortality rates of the patients we grouped according to BMI. METHODS The data of 404 patients who were started and followed up in our clinic between March 2005 and November 2021 were evaluated retrospectively. They were grouped as underweight, normal weight, overweight, and obese according to BMI. RRF, mortality, technique proficiency and peritonitis data of the groups were compared. RESULTS Of the 404 patients, 44 were underweight, 199 were normal weight, 110 were overweight, and 55 were obese. No difference was found between the groups in the technique survey and in the time to first peritonitis with Kaplan-Meier analysis (respectively; p = 0.610, p = 0.445). Multivariate Cox regression analysis showed that BMI did not affect mortality (HR 1.196 [95% CI 0.722-1.981] (p = 0.488)). CONCLUSION In conclusion, we report that BMI has no effect on RRF, peritonitis, technique proficiency, and mortality in patients undergoing PD, and that mortality may depend on additional factors such as mean albumin, time to first peritonitis, and loss of RRF.
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Affiliation(s)
- Murat Altunok
- Department of Nephrology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey.
| | - Erdem Çankaya
- Department of Nephrology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | | | - Enes Çınar
- Department of Nephrology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - Abdullah Uyanık
- Department of Nephrology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - Can Sevinç
- Department of Nephrology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey
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Uzun H, Huner M, Kıvrak M, Zengin E, Ozsagir YÖ, Sönmez B, Akça G. The relationship between anthropometric and metabolic risk factors and testicular function in healthy young men. Clin Exp Reprod Med 2024; 51:48-56. [PMID: 38433014 PMCID: PMC10914502 DOI: 10.5653/cerm.2023.06114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/20/2023] [Accepted: 08/07/2023] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE This study investigated the relationship of anthropometric and metabolic risk factors with seminal and sex steroidal hormone parameters in a screened population of healthy males. METHODS The participants were healthy young men without chronic or congenital diseases. The body composition parameters that we investigated were measured weight, height, and waist circumference (WC), as well as bioelectrical impedance analysis. Semen samples were analyzed for semen volume, sperm concentration, sperm motility and morphology, seminal pH, and liquefaction time. Biochemistry analysis, including glucose and lipid metabolism parameters, was conducted on fasting blood samples. Testicular volume was calculated separately for each testis using ultrasonography. RESULTS Body mass index exhibited an inverse association with total sperm count. WC showed negative correlations with numerous seminal parameters, including sperm concentration, total sperm count, sperm morphology, and follicle-stimulating hormone levels. The basal metabolic rate was associated with seminal pH, liquefaction time, and sperm motility. WC, fat mass percentage, and triglyceride levels exhibited negative correlations with sex hormone binding globulin. The measures of glucose metabolism were associated with a greater number of seminal parameters than the measures of cholesterol metabolism. C-reactive protein levels were inversely associated with sperm concentration and total sperm count. CONCLUSION Anthropometric and metabolic risk factors were found to predict semen quality and alterations in sex steroidal hormone levels.
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Affiliation(s)
- Hakkı Uzun
- Department of Urology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Merve Huner
- Department of Biochemistry, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Mehmet Kıvrak
- Department of Biostatistics, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Ertan Zengin
- Department of Radiology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Yusuf Önder Ozsagir
- Department of Urology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Berat Sönmez
- Department of Urology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
| | - Görkem Akça
- Department of Urology, Recep Tayyip Erdogan University School of Medicine, Rize, Turkey
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Lee D, Chung JM, Lee SD. Pediatric obesity and development of the penis and testis. Investig Clin Urol 2024; 65:189-195. [PMID: 38454829 PMCID: PMC10925733 DOI: 10.4111/icu.20230287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/25/2023] [Accepted: 12/29/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Pediatric obesity is increasing in many countries as socioeconomic status improves and the consumption of high calorie food increases. Thus, effect of obesity on genital development is an important topic. This study aimed to determine relationships of body mass index (BMI) with penile parameters and testicular volume in pediatric patients without penile or testicular abnormalities. MATERIALS AND METHODS Data from 1,499 male pediatric patients from our center were analyzed. Patients with penile or testicular abnormalities were excluded. Their age ranged from 2 to 18 years. These patients were divided into two groups based on their BMI: normal BMI (5th-85th percentile) and high BMI (≥85th percentile). Factors used in analysis included age, anthropometric indicators, baseline penile length (BPL), stretched penile length (SPL), penile circumference (PC), and mean testicular volume. These same parameters were analyzed for different age groups. RESULTS Pediatric patients with normal BMI showed longer BPL and SPL than patients with high BMI (p<0.05). However, PC and mean testicular volumes showed no significant difference between the two groups. BPL was significantly longer in the normal BMI group starting at ten years of age. SPL was significantly longer in the normal BMI group starting at eleven years of age. CONCLUSIONS Our study confirms that having a higher BMI during childhood has a negative effect on penile length. However, there was no significant relationship between BMI and PC or testicular volume.
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Affiliation(s)
- Danbee Lee
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Min Chung
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
| | - Sang Don Lee
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Urology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Weng PW, Chang WP. Influence of body mass index on severity of rotator cuff tears. J Shoulder Elbow Surg 2024; 33:648-656. [PMID: 37573933 DOI: 10.1016/j.jse.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Research on the relationship between obesity and rotator cuff tears (RCTs) has been limited to the impact of obesity on the results of arthroscopic repair of RCTs; thus, a need for rigorous research controlling for other factors affecting RCTs is warranted, especially to better understand the impact of body mass index (BMI) on RCT severity. METHODS A retrospective study of admission records contained in electronic medical records pertaining to patients who were admitted for RCT repair on 1 shoulder between January 2018 and July 2022 was conducted. In total, 386 patients were included. In accordance with guidance regarding obesity from Taiwan's Ministry of Health and Welfare, patients were divided into three groups: underweight or normal weight (BMI <24.0 kg/m2), overweight (BMI 24.0-26.9 kg/m2), or obese (BMI ≥27.0 kg/m2). Magnetic resonance imaging was used to assess RCT severity in terms of four parameters: Patte stage (PS), fatty infiltration (FI), anteroposterior tear size (AP), and retraction size. Multinomial logistic regression analysis was performed on PS and FI grade data, and multiple linear regression analysis was performed on AP tear size and retraction size in order to analyze impact. RESULTS Our results revealed that the average age of the 386 patients was 63.41 years (SD = 9.29) and the mean BMI was 25.88 (SD = 3.72) kg/m2. We found significant differences in PS (P = .003), FI (P < .001), retraction size (P = .001), and AP tear size (P = .001) among patients who were underweight or normal weight, overweight, and obese. After controlling for other risk factors, including age, gender, RCT-prone occupation, duration of shoulder pain prior to surgery, history of shoulder injury, and tobacco use, we found that obese patients had higher severity levels in PS (B = 1.21, OR = 3.36, P = .029), FI (B = 1.38, OR = 3.96, P < .001), retraction size (β = 0.18, P = .001), and AP tear size (β = 0.18, P = .001) compared to underweight or normal weight patients. CONCLUSIONS Our study demonstrates that a correlation exists between BMI-measured obesity and RCT severity. We therefore suggest that adults control their weight given that maintaining a healthy weight is highly associated with better shoulder health.
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Affiliation(s)
- Pei-Wei Weng
- Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Wen-Pei Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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Olukade T, Salama H, Al-Obaidly S, AlQubaisi M, Al-Rifai H. Maternal Body Mass Index and Recommended Gestational Weight Gain in a Middle Eastern Setting. Matern Child Health J 2024; 28:524-531. [PMID: 37955839 PMCID: PMC10914897 DOI: 10.1007/s10995-023-03816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Maternal body mass index (BMI) and gestational weight gain (GWG) are modifiable risk factors that influence pregnancy outcomes. We examined the association between the two factors in pregnant women in Qatar with regard to the GWG recommendations by the Institute of Medicine (IOM) in 2009. METHODS We performed a population-based retrospective cohort analysis of 3547 singleton births, using routinely collected data from a Middle Eastern hospital database. RESULTS The mean maternal age was 29.7 ± 5.5 years, prepregnancy BMI was 27.5 ± 5.8 kg/m2, GWG was 9.58 kg ± 6.87 kg and gestational age at birth was 38.5 ± 1.9 weeks. In line with IOM recommendations, we found that higher BMI was correlated with decreased GWG and BMI was significantly associated with GWG even after adjusting for maternal age, parity, and infants' gestational age at birth. Nonetheless, GWG in more than one-third of women who were overweight or obese exceeded the IOM recommendation.
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Affiliation(s)
- Tawa Olukade
- Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
| | - Husam Salama
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Sawsan Al-Obaidly
- Department of Obstetrics and Gynecology, Hamad Medical Corporation, Doha, Qatar
| | - Mai AlQubaisi
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al-Rifai
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
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Akyıldız İ, Açar G, Çiçekcibaşı AE, Mutluer M. Association between the digit ratio (2D:4D), handgrip strength, wrist ratio, and body fat distribution in women with different carpal tunnel syndrome severity. Early Hum Dev 2024; 190:105972. [PMID: 38377882 DOI: 10.1016/j.earlhumdev.2024.105972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND To evaluate the relationship of the second to fourth digit ratio (2D:4D), a biomarker of prenatal sex hormone exposure, with wrist ratio (WR), wrist-palm ratio (WPR), body mass index (BMI), waist-hip ratio (WHR), and handgrip strength (HGS) in different carpal tunnel syndrome (CTS) severity. METHOD This study involved 90 female participants (aged 18 to 83) with CTS. According to CTS severity, the participants were divided into four groups: normal, mild, moderate, and severe. All parameters of hand anthropometry and body fat distribution were measured, and the mean 2D:4D, WR, WPR, HGS, BMI, and WHR values were compared based on CTS severity. Data were collected with a visual analog scale (VAS) for pain and a Likert (LS) scale for numbness severity. RESULTS The mean age, 2D:4D, WD, WW, WR, WPR, BMI, and HGS values showed a significant differences between CTS severity groups. We found that lower 2D:4D and higher WPR and BMI were associated with increased risk of CTS (AUC = 0.728) after removing the effect of age. Bilateral hands were affected in 38.9 % (70/180) of participants. Regression analysis showed that lower HGS can be used as independent variable for predicting the females having bilateral affected hands. The LS score was considerably higher in the severe and moderate groups. Also, the VAS score was significantly higher in the severe group. CONCLUSION The findings of the study demonstrated an association between 2D:4D, WPR, and BMI among women, emphasizing the effect of intrauterine sex hormone exposure on late life CTS severity.
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Affiliation(s)
- İrfan Akyıldız
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, 42090 Meram, Konya, Turkey
| | - Gülay Açar
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, 42090 Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, 42090 Meram, Konya, Turkey
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Talutis SD, Chin AL, Lawrence PF, Woo K, Farley SM, Duong W, Jimenez JC. Increased body mass index and vein diameter are associated with incomplete target vein closure following microfoam ablation of incompetent saphenous veins. J Vasc Surg Venous Lymphat Disord 2024; 12:101690. [PMID: 37788744 DOI: 10.1016/j.jvsv.2023.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Patient characteristics and risk factors for incomplete or non-closure following thermal saphenous vein ablation have been reported. However, similar findings have not been clearly described following commercially manufactured polidocanol microfoam ablation (MFA). The objective of our study is to identify predictive factors and outcomes associated with non-closure following MFA of symptomatic, refluxing saphenous veins. METHODS A retrospective review of a prospectively maintained patient database was performed from procedures in our Ambulatory Procedure Unit. All consecutive patients who underwent MFA with commercially manufactured 1% polidocanol microfoam for symptomatic superficial vein reflux between June 2018 and September 2022 were identified. Patients treated for tributary veins only, without truncal vein ablation, were excluded. Patients were then stratified into groups: complete closure (Group I) and non-closure (Group II). Preoperative demographics, procedural details, and postoperative outcomes were analyzed. Preoperative variables that were significant on univariate analysis (prior deep venous thrombosis [DVT], body mass index [BMI] ≥30 kg/m2, and vein diameter) were entered into a multivariate logistic regression model with the primary outcome being vein non-closure. RESULTS Between June 2018 and September 2022, a total of 224 limbs underwent MFA in our ambulatory venous center. Of these, 127 limbs in 103 patients met study inclusion criteria. Truncal veins treated included the above-knee great saphenous vein (Group I: n = 89, 77% vs Group II: n = 7, 58%; P = .14), below-knee great saphenous vein (Group I: n = 7, 6% vs Group II: n = 0; P = .38), anterior accessory saphenous vein (Group I: n = 17, 15% vs Group II: n = 4, 33%; P = .12, and small saphenous vein (Group I: n = 4, 4% vs Group II: n = 1, 8%; P = .41). Complete closure (Group I) occurred in 115 limbs, and 12 limbs did not close (Group II) based on postoperative duplex ultrasound screening. The mean BMI in Group II (36.1 ± 6.4 kg/m2) was significantly greater than Group I (28.6 ± 6.1 kg/m2) (P < .001). Vein diameter of ≥10.2 mm was independently associated with truncal vein non-closure with an odds ratio of 4.8. The overall mean foam volume was 6.2 ± 2.7 ml and not different between the two cohorts (Group I: 6.2 ± 2.6 ml vs Group II: 6.3 + 3.5 ml; P = .89). Post MFA improvement in symptoms was higher in Group I (96.9%) compared with Group II (66.7%) (P = .001). The mean postoperative Venous Clinical Severity Score was also lower in Group I (8.0 ± 3.0) compared with Group II (9.9 ± 4.2) (P = .048). The overall incidences of ablation-related thrombus extension and DVT were 4.7% (n = 6) and 1.6% (n = 2), and all occurred in Group I. All were asymptomatic and resolved with anticoagulation. CONCLUSIONS Microfoam ablation of symptomatic, refluxing truncal veins results in excellent overall closure rates and symptomatic relief. BMI ≥30 kg/m2 and increased vein diameter are associated with an increased risk of saphenous vein non-closure following MFA. Non-closure is associated with less symptomatic improvement and a lower post-procedure reduction in Venous Clinical Severity Score. Despite the incidence of ablation-related thrombus extension and DVT in this study being higher than reported rates following thermal ablation, MFA is safe for patients with early postoperative duplex ultrasound surveillance and selective short-term anticoagulation.
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Affiliation(s)
- Stephanie D Talutis
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Amanda L Chin
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Peter F Lawrence
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Karen Woo
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Steven M Farley
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - William Duong
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Juan Carlos Jimenez
- Gonda Venous Center, Division of Vascular and Endovascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
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Zhu Y, Zhuang Z, Lv J, Sun D, Pei P, Yang L, Millwood IY, Walters RG, Chen Y, Du H, Wu X, Schmidt D, Avery D, Chen J, Chen Z, Li L, Yu C. Causal association between snoring and stroke: a Mendelian randomization study in a Chinese population. Lancet Reg Health West Pac 2024; 44:101001. [PMID: 38304719 PMCID: PMC10832459 DOI: 10.1016/j.lanwpc.2023.101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/24/2023] [Accepted: 12/19/2023] [Indexed: 02/03/2024]
Abstract
Background Previous observational studies established a positive relationship between snoring and stroke. We aimed to investigate the causal effect of snoring on stroke. Methods Based on 82,339 unrelated individuals with qualified genotyping data of Asian descent from the China Kadoorie Biobank (CKB), we conducted a Mendelian randomization (MR) analysis of snoring and stroke. Genetic variants identified in the genome-wide association analysis (GWAS) of snoring in CKB and UK Biobank (UKB) were selected for constructing genetic risk scores (GRS). A two-stage method was applied to estimate the associations of the genetically predicted snoring with stroke and its subtypes. Besides, MR analysis among the non-obese group (body mass index, BMI <24.0 kg/m2), as well as multivariable MR (MVMR), were performed to control for potential pleiotropy from BMI. In addition, the inverse-variance weighted (IVW) method was applied to estimate the causal association with genetic variants identified in CKB GWAS. Findings Positive associations were found between snoring and total stroke, hemorrhagic stroke (HS), and ischemic stroke (IS). With GRS of CKB, the corresponding HRs (95% CIs) were 1.56 (1.15, 2.12), 1.50 (0.84, 2.69), 2.02 (1.36, 3.01), and the corresponding HRs (95% CIs) using GRS of UKB were 1.78 (1.30, 2.43), 1.94 (1.07, 3.52), and 1.74 (1.16, 2.61). The associations remained stable in the MR among the non-obese group, MVMR analysis, and MR analysis using the IVW method. Interpretation This study suggests that, among Chinese adults, genetically predicted snoring could increase the risk of total stroke, IS, and HS, and the causal effect was independent of BMI. Funding National Natural Science Foundation of China, Kadoorie Charitable Foundation Hong Kong, UK Wellcome Trust, National Key R&D Program of China, Chinese Ministry of Science and Technology.
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Affiliation(s)
- Yunqing Zhu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhenhuang Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Dianjianyi Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Iona Y. Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Robin G. Walters
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, OX3 7LF, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Xianping Wu
- Suzhou Centers for Disease Control, NO.72 Sanxiang Road, Gusu District, Suzhou, 215004, Jiangsu, China
| | - Dan Schmidt
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Daniel Avery
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, 100022, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, United Kingdom
| | - Liming Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
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Anguzu R, Livergood CM, Hoppe KK, Kulinski J, Fitzgerald GD, Palatnik A. Association between body mass index and chronic hypertension in patients with hypertension disorders of pregnancy one-year postpartum. Pregnancy Hypertens 2024; 35:32-36. [PMID: 38134483 PMCID: PMC10939881 DOI: 10.1016/j.preghy.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/04/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To determine the association between body mass index (BMI) and chronic hypertension (CHTN) one-year postpartum following pregnancies complicated by hypertensive disorders of pregnancy (HDP). STUDY DESIGN A retrospective cohort study of patients with HDP (gestational hypertension or preeclampsia) in a single Midwestern academic center from 2014 to 2018. The primary outcome was CHTN at one-year postpartum, defined as systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg or taking antihypertensive medication at one-year postpartum. The primary exposure variable was BMI at one-year postpartum, categorized as underweight (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25-<30 kg/m2), and obese (≥30 kg/m2) and as continuous BMI variable. Descriptive statistics and adjusted logistic regression analysis were performed. RESULTS Out of 596 patients with HDP included in this analysis, 275 (46.1 %) had CHTN one-year postpartum. Mean one-year postpartum BMI was 27.9 ± 5.2 kg/m2. Prevalence of CHTN at one-year postpartum was higher in obese (38.1 %) and overweight (30.0 %) groups compared to the normal weight group (29.9 %), p < 0.001. In multivariate logistic regression, obesity at one-year postpartum, compared to normal, was associated with 73 % higher likelihood of CHTN following HDP (adjusted OR 1.73, 95 % CI 1.06-2.84). With BMI as a continuous variable, each unit increase in BMI one-year postpartum was associated with 6 % higher likelihood of CHTN (adjusted OR 1.06, 95 % CI 1.02-1.15). CONCLUSIONS Obesity at one-year postpartum following HDP was associated with a higher risk of CHTN compared with normal BMI. Weight is a modifiable risk factor that should be targeted in postpartum interventions to reduce cardiovascular disease following HDP.
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Affiliation(s)
- Ronald Anguzu
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Christine M Livergood
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kara K Hoppe
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin-Madison School of Medicine and Public Health, WI, USA
| | - Jacquelyn Kulinski
- Department of Medicine, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Garrett D Fitzgerald
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Atabilen B, Akdevelioğlu Y, Acar Özen P, Tuncer A. Examining dietary habits in the context of multiple sclerosis: A comprehensive investigative approach. Mult Scler Relat Disord 2024; 83:105467. [PMID: 38301324 DOI: 10.1016/j.msard.2024.105467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/09/2024] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
AIMS The aim of this study is to evaluate the nutritional status of patients with multiple sclerosis (MS) and to develop suggestions for changing eating habits in a healthy direction. METHODS The study was conducted on 171 participants (80.1 % female; 19.9 % male) diagnosed with MS between the ages of 18-60 who applied to Ankara Hacettepe University Hospital Neurology Outpatient Clinic between June 2021 and March 2023. Body weight, height, body composition, waist circumference, upper mid-arm circumference and hand grip strength were measured in accordance with the technique of anthropometric measurements. A three-day food consumption record was taken to evaluate the energy, macro, and micronutrient content of the diet. Mediterranean Diet Assessment Tool was used to assess adherence to diet. RESULTS Mean age of the participants was recorded as 35.2 ± 10.81 years. According to the body mass index (BMI) classification, 59.9 % of females were in normal limits, while 61.8 % of males were classified as overweight and obese. However, when evaluated in terms of body composition, body fat percentage was found to be above of normal limits in both genders. Also, 70.8 % of participants were sedentary. The percentage of patients who met their daily energy requirements in women with light and moderate activity was higher than in men, but it was not statistically significant. In participants with high activity level, the percentage of patients meeting energy requirements was below 50 % for both genders. Dietary fat and saturated fat intake were higher than the recommendations, while monounsaturated fatty acids and dietary fiber intake were less. The percentages of patients meeting their calcium requirement was below 50 % in both genders. Mean intake amounts of vegetables, fruits, legumes, nuts, and dairy products were below the Türkiye Nutrition Guideline recommendations. CONCLUSION This study shows the nutritional characteristic of patients with MS in detail with different aspects. Although most of the patients were in normal limits in terms of BMI, body fat percentages were found to be above normal limits in both genders. Total fat and saturated fat intakes were found to be high according to scientific recommendations while the intake of food groups required for a fibre-based diet and intake of dairy products were low.
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Affiliation(s)
- Büşra Atabilen
- Karamanoğlu Mehmetbey University Faculty of Health Sciences Department of Nutrition and Dietetics, Karaman, Türkiye.
| | - Yasemin Akdevelioğlu
- Gazi University Faculty of Health Sciences Department of Nutrition and Dietetics, Ankara, Türkiye
| | - Pınar Acar Özen
- Hacettepe University Faculty of Medicine Department of Neurology, Ankara, Türkiye
| | - Aslı Tuncer
- Hacettepe University Faculty of Medicine Department of Neurology, Ankara, Türkiye
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Choi J, Wen W, Jia G, Tao R, Long J, Shu XO, Zheng W. Lifestyle factors, genetic susceptibility to obesity and their interactions on coronary artery disease risk: A cohort study in the UK Biobank. Prev Med 2024; 180:107886. [PMID: 38316272 DOI: 10.1016/j.ypmed.2024.107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/02/2024] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE We aimed to evaluate potential modifying effects of genetic susceptibility to obesity on the association of lifestyle factors with coronary artery disease (CAD) risk. METHODS A total of 328,606 participants (54% women) were included using data from the UK Biobank. We evaluated the risk of developing CAD associated with obesity-related polygenic scores (PGSs) and healthy lifestyle scores (HLSs). HLSs were constructed using six lifestyle factors. Obesity PGSs were created using genetic variants identified by genome-wide association studies, including 941 variants for body mass index (BMI) and 457 for waist-to-hip ratio (WHR). Both HLSs and PGSs were categorized into three groups. RESULTS During a 9-year median follow-up, 14,541 participants developed CAD. An unhealthy lifestyle was significantly associated with an increased CAD risk (hazard ratio [HR] = 2.24, 95% confidence interval [CI] = 2.09-2.40). High BMI and WHR PGSs were each significantly associated with an increased CAD risk (HRBMI = 1.23, 1.17-1.29; HRWHR = 1.15, 1.09-1.21). Lifestyle factors explained 41% (95% CI = 38%-45%) of CAD, while genetic variants for BMI explained only 10% (7%-14%). Risks of CAD were increased with poorer HLS independent of obesity-related PGSs. Individuals with the most unhealthy lifestyle and highest BMI PGS had the highest risk of CAD risk (HR = 2.59, 95% CI = 2.26-2.97), compared with participants with the healthiest lifestyle and lowest BMI PGS. CONCLUSIONS While the observational nature of the study precludes the establishment of causality, our study provides supports for a causal association between obesity and CAD risk and the importance of lifestyle modification in the prevention of CAD.
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Affiliation(s)
- Jungyoon Choi
- Division of Oncology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Guochong Jia
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ran Tao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
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Tsukamoto S, Kobayashi K, Toyoda M, Hatori N, Kanaoka T, Wakui H, Sakai H, Furuki T, Chin K, Ito S, Suzuki D, Umezono T, Aoyama T, Nakajima S, Hishiki T, Hatori Y, Hayashi M, Shimura H, Minagawa F, Mokubo A, Takihata M, Sato K, Miyakawa M, Terauchi Y, Tamura K, Kanamori A. Pretreatment body mass index affects achievement of target blood pressure with sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes mellitus and chronic kidney disease. Hypertens Res 2024; 47:628-638. [PMID: 37848562 DOI: 10.1038/s41440-023-01464-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
Sodium-glucose cotransporter 2 inhibitor (SGLT2-I) shows excellent antihypertensive effects in addition to its hypoglycemic effects. However, whether body mass index (BMI) affects the antihypertensive effect of SGLT2-I remains unknown. We investigated the impact of baseline BMI on the achievement of target blood pressure (BP) with SGLT2-I treatment in Japanese patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). We retrospectively evaluated 447 Japanese patients with T2DM and CKD treated with SGLT2-I for at least 1 year. The primary outcome was achieving the target BP (<130/80 mmHg) after SGLT2-I treatment. Patients were divided into two groups according to a baseline BMI of 29.1 determined by receiver operating characteristic analysis and analyzed in a cohort model with propensity score matching. In each group, 130 patients were compared by propensity score matching. The target BP achievement rate was significantly higher in the BMI < 29.1 group than in the BMI ≥ 29.1 group (34% and 21%, respectively, p = 0.03). The odds ratio for achieving the target BP in the BMI ≥ 29.1 group was 0.50 (95% confidence interval, 0.28-0.90, p = 0.02). The BMI < 29.1 group had significantly lower systolic and diastolic BPs after SGLT2-I treatment than the BMI ≥ 29.1 group. Only the BMI < 29.1 group was showed a significant decrease in the logarithmic albumin-to-creatinine ratio from baseline after SGLT2-I treatment. In patients with T2DM and CKD, baseline BMI was associated with the antihypertensive effects of SGLT2-I. Patients in the lower baseline BMI group were more likely to achieve the target BP after SGLT2-I treatment. Pretreatment BMI affects the antihypertensice effect of SGLT2 inhibirors in patients with T2DM and CKD.
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Affiliation(s)
- Shunichiro Tsukamoto
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuo Kobayashi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan.
| | - Masao Toyoda
- Division of Nephrology, Endocrinology and Metabolism, Department of internal medicine, Tokai University School of Medicine, lsehara, Japan
| | - Nobuo Hatori
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Tomohiko Kanaoka
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiromichi Wakui
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroyuki Sakai
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Takayuki Furuki
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Keiichi Chin
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Shun Ito
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Daisuke Suzuki
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Tomoya Umezono
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Togo Aoyama
- Division of Nephrology, Department of internal medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Shinichi Nakajima
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Toshimasa Hishiki
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Yutaka Hatori
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Masahiro Hayashi
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Hidetoshi Shimura
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Fuyuki Minagawa
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Atsuko Mokubo
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Masahiro Takihata
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Kazuyoshi Sato
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Masaaki Miyakawa
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Akira Kanamori
- Committee of Hypertension and Kidney disease, Kanagawa Physicians Association, Yokohama, Japan
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