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He X, Ji J, Liu C, Luo Z, Tang J, Yan H, Guo L. Body mass index and weight loss as risk factors for poor outcomes in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis. Ann Med 2024; 56:2311845. [PMID: 38301276 PMCID: PMC10836485 DOI: 10.1080/07853890.2024.2311845] [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: 09/27/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE The association between nutritional status and prognosis of idiopathic pulmonary fibrosis (IPF) remains unclear. This systematic review and meta-analysis aimed to explore the effect of body mass index (BMI) and weight loss on the prognosis of IPF patients. METHODS We accumulated studies on IPF, BMI, and weight loss from databases including PubMed, Embase, Web of science, Scopus, Ovid and Cochrane Library up to 4 August 2023. Using Cox proportional hazard regression model for subgroup analysis, hazard ratio (HR) and 95% confidence intervals (CI) for BMI in relation to mortality, acute exacerbation (AE), and hospitalization in IPF patients were calculated, and HR, odds ratio (OR), and 95% CI for weight loss corresponding to IPF patient mortality were assessed. Sensitivity analysis was peformed by eliminating every study one by one, and publication bias was judged by Egger's test and trim-and-fill method. RESULTS A total of 34 eligible studies involving 18,343 IPF patients were included in the meta-analysis. The pooled results by univariate Cox regression analysis showed that baseline BMI was a predictive factor for IPF mortality (HR = 0.93, 95%CI = [0.91, 0.94]). Furthermore, the results by the multivariable regression model indicated that baseline BMI was an independent risk factor for predicting IPF mortality (HR = 0.94, 95%CI = [0.91, 0.98]). Weight loss was identified as a risk factor for IPF mortality (HR = 2.74, 95% CI = [2.12, 3.54]; OR = 4.51, 95% CI = [1.72, 11.82]) and there was no predictive value of BMI for acute exacerbation (HR = 1.00, 95% CI= [0.93, 1.07]) or hospitalization (HR = 0.95, 95% CI = [0.89, 1.02]). CONCLUSION Low baseline BMI and weight loss in the course of IPF may indicate a high risk of mortality in patients with IPF, so it is meaningful to monitor and manage the nutritional status of IPF patients, and early intervention should be conducted for low BMI and weight loss.
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Affiliation(s)
- Xing He
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- Department of Pulmonary and Critical Care Medicine, Cheng Du Qing Cheng Mt. Hospital, Chongzhou City, Chengdu, Sichuan Province, China
| | - Jiaqi Ji
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Chi Liu
- Department of Nephrology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, Sichuan Renal Disease Clinical Research Center, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Zeli Luo
- Department of Critical Care Medicine, Wenjiang District People’s Hospital, Chengdu, Sichuan Province, China
| | - Jialong Tang
- Department of Respiratory and Critical Care Medicine, Jiange County People’s Hospital, Guangyuan, Sichuan Province, China
| | - Haiying Yan
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- Department of Pulmonary and Critical Care Medicine, Cheng Du Qing Cheng Mt. Hospital, Chongzhou City, Chengdu, Sichuan Province, China
| | - Lu Guo
- Department of Pulmonary and Critical Care Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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Li X, Luan T, Zhao C, Ling X. Effect of paternal body mass index on maternal and child-health outcomes of singletons after frozen-thawed embryo transfer cycles: a retrospective study. HUM FERTIL 2024; 27:2285343. [PMID: 38205607 DOI: 10.1080/14647273.2023.2285343] [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: 10/20/2022] [Accepted: 10/26/2023] [Indexed: 01/12/2024]
Abstract
The objective was to analyze the effect of paternal body mass index (BMI) on maternal and child-health outcomes of singletons after frozen-thawed embryo transfer (FET) cycles. A retrospective cohort study was conducted between January 2019 and December 2021. Pregnancy, perinatal complications and neonatal outcomes were compared among different paternal BMI. Multivariate logistic regression was performed to evaluate the relationship between different paternal BMI and pregnancy, obstetric and neonatal outcomes. The paternal normal group was more likely to suffer from gestational hypertension than the paternal obesity group (3.59% vs. 2.42%), and paternal underweight group was more likely to suffer from preeclampsia than the other three groups (11.63% vs. 4.43%, 7.57%, 4.03%). Birthweight among infants in the paternal overweight categories was significantly higher than infants in the paternal normal weight categories. The rate of foetal macrosomia was higher among infants in the paternal overweight (12.36%) category, while lower among infants in the paternal underweight categories (2.33%). The incidence of macrosomia in the paternal overweight categories (aOR 1.527, 95% CI 1.078-2.163) was significantly higher than those normal controls after adjustment for known confounding factors. The rates of LGA babies were higher in the paternal overweight category (aOR 1.260, 95% CI 1.001-1.587) compared with those in the paternal normal weight category, before and after adjustment. The results suggest that parental pre-pregnancy overweight or obesity has an adverse effect on the perinatal complications and neonatal outcomes.
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Affiliation(s)
- Xin Li
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Ting Luan
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Chun Zhao
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xiufeng Ling
- Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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Edvinsson C, Björnsson O, Erlandsson L, Hansson SR. Predicting intensive care need in women with preeclampsia using machine learning - a pilot study. Hypertens Pregnancy 2024; 43:2312165. [PMID: 38385188 DOI: 10.1080/10641955.2024.2312165] [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: 09/04/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Predicting severe preeclampsia with need for intensive care is challenging. To better predict high-risk pregnancies to prevent adverse outcomes such as eclampsia is still an unmet need worldwide. In this study we aimed to develop a prediction model for severe outcomes using routine biomarkers and clinical characteristics. METHODS We used machine learning models based on data from an intensive care cohort with severe preeclampsia (n=41) and a cohort of preeclampsia controls (n=40) with the objective to find patterns for severe disease not detectable with traditional logistic regression models. RESULTS The best model was generated by including the laboratory parameters aspartate aminotransferase (ASAT), uric acid and body mass index (BMI) with a cross-validation accuracy of 0.88 and an area under the curve (AUC) of 0.91. Our model was internally validated on a test-set where the accuracy was lower, 0.82, with an AUC of 0.85. CONCLUSION The clinical routine blood parameters ASAT and uric acid as well as BMI, were the parameters most indicative of severe disease. Aspartate aminotransferase reflects liver involvement, uric acid might be involved in several steps of the pathophysiologic process of preeclampsia, and obesity is a well-known risk factor for development of both severe and non-severe preeclampsia likely involving inflammatory pathways..[Figure: see text].
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Affiliation(s)
- Camilla Edvinsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Division of Anaesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Anaesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden
| | - Ola Björnsson
- Division of Mathematical Statistics, Centre for Mathematical Sciences, Lund University, Lund, Sweden
- Department of Energy Sciences, Faculty of Engineering, Lund University, Lund, Sweden
| | - Lena Erlandsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Stefan R Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund/Malmö, Sweden
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Aydin S, Kilinc F, Ugur K, Aydin MA, Yalcin MH, Kuloglu T, Kaya Tektemur N, Albayrak S, Emre E, Yardim M, Akkoc RF, Hancer S, Sahin İ, Cinar V, Akbulut T, Demircan S, Evren B, Gencer BT, Aksoy A, Yilmaz Bozoglan M, Aydemir İ, Aydin S. Effects of irisin and exercise on adropin and betatrophin in a new metabolic syndrome model. Biotech Histochem 2024; 99:21-32. [PMID: 37933453 DOI: 10.1080/10520295.2023.2276205] [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: 11/08/2023] Open
Abstract
Metabolic syndrome (MetS) is a prevalent public health problem. Uric acid (UA) is increased by MetS. We investigated whether administration of UA and 10% fructose (F) would accelerate MetS formation and we also determined the effects of irisin and exercise. We used seven groups of rats. Group 1 (control); group 2 (sham); group 3 (10% F); group 4 (1% UA); group 5 (2% UA); group 6 (10% F + 1% UA); and Group 7, (10% F + 2% UA). After induction of MetS (groups 3 -7), Group 3 was divided into three subgroups: 3A, no further treatment; 3B, irisin treatment; 3C, irisin treatment + exercise. Group 4, 1% UA, which was divided into three subgroups: 4A, no further treatment; 4B, irisin treatment; 4C, Irisin treatment + exercise. Group 5, 2% UA, which was divided into three subgroups: 5A, no further treatment; 5B, irisin treatment; 5C, irisin treatment + exercise. Group 6, 10% F + 1% UA, which was divided into three subgroups: 6A, no further treatment; 6B, irisin treatment; 6C, irisin treatment + exercise. Group 7, 10% F + 2% UA, which was divided into three subgroups: 7A, no further treatment; 7B, irisin treatment; 7C, irisin treatment + exercise., İrisin was administered 10 ng/kg irisin intraperitoneally on Monday, Wednesday, Friday, Sunday each week for 1 month. The exercise animals (in addition to irisin treatment) also were run on a treadmill for 45 min on Monday, Wednesday, Friday, Sunday each week for 1 month. The rats were sacrificed and samples of liver, heart, kidney, pancreas, skeletal muscles and blood were obtained. The amounts of adropin (ADR) and betatrophin in the tissue supernatant and blood were measured using an ELISA method. Immunohistochemistry was used to detect ADR and betatrophin expression in situ in tissue samples. The duration of these experiments varied from 3 and 10 weeks. The order of development of MetS was: group 7, 3 weeks; group 6, 4 weeks; group 5, 6 weeks; group 4, 7 weeks; group 3, 10 weeks. Kidney, liver, heart, pancreas and skeletal muscle tissues are sources of adropin and betatrophin. In these tissues and in the circulation, adropin was decreased significantly, while betatrophin was increased significantly due to MetS; irisin + exercise reversed this situation. We found that the best method for creating a MetS model was F + UA2 supplementation. Our method is rapid and simple. Irisin + exercise was best for preventing MetS.
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Affiliation(s)
- Suna Aydin
- Department of Cardiovascular Surgery, Fethi Sekin City Hospital, Elazig, Turkiye
- Department of Anatomy, School of Medicine, Firat University, Elazig, Turkiye
- Department of Histology and Embryology, School of Veterinary Medicine, Firat University, Elazig, Turkiye
| | - Faruk Kilinc
- Department of Internal Medicine (Endocrinology and Metabolism Diseases), School of Medicine, Firat University, Elazig, Turkiye
| | - Kader Ugur
- Department of Internal Medicine (Endocrinology and Metabolism Diseases), School of Medicine, Firat University, Elazig, Turkiye
| | | | - Mehmet Hanifi Yalcin
- Department of Histology and Embryology, School of Veterinary Medicine, Firat University, Elazig, Turkiye
| | - Tuncay Kuloglu
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkiye
| | - Nalan Kaya Tektemur
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkiye
| | - Serdal Albayrak
- Department of Brain and Nerve Surgery, Elazig Fethi Sekin City Hospital, Elazig, Turkiye
| | - Elif Emre
- Department of Anatomy, School of Medicine, Firat University, Elazig, Turkiye
| | - Meltem Yardim
- Department of Medical Biochemistry, Faculty of Sport Sciences, Yerkoy State Hospital, Yozgat, Turkiye
| | - Ramazan Fazil Akkoc
- Department of Anatomy, School of Medicine, Firat University, Elazig, Turkiye
| | - Serhat Hancer
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkiye
| | - İbrahim Sahin
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Medical School, Firat University, Elazig, Turkiye
- Department of Medical Biology, Medical School, Erzincan Binali Yildirim University, Erzincan, Turkiye
| | - Vedat Cinar
- Department of Physical Education and Sports Teaching, Faculty of Sport Sciences, Firat University, Elazig, Turkey
| | - Taner Akbulut
- Department of Sports and Health, Faculty of Sport Sciences, Firat University, Elazig, Turkiye
| | - Selcuk Demircan
- Department of Intensive Care, Inonu University Hospital, Malatya, Turkiye
| | - Bahri Evren
- Department of Internal Medicine, School of Medicine, Inonu University, Malatya, Turkiye
| | - Berrin Tarakci Gencer
- Department of Histology and Embryology, School of Veterinary Medicine, Firat University, Elazig, Turkiye
| | - Aziz Aksoy
- Nature and Engineering Faculty, Malatya Turgut Ozal University, Malatya, Turkiye
| | - Merve Yilmaz Bozoglan
- Department of Medical Pharmacology, Medical School, Firat University, Elazig, Turkiye
| | - İsa Aydemir
- Department of Physical Education and Sports Teaching, Faculty of Sport Sciences, Firat University, Elazig, Turkey
| | - Suleyman Aydin
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Medical School, Firat University, Elazig, Turkiye
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5
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Miura K, Yu R, Entwistle TR, McKenzie SC, Green AC. Association of diet quality and weight increase in adult heart transplant recipients. J Hum Nutr Diet 2024; 37:408-417. [PMID: 37997547 DOI: 10.1111/jhn.13263] [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: 07/23/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Understanding the quality of the diet of heart transplant recipients (HTRs) is essential to developing effective dietary interventions for weight control, but relevant evidence is scarce. We investigated diet quality and its association with post-transplant increase in weight adjusted for height (body mass index [BMI]) in Australian HTRs. METHODS We recruited adult HTRs from Queensland's thoracic transplant clinic, 2020-2021. Study participants completed a 3-day food diary using a smart-phone app. Socio-demographic information was collected by self-administered questionnaire, and height, serial weight and clinical information were obtained from medical records. We calculated the Dietary Approaches to Stop Hypertension (DASH) index based on nine food groups and nutrients (index of 90 indicates highest possible quality), and any changes in BMI (≤ 0 kg m-2 or >0 kg m-2) post-transplantation. Median DASH index values were assessed in relation to sex and BMI change using Mann-Whitney U test. RESULTS Among 49 consented HTRs, 25 (51%) completed the food diary (median age 48 years, 52% females). Median BMI at enrolment was 27.2 kg m-2; median BMI change since transplant was +3.7 kg m-2. Fruit, vegetable, and whole grain intakes were generally lower than recommended, giving a low overall median DASH index of 30 with no sex differences. HTRs for which the BMI increased post-transplant had significantly lower median DASH indices than those whose BMI did not increase (30 vs. 45, p = 0.013). CONCLUSIONS The diet quality of HTRs appears suboptimal overall, with fruit and vegetable intakes especially low. HTRs whose BMI increased post-transplant had substantially lower quality diets than HTRs whose BMI did not increase.
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Affiliation(s)
- Kyoko Miura
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Regina Yu
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | | | - Scott C McKenzie
- Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Advanced Heart Failure and Cardiac Transplant Unit, The Prince Charles Hospital, Chermside, QLD, Australia
| | - Adèle C Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
- CRUK Manchester Institute and University of Manchester, Manchester, UK
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6
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Oze I, Ito H, Koyanagi YN, Abe SK, Rahman MS, Islam MR, Saito E, Gupta PC, Sawada N, Tamakoshi A, Shu XO, Sakata R, Malekzadeh R, Tsuji I, Kim J, Nagata C, You SL, Park SK, Yuan JM, Shin MH, Kweon SS, Pednekar MS, Tsugane S, Kimura T, Gao YT, Cai H, Pourshams A, Lu Y, Kanemura S, Wada K, Sugawara Y, Chen CJ, Chen Y, Shin A, Wang R, Ahn YO, Shin MH, Ahsan H, Boffetta P, Chia KS, Qiao YL, Rothman N, Zheng W, Inoue M, Kang D, Matsuo K. Obesity is associated with biliary tract cancer mortality and incidence: A pooled analysis of 21 cohort studies in the Asia Cohort Consortium. Int J Cancer 2024; 154:1174-1190. [PMID: 37966009 PMCID: PMC10873020 DOI: 10.1002/ijc.34794] [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: 02/10/2023] [Revised: 10/10/2023] [Accepted: 10/20/2023] [Indexed: 11/16/2023]
Abstract
Body fatness is considered a probable risk factor for biliary tract cancer (BTC), whereas cholelithiasis is an established factor. Nevertheless, although obesity is an established risk factor for cholelithiasis, previous studies of the association of body mass index (BMI) and BTC did not take the effect of cholelithiasis fully into account. To better understand the effect of BMI on BTC, we conducted a pooled analysis using population-based cohort studies in Asians. In total, 905 530 subjects from 21 cohort studies participating in the Asia Cohort Consortium were included. BMI was categorized into four groups: underweight (<18.5 kg/m2 ); normal (18.5-22.9 kg/m2 ); overweight (23-24.9 kg/m2 ); and obese (25+ kg/m2 ). The association between BMI and BTC incidence and mortality was assessed using hazard ratios (HR) and 95% confidence intervals (CIs) by Cox regression models with shared frailty. Mediation analysis was used to decompose the association into a direct and an indirect (mediated) effect. Compared to normal BMI, high BMI was associated with BTC mortality (HR 1.19 [CI 1.02-1.38] for males, HR 1.30 [1.14-1.49] for females). Cholelithiasis had significant interaction with BMI on BTC risk. BMI was associated with BTC risk directly and through cholelithiasis in females, whereas the association was unclear in males. When cholelithiasis was present, BMI was not associated with BTC death in either males or females. BMI was associated with BTC death among females without cholelithiasis. This study suggests BMI is associated with BTC mortality in Asians. Cholelithiasis appears to contribute to the association; and moreover, obesity appears to increase BTC risk without cholelithiasis.
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Affiliation(s)
- Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuriko N Koyanagi
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Sarah Krull Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Md. Shafiur Rahman
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Md. Rashedul Islam
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Prakash C. Gupta
- Healis - Sekhsaria Institute for Public Health, Navi Mumbai, India
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Jeongseon Kim
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - San-Lin You
- School of Medicine & Big Data Research Center, Fu Jen Catholic University, Taipei, Taiwan
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Myung-Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Gyeonggi-do, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | | | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Akram Pourshams
- Digestive Diseases Research institute, Tehran University of Medical Science, Tehran, Iran
| | - Yukai Lu
- Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, NYU Grossman School of Medicine
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Renwei Wang
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yoon-Ok Ahn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - You-Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Daehee Kang
- Seoul National University College of Medicine, Seoul, Korea
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Ma J, Liu M, Wang R, Du L, Ji L. Efficacy and safety of tirzepatide in people with type 2 diabetes by baseline body mass index: An exploratory subgroup analysis of SURPASS-AP-Combo. Diabetes Obes Metab 2024; 26:1454-1463. [PMID: 38302718 DOI: 10.1111/dom.15446] [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: 10/26/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024]
Abstract
AIMS To assess the efficacy and safety of tirzepatide versus insulin glargine in people with type 2 diabetes (T2D) by baseline body mass index (BMI). MATERIALS AND METHODS Participants with T2D from the Phase 3 SURPASS-AP-Combo trial (NCT04093752) were categorized into three BMI subgroups (normal weight [<25 kg/m2 ], overweight [≥25 and <30 kg/m2 ], and obese [≥30 kg/m2 ]) according to World Health Organization criteria. Exploratory outcomes including glycaemic control, body weight, cardiometabolic risk, and safety were compared among three tirzepatide doses (5, 10 or 15 mg) and insulin glargine. RESULTS Of 907 participants, 235 (25.9%) had a BMI <25 kg/m2 , 458 (50.5%) a BMI ≥25 to <30 kg/m2 , and 214 (23.6%) a BMI ≥30 kg/m2 at baseline. At Week 40, all tirzepatide doses led to a greater reduction in mean glycated haemoglobin (HbA1c; -2.0% to -2.8% vs. -0.8% to -1.0%, respectively) and percent change in body weight (-5.5% to -10.8% vs. 1.0% to 2.5%, respectively) versus insulin glargine, across the BMI subgroups. Compared with insulin glargine, a higher proportion of tirzepatide-treated participants achieved treatment goals for HbA1c and body weight reduction. Improvements in other cardiometabolic indicators were also observed with tirzepatide across all the BMI subgroups. The safety profile of tirzepatide was similar across all subgroups by BMI. The most frequent adverse events with tirzepatide were gastrointestinal-related events and decreased appetite, with relatively few events leading to treatment discontinuation. CONCLUSIONS In participants with T2D, regardless of baseline BMI, treatment with tirzepatide resulted in statistically significant and clinically meaningful glycaemic reductions and body weight reductions compared with insulin glargine, with a safety profile consistent with previous reports.
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Affiliation(s)
- Jianhua Ma
- Nanjing First Hospital Nanjing Medical University, Nanjing, China
| | - Ming Liu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Wang
- Eli Lilly Suzhou Pharmaceuticals Co. Ltd., Shanghai, China
| | - Liying Du
- Eli Lilly Suzhou Pharmaceuticals Co. Ltd., Shanghai, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
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8
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Pehlivan M, Saleki N, Sezer FE, Özyürek F, Delice B, Hızlı Güldemir H. Water and beverage consumption habits of adults in Turkey by gender and BMI: a cross-sectional survey. Int J Environ Health Res 2024; 34:1910-1925. [PMID: 36739539 DOI: 10.1080/09603123.2023.2172385] [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: 11/22/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
The study aims to determine water and beverage consumption status and related factors in daily nutrition of adults living in Turkey. This study was conducted with 6332 adults aged 18-65 years across Turkey. Demographics and anthropometric data of subjects, their daily water and beverage consumption habits were explored using the retrospective 24-hour recall method. Water and black tea were the most consumed beverages (1801.38 ± 11.06 mL/day, 455 ± 6.10 mL/day, respectively). Increased BMI was associated with a significantly decreased rate of insufficient fluid intake among the participants. Underweight individuals were found to be consuming less (by 0.558 times) fluid compared to those with normal BMI, while obese individuals appeared to have greater energy intake from daily fluid consumption (by 1.111 times). This study showed a relationship between water and beverage intake and anthropometric measurements, suggesting that further research on personalized water intake strategies is beneficial in weight management.
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Affiliation(s)
- Merve Pehlivan
- Department of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Neda Saleki
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Fatma Elif Sezer
- Department of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Fatmanur Özyürek
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Büşranur Delice
- Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey
| | - Hilal Hızlı Güldemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Anadolu University, Eskisehir, Turkey
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9
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Kral P, Allen FL, Larsen S, Holst-Hansen T, Olivieri AV, Manton A. Treatment effect of semaglutide 2.4 mg on health-related quality of life from STEP 1 SF-6D derived from SF-36 with Australian weights. Diabetes Obes Metab 2024; 26:1171-1179. [PMID: 38195847 DOI: 10.1111/dom.15426] [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: 08/24/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 01/11/2024]
Abstract
AIM This study aimed to determine the comparative treatment effects of semaglutide 2.4 mg and placebo on health utility index scores [6-dimension short-form survey (SF-6D)] with Australian weights in full analysis set (FAS) and in post-hoc subgroups of the STEP 1 trial, defined according to different body mass index (BMI) cut-off points and presence of comorbidities at baseline. The study also explored the correlation between baseline BMI and SF-6D in the STEP 1 trial population. METHODS The 36-item SF survey (SF-36) scores from STEP 1 were mapped to SF-6D health states and converted to utility index scores using an Australian valuation algorithm. The change from baseline in SF-6D utility score (95% confidence intervals) was compared between semaglutide 2.4 mg and placebo at week 68 using the mixed model for repeated measurements approach. The relationship between utility scores and BMI at baseline was assessed by multiple linear regression analyses, controlling for demographic and clinical parameters. RESULTS The estimated mean treatment difference in SF-6D utility score favoured semaglutide 2.4 mg, and, at week 68, it was 0.057 (0.038-0.076) for the FAS. A greater treatment effect was noted in subgroups with presence of symptomatic comorbidities, i.e. 0.077 (0.027-0.128) to 0.105 (0.030-0.179) at week 68. A 1-unit increase in BMI was associated with a utility loss of 0.0075 (-0.0089 to -0.0062) for the FAS population, while controlling for demographic and clinical parameters. CONCLUSION To our knowledge, this is the first study showing statistically significant and clinically meaningful improvements in SF-6D utility scores with weight-loss pharmacotherapy in Australia.
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Affiliation(s)
- Pavol Kral
- IQVIA, Bratislava, Slovakia, IQVIA, Bratislava, Slovakia
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10
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Kirkpatrick BM, Porter KJ, Reid AL, Brock D, Markwalter TH, Zoellner JM. Associations of Body Mass Index with Self-Rated Health and Weight Perceptions Among Rural Appalachian Adolescent Students. J Sch Health 2024; 94:346-356. [PMID: 37545021 DOI: 10.1111/josh.13383] [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] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Adolescents with overweight or obesity are at greater risk of having physical and psychosocial consequences. With increased disparities and inadequate literature on prevalence of adolescent weight status in rural Appalachia, there is potential for further complications. Unfortunately, adolescent obesity treatment options are often limited, especially in medically underserved regions. METHODS This cross-sectional study of adolescents at eight rural Appalachian schools examined weight status among and associations between body mass index percentile (BMIp) categories and health-related perceptions and weight-control intentions. Previously validated instruments were utilized. Analyses included independent samples t-tests, ANOVA tests, and chi-squared tests. RESULTS Of 814 adolescents (ages 11-13; 55.0% girls), BMIp revealed 20.8% overweight, 22.7% obese, and 10.6% severely obese. Adolescents with higher BMIp categories reported poorer self-rated health, inaccurate weight perceptions, and greater weight loss intentions (all p < .05). CONCLUSIONS Findings, including high prevalence of adolescents with overweight and obesity, emphasize the need for more obesity prevention and treatment options. Schools may be an ideal setting to reach at-risk adolescents and provide obesity prevention and treatment options, especially in medically underserved regions such as rural Appalachia. Opportunities and challenges to apply findings, including school-based obesity programs, are discussed.
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Affiliation(s)
- Brittany M Kirkpatrick
- University of Virginia, Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073
| | - Kathleen J Porter
- University of Virginia, Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073
| | - Annie L Reid
- University of Virginia, Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073
| | - Donna Brock
- University of Virginia, Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073
| | - Theresa H Markwalter
- University of Virginia, Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073
| | - Jamie M Zoellner
- University of Virginia, Department of Public Health Sciences, UVA Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA, 24073
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11
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Vajravelu ME, Chu PY, Frank DA, Ragavan MI, Vajravelu RK. Projected impact of anti-obesity pharmacotherapy use on racial and ethnic disparities in adolescent obesity. Pediatr Obes 2024; 19:e13103. [PMID: 38318987 DOI: 10.1111/ijpo.13103] [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: 09/14/2023] [Revised: 11/22/2023] [Accepted: 12/18/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Paediatric obesity disproportionately impacts individuals from minoritized racial and ethnic backgrounds. Recent guidelines support use of anti-obesity pharmacotherapy for adolescents with obesity, but the potential impact on disparities in obesity prevalence has not been evaluated. OBJECTIVES To model changes in obesity prevalence with increasing utilization of anti-obesity pharmacotherapy among adolescents. METHODS Data representative of American adolescents ages 12-17 years were obtained from the National Health and Nutrition Examination Survey, cycles 2011 through pre-pandemic 2020. A body mass index (BMI) reduction of 16.7% was applied to each participant based on clinical trial results of weekly subcutaneous semaglutide 2.4 mg among adolescents. Utilization disparities were based on utilization of the same medication class among adults. Obesity prevalence was calculated assuming utilization of 10%-100%, stratified by race and ethnicity. RESULTS Among 4442 adolescents representing 26 247 384 American adolescents, projected overall obesity prevalence decreased from 22.2% to 8.4% with 100% utilization. However, disparities increased relative to Non-Hispanic White youth, with prevalence among Non-Hispanic Black and Mexican American youth ranging from 40%-60% higher to 90%-120% higher, respectively. CONCLUSIONS Increasing utilization of anti-obesity pharmacotherapy may widen relative disparities in obesity, particularly if utilization is unequal. Advocacy for equitable access is needed to minimize worsening of obesity-related disparities.
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Affiliation(s)
- Mary Ellen Vajravelu
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, University of Pittsburgh School of Medicine and UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Patricia Y Chu
- Division of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David A Frank
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Maya I Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh School of Medicine and UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ravy K Vajravelu
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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12
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Kaak KB, Holliday CP, Mulekar MS, Trepman E, Holliday NP. Women's perceptions of body mass graphics and their preferences for weight counselling. Clin Obes 2024; 14:e12632. [PMID: 38114087 DOI: 10.1111/cob.12632] [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: 05/02/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023]
Abstract
Health care providers may lack data-driven guidance about best practises for discussing weight. We assessed women's self-perception of body mass index (BMI) and preferences for weight counselling by provider characteristics and the initiating question. A voluntary, anonymous survey was completed by 756 women (age ≥ 19 year) at our tertiary care obstetrics and gynaecology clinics in autumn 2021. The respondents' height and weight were collected before respondents selected graphics from a validated Body Image Scale that they felt best represented their current body size and which graphs should prompt weight loss or gain recommendations. Respondents were asked their preferences about provider characteristics for discussion about weight and to identify which of six initiating questions from a provider was most and least preferred. Blank responses were allowed. In 708 responses, 366 women (52%) selected the most accurate graphic that corresponded to their BMI; the selected graphic represented a lower than actual BMI in 268 women (38%) and higher in 74 women (10%). In 648 responses, 374 women (58%) preferred a female provider, but provider body shape, ethnicity/race and age were not important to most women. The most preferred question to initiate a discussion about weight was "A lot of women have trouble achieving or maintaining a healthy weight; is that something we can discuss?" in 181 of 555 women (33%), and the least preferred question was "Do you feel like you are at an appropriate weight?" in 172 of 554 women (31%). Provider knowledge about patient preferences regarding questions may facilitate the discussion about weight.
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Affiliation(s)
- Katherine B Kaak
- Department of Obstetrics and Gynecology, University of South Alabama College of Medicine, Mobile, Alabama, USA
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA
| | - Candice P Holliday
- Department of Obstetrics and Gynecology, University of South Alabama College of Medicine, Mobile, Alabama, USA
| | - Madhuri S Mulekar
- Department of Mathematics and Statistics, University of South Alabama College of Arts and Sciences, Mobile, Alabama, USA
| | - Elly Trepman
- University of South Alabama College of Medicine, Mobile, Alabama, USA
| | - Nicolette P Holliday
- Department of Obstetrics and Gynecology, University of South Alabama College of Medicine, Mobile, Alabama, USA
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13
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Sun X, Ping J, Guo X, Long J, Cai Q, Shu XO, Shu X. Drug-target Mendelian randomization revealed a significant association of genetically proxied metformin effects with increased prostate cancer risk. Mol Carcinog 2024. [PMID: 38517045 DOI: 10.1002/mc.23692] [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] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 03/23/2024]
Abstract
The association between metformin use and risk of prostate cancer remains controversial, while data from randomized trials is lacking. We aim to evaluate the association of genetically proxied metformin effects with prostate cancer risk using a drug-target Mendelian randomization (MR) approach. Summary statistics for prostate cancer were obtained from the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome Consortium (79,148 cases and 61,106 controls). Cis-expression quantitative trait loci (cis-eQTL) variants in the gene targets of metformin were identified in the GTEx project and eQTLGen consortium. We also obtained male-specific genome-wide association study data for type 2 diabetes, body mass index (BMI), total testosterone, bioavailable testosterone, estradiol, and sex hormone binding globulin for mediation analysis. Inverse-variance weighted (IVW) regression, weighted median, MR-Egger regression, and MR-PRESSO were performed in the main MR analysis. Multivariable MR was used to identify potential mediators and genetic colocalization analysis was performed to assess any shared genetic basis between two traits of interest. We found that genetically proxied metformin effects (1-SD HbA1c reduction, equivalent to 6.75 mmol/mol) were associated with higher risk of prostate cancer (odds ratioIVW [ORIVW]: 1.55, 95% confidence interval, CI: 1.23-1.96, p = 3.0 × 10-3). Two metformin targets, mitochondrial complex I (ORIVW: 1.48, 95% CI: 1.07-2.03, p = 0.016) and gamma-secretase complex (ORIVW: 2.58, 95%CI :1.47-4.55, p = 0.001), showed robust associations with prostate cancer risk, and their effects were partly mediated through BMI (16.4%) and total testosterone levels (34.3%), respectively. These results were further supported by colocalization analysis that expressions of NDUFA13 and BMI, APH1A, and total testosterone may be influenced by shared genetic factors, respectively. In summary, our study indicated that genetically proxied metformin effects may be associated with an increased risk of prostate cancer. Repurposing metformin for prostate cancer prevention in general populations is not supported by our findings.
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Affiliation(s)
- Xiaohui Sun
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
- Department of Epidemiology, Zhejiang Chinese Medical University, Zhejiang, China
| | - Jie Ping
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Xingyi Guo
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Xiang Shu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
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14
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Lin L, Huang Y, Chen L, Zheng L, Feng Y, Lin J, Yan J. Gestational weight trajectory and risk of adverse pregnancy outcomes among women with gestational diabetes mellitus: A retrospective cohort study. Matern Child Nutr 2024:e13645. [PMID: 38517119 DOI: 10.1111/mcn.13645] [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] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
The aim of this study was to explore gestational weight gain (GWG) trajectories and their associations with adverse pregnancy outcomes. A retrospective cohort study including 11,064 women with gestational diabetes mellitus (GDM) was conducted between 2015 and 2019 in China. The latent class trajectory model was used to identify GWG trajectories, and logistic regression was performed to examine odds ratio (OR) of pregnancy outcomes. Three trajectories of GWG were identified in these 11,604 women with GDM. Trajectory 1: 64.02% of women had sustained moderate GWG throughout pregnancy; Trajectory 2: 17.75% of women showed a high initial GWG but followed by a low GWG from the third trimester until delivery; Trajectory 3: 18.23% had low initial GWG but followed by drastic GWG from the second trimester until delivery. Compared with pregnant women with Trajectory 1, women with Trajectory 2 had a higher risk of large for gestational age (adjusted odds ratio [AOR]: 1.29, 95% confidence interval [CI]: 1.12-1.48) but at a lower risk of having hypertensive disorders of pregnancy (AOR: 0.76, 95% CI: 0.57-0.96). Women in Trajectory 3 were more likely to develop small for gestational age (AOR: 2.12, 95% CI: 1.62-2.78), low birthweight (AOR: 1.49, 95% CI: 1.07-2.08), preterm birth (AOR: 1.28, 95% CI: 1.05-1.63), caesarean section (AOR: 1.26, 95% CI: 1.112-1.42) and hypertensive disorders of pregnancy (AOR: 2.24, 95% CI: 1.82-2.76). The association of GWG trajectory with adverse pregnancy outcomes differs across prepregnancy body mass index and GWG categories. Women with a slow initial GWG but followed by drastic GWG had higher risks of adverse pregnancy outcomes. Early clinical recognition of poor GWG trajectory will contribute to early intervention in high-risk groups to minimise adverse outcomes.
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Affiliation(s)
- Lihua Lin
- Department of Healthcare, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Yanhong Huang
- Department of Healthcare, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Lijuan Chen
- Department of Child Healthcare Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Lianghui Zheng
- Department of Obstetric, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Yebin Feng
- Department of Research Office, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Juan Lin
- Department of Obstetric, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
| | - Jianying Yan
- Department of Obstetric, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China
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15
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Feng Z, Chen L, Wu Q, Xu F, Tong Q, Wang G. Acute Helicobacter pylori infection prevalence and association with metabolic abnormality in general Chinese population: A retrospective study. Medicine (Baltimore) 2024; 103:e37117. [PMID: 38518022 PMCID: PMC10956972 DOI: 10.1097/md.0000000000037117] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/09/2024] [Indexed: 03/24/2024] Open
Abstract
Helicobacter pylori (H pylori) infection was common worldwide and previous researches on the correlation between H pylori infection and metabolic abnormality provided inconsistent conclusions. We assessed acute H pylori infection prevalence and the relationship with metabolic abnormality in general Chinese population. Participants attending for the physical examination underwent a carbon-13 urea breath test. For individual, the following data were collected: age, gender, body mass index (BMI), systolic blood pressure, diastolic blood pressure, total protein, albumin, globulin (GLB), total bilirubin, direct bilirubin (DBIL), indirect bilirubin, alanine transaminase, glutamyl transpeptidase, alkaline phosphatase, cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, urea nitrogen, creatinine, uric acid, fasting plasma glucose (FPG), and homocysteine. A total of 29,154 participants were enrolled. The prevalence of acute H pylori infection was 29.79% (8684/29,154). Spearson correlation analysis showed that gender, BMI, ALB, GLB, total bilirubin, DBIL, indirect bilirubin, and FPG were closely related to H pylori infection. Multinomial logistic regressions analysis with stepwise subset selection further identified gender, BMI, ALB, GLB, DBIL, and FPG as independent risk factors for acute H pylori infection. Our results indicated that acute H pylori infection might has a significant impact on metabolic abnormalities, which should be further confirmed.
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Affiliation(s)
- Zhan Feng
- Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Lan Chen
- Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Qing Wu
- Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Fan Xu
- Department of Geriatrics, Dongxiang Hospital of Traditional Chinese Medicine, Fuzhou, Jiangxi, China
| | - Qian Tong
- Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Guofu Wang
- Zhejiang Hospital, Hangzhou, Zhejiang, China
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Benchelha H, Chakit M, Mouilly M, Nadir K, Barkaoui M, Moustaine A, Elkhatir A, Ahami AOT, Bikjdaouene L. Gender and Body Mass Index Difference in Aerobic Capacity: A Study in Moroccan High School Students. Int Tinnitus J 2024; 27:198-202. [PMID: 38507635 DOI: 10.5935/0946-5448.20230030] [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: 03/22/2024]
Abstract
Different tests are used to evaluate the aerobic capacity of a person. This study aims to investigate the gender and Body Mass Index (BMI) difference in aerobic capacity measured by using shuttle and Spartacus test. The study was conducted on 230 high school students (135 girls and 95 boys) followed their study in public establishment in kenitra city (Morocco). All participants were classified according to their gender (male vs. female) and their BMI (normal weight vs. overweight-obese) and performed the both test of shuttle and Spartacus. Running speed at the last completed stage, run time, maximum heart rate (max HR) max HR and perceived exertion were measured and analyzed. For each test, VO2max was estimated by using the proposed equation. There was significant BMI difference in the measured parameters (p<0.001). Difference in VO2max between male and female remained significant with high-speed level in boys. A significant difference between males and females (p < 0.001) was observed in shuttle test. Participants with normal weight or physical activity had good aerobic capacity. Compared to the Shuttle test, the Spartacus provides a 11.5% higher final speed (11.2 vs. 9.7km/h) and a total test time 2.3 times longer (11.3vs. 4.9 min) (p < 0.001). Our study underlines the interest of the Spartacus test and is preliminary. Indeed, these results must now be replicated in a larger sample of obese adolescents.
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Affiliation(s)
- Hassan Benchelha
- Biology and Health Laboratory, Department of Biology, Faculty of Sciences, Ibn Tofail University, Kenitra, Morocco
| | - Miloud Chakit
- Biology and Health Laboratory, Department of Biology, Faculty of Sciences, Ibn Tofail University, Kenitra, Morocco
| | - Mustapha Mouilly
- Department of Biology, Faculty of Sciences and Technics, Moulay Ismail University, Errachidia, Morocco
| | - Karim Nadir
- Department of Biology, Faculty of Sciences and Technics, Moulay Ismail University, Errachidia, Morocco
| | - Mohamed Barkaoui
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University, Settat, Morocco
| | - Abdelhak Moustaine
- Supervisor of Physical Education and Sports in Ministry of Education. Morocco
| | - Abdelkarim Elkhatir
- Biology and Health Laboratory, Department of Biology, Faculty of Sciences, Ibn Tofail University, Kenitra, Morocco
| | - Ahmed O T Ahami
- Biology and Health Laboratory, Department of Biology, Faculty of Sciences, Ibn Tofail University, Kenitra, Morocco
| | - Leila Bikjdaouene
- Biology and Health Laboratory, Department of Biology, Faculty of Sciences, Ibn Tofail University, Kenitra, Morocco
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Uldbjerg CS, Lim YH, Renault CH, Hansen D, Juul A, Bräuner EV, Jensen RB. Girls with idiopathic central precocious puberty did not display substatial changes in body mass index after treatment with gonadotropin-releasing hormone analogues. Acta Paediatr 2024. [PMID: 38506052 DOI: 10.1111/apa.17185] [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: 09/27/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/21/2024]
Abstract
AIM To evaluate changes in body mass index (BMI) in girls during and after treatment for idiopathic central precocious puberty (iCPP). METHODS We studied 123 girls receiving gonadotropin-releasing hormone analogue (GnRHa)treatment for iCPP from 2009 to 2019. Pubertal and anthropometric measurements were monitored at routine clinical visits. BMI standard deviation scores (SDS) were estimated at baseline and followed in two stages from baseline to end of treatment (median 18.9 months) and from end of treatment to end of follow-up (median 18.2 months). The influence of baseline BMI SDS and the frequency and dose of treatment was evaluated using BMI trajectories and latent class mixed models. RESULTS The median age at treatment initiation was 8.5 years. The median BMI SDS at baseline was 0.7, corresponding to a median BMI of 17.4 kg/m2 . Overall, no changes in BMI SDS were observed during treatment. According to baseline BMI subgroups, an increasing trend in BMI trajectories during treatment was observed for girls in the lowest BMI group. After treatment, most girls maintained stable BMI levels. CONCLUSION Our retrospective study did not provide evidence that GnRHa treatment for iCPP had a significant impact on BMI trajectories in girls.
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Affiliation(s)
- Cecilie Skaarup Uldbjerg
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Youn-Hee Lim
- Department of Public Health, Section of Environmental Health, University of Copenhagen, Copenhagen, Denmark
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Christoffer Højrup Renault
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Dorte Hansen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Rikke Beck Jensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital - Herlev and Gentofte Hospital, Herlev, Denmark
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18
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Di Lodovico L, Al Tabchi A, Clarke J, Mancusi RL, Messeca D, Duriez P, Hanachi M, Gorwood P. Trajectories and predictive factors of weight recovery in patients with anorexia nervosa completing treatment. A latent class mixed model approach. Eur Eat Disord Rev 2024. [PMID: 38504499 DOI: 10.1002/erv.3088] [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: 11/20/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Treatment of anorexia nervosa (AN) sometimes requires hospitalisation, which is often lengthy, with little ability to predict individual trajectory. Depicting specific profiles of treatment response and their clinical predictors could be beneficial to tailor inpatient management. The aim of this research was to identify clusters of weight recovery during inpatient treatment, and their clinical predictors. METHODS A sample of 181 inpatients who completed a treatment programme for AN was included in a retrospective study. A latent class mixed model approach was used to identify distinct weight-gain trajectories. Clinical variables were introduced in a multinomial logistic regression model as predictors of the different classes. RESULTS A four-class quadratic model was retained, able to correctly classify 63.7% of the cohort. It encompassed a late-rising, flattening, moderate trajectory of body mass index (BMI) increase (class 1), a late-rising, steady, high trajectory (class 2), an early-rising, flattening, high trajectory (class 3) and an early-rising, steady, high trajectory (class 4). Significant predictors of belonging to a class were baseline BMI (all classes), illness duration (class 2), and benzodiazepine prescription (class 3). CONCLUSION Predicting different kinetics of weight recovery based on routinely collected clinical indicators could improve clinician awareness and patient engagement by enabling shared expectations of treatment response.
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Affiliation(s)
- Laura Di Lodovico
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Bordeaux, France
- Université Paris Cité, INSERM, Institut de Psychiatrie et Neuroscience de Paris (IPNP), U1266, Paris, France
| | - Amir Al Tabchi
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Julia Clarke
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Rossella Letizia Mancusi
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Dylan Messeca
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Philibert Duriez
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, INSERM, Institut de Psychiatrie et Neuroscience de Paris (IPNP), U1266, Paris, France
| | - Mouna Hanachi
- Clinical Nutrition Unit, Paul Brousse University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Villejuif, France
- UMR Micalis Institute, INRA, Paris Saclay University, Jouy-En-Josas, France
| | - Philip Gorwood
- Clinique des Maladies Mentales et de l'Encéphale, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, INSERM, Institut de Psychiatrie et Neuroscience de Paris (IPNP), U1266, Paris, France
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19
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López-Herrera JA, Castillo AN, Ordoñez-Betancourth JE, Martínez Quiroz WDJ, Higuita-Gutiérrez LF, Suarez-Ortegon MF. Metabolically Unhealthy Normal Weight: Prevalence and Associated Factors in an Adult Population from Northwest Colombia. Diabetes Metab Syndr Obes 2024; 17:1337-1357. [PMID: 38525161 PMCID: PMC10959303 DOI: 10.2147/dmso.s449213] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/11/2024] [Indexed: 03/26/2024] Open
Abstract
Background and Aim Individuals with a normal weight may have metabolic alterations at risk for chronic non-communicable diseases. The prevalence of this condition and associated factors have not been reported in Latin American populations. We aimed to estimate the presence and associated factors of Metabolically Unhealthy Normal Weight (MUNW) in adults from a public program for the control and prevention of chronic diseases in Medellín, Colombia. Methods Cross-sectional study. Overweight and normal weight were characterized according to the absence or presence of one or more components of the metabolic syndrome, obtaining four phenotypes: Metabolically Healthy Normal Weight (MHNW), MUNW (phenotype of interest), Metabolically Healthy Overweight (MHO), and Metabolically Unhealthy Overweight (MUO). The association of these phenotypes with sociodemographic variables of lifestyles and increased waist circumference was conducted by using logistic regression. Results In 37,558 individuals (72.7% women), the prevalence of MUNW was 23.3%. Among the additional phenotypes, MUO was found to be more prevalent (71.6%), while MHNW and MHO were very slightly common, 2% and 3.1%, respectively. In a multiple model, the factors associated with MUNW were age over 60 years (trend [OR 1.56 95% CI 0.97-2.52] p-value = 0.066), living in a rural area ([OR 1.58 95% CI 1.09-2.29] p-value = 0.015), and increased waist circumference ([OR 1.68 95% CI 1.45-1.95] p-value < 0.001). Male gender was inversely associated with all phenotypes (P < 0.05). Conclusion Almost a quarter of the analyzed population presented MUNW. People living in a rural area and over 60 years old were more likely to present MUNW. Men were less likely to present the weight phenotypes studied, although they could have been underrepresented.
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Affiliation(s)
- Julián Andrés López-Herrera
- Departamento de Salud Pública, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Seccional Cali, Cali, Colombia
| | - Adriana Nathaly Castillo
- Departamento de nutrición y dietética, Institución Universitaria Escuela Nacional del Deporte, Cali, Colombia
| | | | | | - Luis Felipe Higuita-Gutiérrez
- School of Medicine, Universidad Cooperativa de Colombia, Medellín, Colombia
- School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Milton F Suarez-Ortegon
- Departamento de Alimentación y Nutrición, Facultad de Ciencias de la Salud, Pontificia Universidad Javeriana Seccional Cali, Cali, Colombia
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20
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Song C, Zhang W, Luo C, Zhao X. Prognostic factors for surgical site infection in patients with spinal metastases and following surgical treatment. Medicine (Baltimore) 2024; 103:e37503. [PMID: 38489716 PMCID: PMC10939512 DOI: 10.1097/md.0000000000037503] [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: 12/29/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
There were few articles reviewed prognostic factors of surgical site infection (SSI) in patients with spinal metastases following surgery. The purpose of the present study was to systematically: (1) investigate the incidence rates of SSI following spinal metastases surgery; (2) identify the factors which were independently associated with postoperative wound infection. One hundred sixty-seven consecutive adult patients with spinal metastases and underwent surgical treatment were retrospectively enrolled from January 2011 to February 2022. Demographic data, disease and operation-related indicators were extracted and analyzed. Univariate and multivariate logistic analysis model were performed respectively to determine independent risk factors of SSI. 17 cases infection were collected in this study. The overall incidence of SSI after surgery of spinal metastases patients was 10.2%. Univariate regression analysis showed that age (P = .028), preoperative ALB level (P = .024), operation time (P = .041), intraoperative blood loss (P = .030), Karnofsky Performance Status score (P = .000), body mass index (P = .013), American Society of Anesthesiologists > 2 (P = .010), Tobacco consumption (P = .035), and number of spinal levels involved in surgical procedure (P = .007) were associated with wound infection. Finally, the multivariate logistic model demonstrated that body mass index (P = .043; OR = 1.038), preoperative ALB level (P = .018; OR = 1.124), and number of spinal levels (P = .003; OR = 1.753) were associated with SSI occurrence. Surgery on multiple vertebral levels for spinal metastases significantly increases the risk of SSI and weight management, nutritional support and palliative surgery have the positive significance in reducing wound complications. Orthopedist should focus on identifying such high-risk patients and decrease the incidence of wound infection by formulating comprehensive and multi-disciplinary care strategy.
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Affiliation(s)
- Chen Song
- Department of Geriatric Orthopedics, The Second Hospital of Tangshan, Tangshan, Hebei, P.R. China
| | - Wanxi Zhang
- Department of Foot and Ankle Surgery, The Second Hospital of Tangshan, Tangshan, Hebei, P.R. China
| | - Cheng Luo
- Department of Geriatric Orthopedics, The Second Hospital of Tangshan, Tangshan, Hebei, P.R. China
| | - Xiaoyong Zhao
- Department of Geriatric Orthopedics, The Second Hospital of Tangshan, Tangshan, Hebei, P.R. China
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21
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Kominiarek MA, Espinal M, Cassimatis IR, Peace JM, Premkumar A, Toledo P, Shramuk M, MSt EQW. Peripartum Interventions for People with Class III Obesity: A Systematic Review and Meta-Analysis. Am J Obstet Gynecol MFM 2024:101354. [PMID: 38494155 DOI: 10.1016/j.ajogmf.2024.101354] [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: 11/17/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE To identify evidenced-based peripartum interventions for people with a body mass index (BMI) ≥40kg/m2. DATA SOURCES PubMed, MEDLINE, EMBASE, Cochrane, CINAHL and ClinicalTrials.gov were searched from inception to 2022 without date, publication type, or language restrictions. STUDY ELIGIBILITY CRITERIA Cohort and randomized controlled trials (RCT) that implemented an intervention and evaluated peripartum outcomes of people with a BMI≥40kg/m2 were included. The primary outcome depended on the intervention but commonly related to wound morbidity after cesarean delivery (i.e., infection, separation, hematoma). STUDY APPRAISAL AND SYNTHESIS METHODS Meta-analysis was completed for interventions with at least 2 studies. Pooled risk ratios (RR) with 95% confidence intervals (CI) and heterogeneity (I2 statistics) were reported. RESULTS Of 20,301 studies screened, 30 studies (17 cohort, 13 RCT) encompassing 10 types of interventions were included. Interventions related to delivery planning (induction of labor, planned cesarean delivery), antibiotics during labor induction or for surgical prophylaxis, six types of cesarean delivery techniques, and anticoagulation dosing after a cesarean delivery. Planned cesarean delivery compared to planned vaginal delivery did not improve outcomes based on 3 cohort studies. One cohort study compared 3g to 2g of cephazolin prophylaxis for cesarean delivery and found no differences in surgical site infections. According to 3 cohort studies and 2 RCTs, there was no improvement in outcomes with a non-low transverse skin incision. Ten studies (4 cohort, 6 RCT) met inclusion criteria for the meta-analysis. Two RCTs compared subcuticular closure with suture vs. staples after cesarean delivery and found no differences in wound morbidity within 6 weeks of cesarean delivery (n=422; RR 1.09, 95% CI [0.75-1.59], I2=9%). Prophylactic negative pressure wound therapy was compared to standard dressing in 4 cohort and 4 RCTs and found no differences in wound morbidity (cohort n=2200; RR 1.19, 95% CI [0.88-1.63], I2=66.1%) or surgical site infections (RCT n=1262; RR 0.90, 95% CI [0.63-1.29], I2=0). CONCLUSION Few studies address interventions in people with a BMI≥40kg/m2 and most studies did not demonstrate a benefit. Either staples or suture are recommended for subcuticular closure, but available data do not support prophylactic NPWT after cesarean delivery for people with a BMI ≥40kg/m2.
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Affiliation(s)
- Michelle A Kominiarek
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine; Chicago, IL.
| | - Mariana Espinal
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine; Chicago, IL.
| | - Irina R Cassimatis
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine Oregon Health and Science University; Portland, OR.
| | - Jack M Peace
- Department of Anesthesiology, Temple University Lewis Katz School of Medicine; Philadelphia, PA.
| | - Ashish Premkumar
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Chicago; Chicago IL.
| | - Paloma Toledo
- Department of Anesthesiology, University of Miami; Miami, IL.
| | - Maxwell Shramuk
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine; Chicago, IL.
| | - Eileen Q Wafford MSt
- Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine; Chicago, IL.
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22
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Gao C, Zou D, Cao R, Li Y, Su D, Han J, Gao F, Qi X. Effect of Body Mass Index on Cecal Intubation Time During Unsedated Colonoscopy: Variation Across the Learning Stages of an Endoscopist. Med Sci Monit 2024; 30:e942661. [PMID: 38520116 PMCID: PMC10944010 DOI: 10.12659/msm.942661] [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: 09/24/2023] [Accepted: 01/03/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Body mass index (BMI) and endoscopists' experiences can be associated with cecal intubation time (CIT), but such associations are controversial. This study aimed to clarify the association between BMI and CIT during unsedated colonoscopy at 3 learning stages of a single endoscopist. MATERIAL AND METHODS A total of 1500 consecutive patients undergoing unsedated colonoscopy by 1 endoscopist at our department from December 11, 2020, to August 21, 2022, were reviewed. They were divided into 3 learning stages according to the number of colonoscopies performed by 1 endoscopist, including intermediate (501-1000 colonoscopies), experienced (1001-1500 colonoscopies), and senior stages (1501-2000 colonoscopies). Variables that significantly correlated with CIT were identified by Spearman rank correlation analyses and then included in multiple linear regression analysis. RESULTS Overall, 1233 patients were included. Among them, 392, 420, and 421 patients were divided into intermediate, experienced, and senior stages, respectively. Median CIT was 7.83, 6.38, and 5.58 min at intermediate, experienced, and senior stages, respectively (P.
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Affiliation(s)
- Cong Gao
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
- Postgraduate College, Dalian Medical University, Dalian, Liaoning, PR China
| | - Deli Zou
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
| | - Rongrong Cao
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
| | - Yingchao Li
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
| | - Dongshuai Su
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
| | - Jie Han
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
| | - Fei Gao
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, PR China
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23
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Zelig R, Lyon A, Touger-Decker R, Singer SR, Samavat H. Dentition and weight status in community-dwelling older adults. Gerodontology 2024. [PMID: 38468455 DOI: 10.1111/ger.12747] [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] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND/OBJECTIVE Tooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults. MATERIALS AND METHODS This was a cross-sectional study of data from a convenience sample of older adults (65-89 years) treated at an urban U.S. dental school clinic. Clinical and demographic data were obtained from electronic health records. Dentition status was determined based on data from odontograms. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of having a non-normal weight status for each measure of dentition status, after adjusting for covariates. RESULTS Patients (n = 1765) were 54.1% female, 51.5% White, 41.6% African American and 22.5% Hispanic/Latino. The median (interquartile range [IQR]) age was 71 (67.0-75.0) years; the mean (±SD) BMI was 28.5 (±5.7) kg/m2 ; 72.5% were overweight or obese. The median (IQR) number of remaining teeth was 20.0 (13.0-24.0); the median numbers of anterior and posterior occluding pairs of teeth were 5.0 (2.0-6.0) and 2.0 (0.0-5.0), respectively; and 44.9% had a functional dentition (≥21 teeth). Having a higher number of remaining teeth and more posterior occluding pairs were associated with lower odds of obesity (OR = 0.980, 95% CI = 0.964, 0.997, p = .022 and OR = 0.931, 95% CI = 0.885, 0.980, p = .006, respectively). Lack of a functional dentition was associated with higher odds of obesity (OR = 1.400, 95% CI = 1.078, 1.818, p = .012), after controlling for covariates. CONCLUSION Older adults with tooth loss - especially loss of posterior occlusion and lack of a functional dentition - were more likely to be obese than of normal weight.
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Affiliation(s)
- Rena Zelig
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, New Jersey, USA
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey, USA
| | - Amy Lyon
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, New Jersey, USA
| | - Riva Touger-Decker
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, New Jersey, USA
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey, USA
| | - Steven R Singer
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, New Jersey, USA
| | - Hamed Samavat
- Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, New Jersey, USA
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24
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Miao L, Niu X, Huang M, Cao G, Fu C. Association between body mass index and burnout among nurses in China: a cross-sectional study. BMJ Open 2024; 14:e081203. [PMID: 38471687 DOI: 10.1136/bmjopen-2023-081203] [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: 03/14/2024] Open
Abstract
OBJECTIVES Body mass index (BMI) can affect an individual's health. The night shift is a characteristic of the nursing profession, which is associated with an abnormal BMI. However, few studies have investigated the association between BMI and burnout in Chinese nurses. This study examined the association between BMI and burnout among Chinese nurses. METHODS A total of 1863 nurses from 12 tertiary hospitals in Shandong Province of China were selected. BMI was calculated as body weight divided by height squared. The Maslach Burnout Service Inventory General Survey (MBI-GS) was used to measure the level of burnout among nurses. Ordinal logistic regression was used to analyse the association between BMI and burnout. RESULTS In this study, the prevalence of normal BMI, underweight, overweight, and obesity was 69.2%, 7.5%, 18.2%, and 5.2%, respectively. The prevalence of high emotional exhaustion, high cynicism, and low personal accomplishment among nurses was 26.1%, 38.7%, and 35.6%, respectively. Nurses who were obese were more likely to have high levels of emotional exhaustion (OR=1.493, 95% CI: 1.011 to 2.206) and cynicism (OR=1.511, 95% CI: 1.014 to 2.253), and nurses who were underweight were more likely to have high levels of cynicism (OR=1.593, 95% CI: 1.137 to 2.232) compared with those who were normal weight. CONCLUSIONS Obesity was positively associated with emotional exhaustion and cynicism, and being underweight was only positively associated with cynicism among Chinese nurses. Hospital administrators should consider BMI when taking effective measures to reduce burnout among nurses.
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Affiliation(s)
| | - Xiaogui Niu
- Department of Pediatric Hematology, Binzhou Medical University Hospital, Binzhou, China
| | - Minxiang Huang
- Department of Pediatric Surgery, Binzhou Medical University Hospital, Binzhou, China
| | - Gaofang Cao
- School of Health and Management, Binzhou Medical University, Yantai, China
| | - Chang Fu
- School of Health and Management, Binzhou Medical University, Yantai, China
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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25
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Lee DJ, O'Donnell EK, Raje N, Panaroni C, Redd R, Ligibel J, Sears DD, Nadeem O, Ghobrial IM, Marinac CR. Design and Rationale of Prolonged Nightly Fasting for Multiple Myeloma Prevention (PROFAST): Protocol for a Randomized Controlled Pilot Trial. JMIR Res Protoc 2024; 13:e51368. [PMID: 38466984 DOI: 10.2196/51368] [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: 07/31/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Obesity is an established, modifiable risk factor of multiple myeloma (MM); yet, no lifestyle interventions are routinely recommended for patients with overweight or obesity with MM precursor conditions. Prolonged nightly fasting is a simple, practical dietary regimen supported by research, suggesting that the synchronization of feeding-fasting timing with sleep-wake cycles favorably affects metabolic pathways implicated in MM. We describe the design and rationale of a randomized controlled pilot trial evaluating the efficacy of a regular, prolonged nighttime fasting schedule among individuals with overweight or obesity at high risk for developing MM or a related lymphoid malignancy. OBJECTIVE We aim to investigate the effects of 4-month prolonged nightly fasting on body composition and tumor biomarkers among individuals with overweight or obesity with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), or smoldering Waldenström macroglobulinemia (SWM). METHODS Individuals with MGUS, SMM, or SWM aged ≥18 years and a BMI of ≥25 kg/m2 are randomized to either a 14-hour nighttime fasting intervention or a healthy lifestyle education control group. Participants' baseline diet and lifestyle patterns are characterized through two 24-hour dietary recalls: questionnaires querying demographic, comorbidity, lifestyle, and quality-of-life information; and wrist actigraphy measurements for 7 days. Fasting intervention participants are supported through one-on-one telephone counseling by a health coach and automated SMS text messaging to support fasting goals. Primary end points of body composition, including visceral and subcutaneous fat (by dual-energy x-ray absorptiometry); bone marrow adiposity (by bone marrow histology); and tumor biomarkers, specifically M-proteins and serum free light-chain concentrations (by gel-based and serum free light-chain assays), are assessed at baseline and after the 4-month study period; changes therein from baseline are evaluated using a repeated measures mixed-effects model that accounts for the correlation between baseline and follow-up measures and is generally robust to missing data. Feasibility is assessed as participant retention (percent dropout in each arm) and percentage of days participants achieved a ≥14-hour fast. RESULTS The PROlonged nightly FASTing (PROFAST) study was funded in June 2022. Participant recruitment commenced in April 2023. As of July 2023, six participants consented to the study. The study is expected to be completed by April 2024, and data analysis and results are expected to be published in the first quarter of 2025. CONCLUSIONS PROFAST serves as an important first step in exploring the premise that prolonged nightly fasting is a strategy to control obesity and obesity-related mechanisms of myelomagenesis. In evaluating the feasibility and impact of prolonged nightly fasting on body composition, bone marrow adipose tissue, and biomarkers of tumor burden, this pilot study may generate hypotheses regarding metabolic mechanisms underlying MM development and ultimately inform clinical and public health strategies for MM prevention. TRIAL REGISTRATION ClinicalTrials.gov NCT05565638; http://clinicaltrials.gov/ct2/show/NCT05565638. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51368.
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Affiliation(s)
- David J Lee
- Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Elizabeth K O'Donnell
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Center for Early Detection and Interception of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Noopur Raje
- Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Cristina Panaroni
- Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Robert Redd
- Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Jennifer Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Omar Nadeem
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Center for Early Detection and Interception of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Irene M Ghobrial
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Center for Early Detection and Interception of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Catherine R Marinac
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Center for Early Detection and Interception of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA, United States
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Golbasi H, Bayraktar B, Golbasi C, Omeroglu I, Atakul BK, Cakir ZE, Toka IG, Ekin A. Third-trimester fetal pancreas imaging in uncomplicated pregnancies and association with pregnancy outcomes. J Clin Ultrasound 2024. [PMID: 38465703 DOI: 10.1002/jcu.23667] [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: 01/09/2024] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To examine third-trimester sonographic imaging of the fetal pancreas in uncomplicated pregnancies and its association with pregnancy outcomes. METHODS This was a prospective cohort study including 274 pregnant women. Uncomplicated pregnancies in the third trimester (28-40 weeks) were included in the study. Maternal chronic disease, pregnancy-related disorders such as hypertension, diabetes, cholestasis, smoking, and fetal abnormalities were determined as exclusion criteria. Sonographic fetal pancreatic measurement and echogenicity were evaluated in all participants. For intra-observer reliability, each participant's fetal pancreatic circumference was measured two times. The echogenicity of the pancreas was compared with the liver and ribs and classified as grade 1, 2, and 3. The pregnancy outcomes of all participants were obtained from the hospital digital registration system. RESULTS The average fetal pancreatic circumference in the third trimester was 70.7 ± 0.6 mm (median, 70 [44-100.7]), with high intra-observer agreement (ICC 0.996 [0.995; 0.997]). A significant positive correlation was found between pancreatic circumference, body mass index (BMI), gestational age, and birth weight. Pancreatic measurements were significantly higher in composite adverse outcomes cases that included at least one of respiratory distress syndrome, hyperbilirubinemia, neonatal pneumonia, infection, and sepsis (p < 0.001). No relationship was found between pancreatic echogenicity and perinatal outcomes. CONCLUSION Fetal pancreas size was positively correlated with gestational age, BMI, and birth weight, and increased fetal pancreas size was associated with composite adverse neonatal outcomes.
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Affiliation(s)
- Hakan Golbasi
- Department of Obstetrics and Gynecology Division of Perinatology, Bakircay University Cigli Education and Research Hospital, Izmir, Turkey
| | - Burak Bayraktar
- Department of Obstetrics and Gynecology Division of Perinatology, University of Health Sciences Ankara Etlik City Hospital, Ankara, Turkey
| | - Ceren Golbasi
- Department of Obstetrics and Gynecology, Tinaztepe University Faculty of Medicine, Izmir, Turkey
| | - Ibrahim Omeroglu
- Department of Obstetrics and Gynecology Division of Perinatology, Izmir City Hospital, Izmir, Turkey
| | - Bahar Konuralp Atakul
- Department of Obstetrics and Gynecology Division of Perinatology, Izmir City Hospital, Izmir, Turkey
| | - Zubeyde Emiralioglu Cakir
- Department of Obstetrics and Gynecology Division of Perinatology, Izmir City Hospital, Izmir, Turkey
| | - Ilknur Gumus Toka
- Department of Obstetrics and Gynecology Division of Perinatology, Izmir City Hospital, Izmir, Turkey
| | - Atalay Ekin
- Department of Obstetrics and Gynecology Division of Perinatology, Izmir City Hospital, Izmir, Turkey
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27
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Bradford HM, Puhl RM, Phillippi JC, Dietrich MS, Neal JL. Weight Bias Among Certified Nurse-Midwives and Certified Midwives: Findings From a National Sample. J Midwifery Womens Health 2024. [PMID: 38459813 DOI: 10.1111/jmwh.13608] [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] [Revised: 12/01/2023] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Weight bias toward individuals with higher body weights permeates health care settings in the United States and has been associated with poor weight-related communication and quality of care as well as adverse health outcomes. However, there has been limited quantitative investigation into weight bias among perinatal care providers. Certified nurse-midwives (CNMs)/certified midwives (CMs) attend approximately 11% of all births in the United States. The aims of this study were to measure the direction and extent of weight bias among CNMs/CMs and compare their levels of weight bias to the US public and other health professionals. METHODS Through direct postcard distribution, social media accounts, professional networks, and email listservs, American Midwifery Certification Board (AMCB)-certified midwives were solicited to complete an online survey of their implicit weight bias using the Implicit Association Test and their explicit weight bias using the Antifat Attitudes Questionnaire, Fat Phobia Scale, and Preference for Thin People measure. RESULTS A total of 2257 midwives participated in the survey, yielding a completion rate of 17.7%. Participants were mostly White and female, with a median age of 46 years and 11 years since AMCB certification. More than 70% of midwives have some level of implicit weight bias, although to a lesser extent compared with previously published findings among the US public (P < .01) and other health professionals (P < .01). In a subsample comparison of female midwives to female physicians, implicit weight bias levels were similar (P > .05). Midwives also express explicit weight bias, but at lower levels than the US public and other health professionals (P < .05). DISCUSSION This study provides the first quantitative research documenting weight bias among a national US sample of perinatal care providers. Findings can inform educational efforts to mitigate weight bias in the perinatal care setting and decrease harm.
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Affiliation(s)
- Heather M Bradford
- Georgetown University, School of Nursing, Washington, District of Columbia
- Vanderbilt University, School of Nursing, Nashville, Tennessee
| | - Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut
| | | | - Mary S Dietrich
- Vanderbilt University, School of Nursing, Nashville, Tennessee
- Vanderbilt University, School of Medicine, Nashville, Tennessee
| | - Jeremy L Neal
- Vanderbilt University, School of Nursing, Nashville, Tennessee
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Zhang Z, Chen L, Zhang H, Xiao W, Yang J, Huang J, Hu Q, Jin K, Hong Y. Genetic correlations and causal relationships between cardio-metabolic traits and sepsis. Sci Rep 2024; 14:5718. [PMID: 38459230 PMCID: PMC10923865 DOI: 10.1038/s41598-024-56467-7] [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] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 03/06/2024] [Indexed: 03/10/2024] Open
Abstract
Cardio-metabolic traits have been reported to be associated with the development of sepsis. It is, however, unclear whether these co-morbidities reflect causal associations, shared genetic heritability, or are confounded by environmental factors. We performed three analyses to explore the relationships between cardio-metabolic traits and sepsis. Mendelian randomization (MR) study to evaluate the causal effects of multiple cardio-metabolic traits on sepsis. Global genetic correlation analysis to explore the correlations between cardio-metabolic traits and sepsis. Local genetic correlation (GC) analysis to explore shared genetic heritability between cardio-metabolic traits and sepsis. Some loci were further examined for related genes responsible for the causal relationships. Genetic associations were obtained from the UK Biobank data or published large-scale genome-wide association studies with sample sizes between 200,000 to 750,000. In MR, we found causality between BMI and sepsis (OR: 1.53 [1.4-1.67]; p < 0.001). Body mass index (BMI), which is confirmed by sensitivity analyses and multivariable MR adjusting for confounding factors. Global GC analysis showed a significant correlation between BMI and sepsis (rg = 0.55, p < 0.001). More cardio-metabolic traits were identified to be correlated to the sepsis onset such as CRP (rg = 0.37, p = 0.035), type 2 diabetes (rg = 0.33, p < 0.001), HDL (rg = - 0.41, p < 0.001), and coronary artery disease (rg = 0.43, p < 0.001). Local GC revealed some shared genetic loci responsible for the causality. The top locus 1126 was located at chromosome 7 and comprised genes HIBADH, JAZF1, and CREB5. The present study provides evidence for an independent causal effect of BMI on sepsis. Further detailed analysis of the shared genetic heritability between cardio-metabolic traits and sepsis provides the opportunity to improve the preventive strategies for sepsis.
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Affiliation(s)
- Zhongheng Zhang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.
| | - Lin Chen
- Neurological Intensive Care Unit, Department of Neurosurgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Haoyang Zhang
- School of Computer Science and Engineering, Sun Yat-Sen University, Guangzhou, China
| | - Wei Xiao
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Jie Yang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Jiajie Huang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
| | - Qichao Hu
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd., Hangzhou, Zhejiang, China
| | - Ketao Jin
- Department of Gastrointestinal, Colorectal and Anal Surgery, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, 310006, Zhejiang, China
| | - Yucai Hong
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China
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29
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Beck RH, Afrooz I, Suhail Masalawala M, Watad R, Al Shaban T, Deeb A. Characteristics of adolescents referred for bariatric surgery in Abu Dhabi, United Arab Emirates. Front Pediatr 2024; 12:1297251. [PMID: 38523841 PMCID: PMC10957758 DOI: 10.3389/fped.2024.1297251] [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: 09/20/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
About a third of children and adolescents are overweight or obese in the United Arab Emirates, and referrals for metabolic and bariatric surgery (MBS) are now common. Despite excellent evidence that MBS should be considered in adolescents with severe obesity, it remains a management approach of last resort in many cases. Baseline, real-world data on adolescent patients living with obesity referred for surgery, their characteristics, and how these relate to current and future referral policy are important to ensure best practice. Here we examined the demographic, anthropometric, and clinical characteristics of adolescents referred for MBS over a three-year period to Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, UAE. Ninety-two adolescents living with obesity were recruited: 54.3% were female, the average age was 16.3 ± 2.4 years, and 88.0% of patients had a first-degree relative with a history of obesity and 62% a family history of bariatric surgery. The average BMI was 47.7 ± 10.5, and the average percentage of the 95th percentile BMI was 169.5 ± 38.8%. Complications of obesity (hypertension, type 2 diabetes and prediabetes, dyslipidemia, and liver function abnormalities) were common. Our analysis highlights that there exists a mismatch between the profiles of patients referred for MBS, local guidelines, and international best practice in decision-making for referral to MBS services. While many adolescents in the UAE seem to enjoy family support and experience in the surgical management of obesity, local guidelines need updating to reflect changes in the definitions of obesity, thresholds for referral, and to remove unnecessary developmental stage barriers to increase the window for personalized surgical management.
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Affiliation(s)
- Reem Hassan Beck
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Imrana Afrooz
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | - Rama Watad
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Talat Al Shaban
- Department of Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Asma Deeb
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
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Lynch S, Killeen SL, O'Brien E, Mullane K, Hokey E, Mealy G, McAuliffe FM. Diet quality and blood pressure among pregnant women with overweight or obesity: A secondary analysis of two randomized controlled trials. Acta Obstet Gynecol Scand 2024. [PMID: 38450653 DOI: 10.1111/aogs.14821] [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: 07/06/2023] [Revised: 01/16/2024] [Accepted: 01/31/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Maternal obesity is a significant risk factor for hypertensive disorders of pregnancy. High diet quality may protect against this, yet data regarding the relationship between diet quality and blood pressure among pregnant women with raised body mass index (BMI) is limited. MATERIAL AND METHODS This is a secondary analysis (n = 543) of women with BMI ≥25 kg/m2 from two randomized controlled trials; PEARS (Pregnancy Exercise and nutrition Research Study with smartphone application support) and ROLO (Randomized cOntrol trial of LOw glycemic index diet to prevent macrosomia in euglycemic women). Blood pressure was measured at 10-18 weeks and 28 weeks of pregnancy. Mean arterial pressure was calculated as (diastolic blood pressure+ 1 3 × $$ +\frac{1}{3}\times $$ [systolic blood pressure - $$ - $$ diastolic blood pressure]). Diet quality was assessed using 3-day food diaries, and Alternative Healthy Eating Index for Pregnancy (AHEI-P) scores were generated, quantifying alignment of food intakes with dietary guidelines in first and early third trimesters. The cohort was divided based on AHEI-P tertiles to explore differences at an alpha significance value of <0.05. RESULTS The mean age of the group was 32.21 ± 4.39 years with a median body mass index (BMI) of 28.13 (IQR 3.47) kg/m2 . Mean arterial pressures in the first and third trimesters were 81.07 ± 9.00 mmHg and 82.33 ± 7.53 mmHg, respectively. Rates of elevated blood pressure (≥120/80 mmHg) were 22.33% in trimester 1 and 24.48% in early trimester 3. Mean AHEI-P scores in trimester 1 and early trimester 3 were 53.90 ± 10.43 and 54.05 ± 10.76, respectively. There was no correlation between AHEI-P score and blood pressure and no differences in blood pressure between AHEI-P tertiles at either timepoint (all P-values <0.05). A higher proportion of those with elevated early third trimester blood pressure had a BMI of ≥30 kg/m2 compared with those with normal blood pressure (40.31% vs 28.64%, P = 0.016). CONCLUSIONS While diet remains an important factor in maternal health and wellbeing, we did not find a relationship between diet quality as measured by AHEI-P and blood pressure among pregnant women with BMI ≥25 kg/m2 . High BMI remains a risk factor for hypertensive disorders of pregnancy.
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Affiliation(s)
- Sorcha Lynch
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
| | - Eileen O'Brien
- School of Biological, Health and Sports Science, Technological University Dublin, Dublin, Ireland
| | - Kate Mullane
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
| | - Emma Hokey
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
| | - Grace Mealy
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin 2, Ireland
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Torbahn G, Jones A, Griffiths A, Matu J, Metzendorf MI, Ells LJ, Gartlehner G, Kelly AS, Weghuber D, Brown T. Pharmacological interventions for the management of children and adolescents living with obesity-An update of a Cochrane systematic review with meta-analyses. Pediatr Obes 2024:e13113. [PMID: 38454737 DOI: 10.1111/ijpo.13113] [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: 09/29/2023] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
IMPORTANCE The effectiveness of anti-obesity medications for children and adolescents is unclear. OBJECTIVE To update the evidence on the benefits and harms of anti-obesity medication. DATA SOURCES Cochrane CENTRAL, MEDLINE, ClinicalTrials.gov and WHO ICTRP (1/1/16-17/3/23). STUDY SELECTION Randomized controlled trials ≥6 months in people <19 years living with obesity. DATA EXTRACTION AND SYNTHESIS Screening, data extraction and quality assessment conducted in duplicate, independently. MAIN OUTCOMES AND MEASURES Body mass index (BMI): 95th percentile BMI, adverse events and quality of life. RESULTS Thirty-five trials (N = 4331), follow-up: 6-24 months; age: 8.8-16.3 years; BMI: 26.2-41.7 kg/m2 . Moderate certainty evidence demonstrated a -1.71 (95% confidence interval [CI]: -2.27 to -1.14)-unit BMI reduction, ranging from -0.8 to -5.9 units between individual drugs with semaglutide producing the largest reduction of -5.88 kg/m2 (95% CI: -6.99 to -4.77, N = 201). Drug type explained ~44% of heterogeneity. Low certainty evidence demonstrated reduction in 95th percentile BMI: -11.88 percentage points (95% CI: -18.43 to -5.30, N = 668). Serious adverse events and study discontinuation due to adverse events did not differ between medications and comparators, but medication dose adjustments were higher compared to comparator (10.6% vs 1.7%; RR = 3.74 [95% CI: 1.51 to 9.26], I2 = 15%), regardless of approval status. There was a trend towards improved quality of life. Evidence gaps exist for children, psychosocial outcomes, comorbidities and weight loss maintenance. CONCLUSIONS AND RELEVANCE Anti-obesity medications in addition to behaviour change improve BMI but may require dose adjustment, with 1 in 100 adolescents experiencing a serious adverse event.
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Affiliation(s)
- Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Andrew Jones
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Alex Griffiths
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Jamie Matu
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Louisa J Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Evaluation, Cochrane Austria, Danube University Krems, Krems, Austria
- RTI International, Research Triangle Park, North Carolina, USA
| | - Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Tamara Brown
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
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Garcia MM, Corrales P, Huerta MÁ, Czachorowski MJ, López-Miranda V, Medina-Gómez G, Cobos EJ, Goicoechea C, Molina-Álvarez M. Adults with excess weight or obesity, but not with overweight, report greater pain intensities than individuals with normal weight: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1340465. [PMID: 38510698 PMCID: PMC10950917 DOI: 10.3389/fendo.2024.1340465] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Context Over 1.9 billion adult people have overweight or obesity. Considered as a chronic disease itself, obesity is associated with several comorbidities. Chronic pain affects approximately 60 million people and its connection with obesity has been displayed in several studies. However, controversial results showing both lower and higher pain thresholds in subjects with obesity compared to individuals with normal weight and the different parameters used to define such association (e.g., pain severity, frequency or duration) make it hard to draw straight forward conclusions in the matter. The objective of this article is to examine the relationship between overweight and obesity (classified with BMI as recommended by WHO) and self-perceived pain intensity in adults. Methods A literature search was conducted following PRISMA guidelines using the databases CINAHL, Cochrane Library, EMBASE, PEDro, PubMed, Scopus and Web of Science to identify original studies that provide BMI values and their associated pain intensity assessed by self-report scales. Self-report pain scores were normalized and pooled within meta-analyses. The Cochrane's Q test and I2 index were used to clarify the amount of heterogeneity; meta-regression was performed to explore the relationship between each outcome and the risk of bias. Results Of 2194 studies, 31 eligible studies were identified and appraised, 22 of which provided data for a quantitative analysis. The results herein suggested that adults with excess weight (BMI ≥ 25.0) or obesity (BMI ≥ 30.0) but not with overweight (pre-obesity) alone (BMI 25.0-29.9), are more likely to report greater intensities of pain than individuals of normal weight (BMI 18.5-24.9). Subgroup analyses regarding the pathology of the patients showed no statistically significant differences between groups. Also, influence of age in the effect size, evaluated by meta-regression, was only observed in one of the four analyses. Furthermore, the robustness of the findings was supported by two different sensitivity analyses. Conclusion Subjects with obesity and excess weight, but not overweight, reported greater pain intensities than individuals with normal weight. This finding encourages treatment of obesity as a component of pain management. More research is required to better understand the mechanisms of these differences and the clinical utility of the findings. Systematic Review Registration https://doi.org/10.17605/OSF.IO/RF2G3, identifier OSF.IO/RF2G3.
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Affiliation(s)
- Miguel M. Garcia
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada de I+D+i al Instituto de Química Médica (IQM) CSIC-URJC, Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Universidad Rey Juan Carlos (PHARMAKOM), Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor (i+DOL), Alcorcón, Spain
| | - Patricia Corrales
- Area of Biochemistry, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain
- High Performance Research Group in the Study of the Molecular Mechanisms of Glucolipotoxicity and Insulin Resistance: Implications in Obesity, Diabetes and Metabolic Syndrome, Universidad Rey Juan Carlos (LIPOBETA), Alcorcón, Spain
- Consolidated Research Group on Obesity and Type 2 Diabetes: Adipose Tissue Biology (BIOFAT), Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Miguel Á. Huerta
- Department of Pharmacology and Neurosciences Institute (Biomedical Research Center), Universidad de Granada, Granada, Spain
- Biosanitary Research Institute ibs.GRANADA, Granada, Spain
| | | | - Visitación López-Miranda
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada de I+D+i al Instituto de Química Médica (IQM) CSIC-URJC, Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Universidad Rey Juan Carlos (PHARMAKOM), Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor (i+DOL), Alcorcón, Spain
| | - Gema Medina-Gómez
- Area of Biochemistry, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Spain
- High Performance Research Group in the Study of the Molecular Mechanisms of Glucolipotoxicity and Insulin Resistance: Implications in Obesity, Diabetes and Metabolic Syndrome, Universidad Rey Juan Carlos (LIPOBETA), Alcorcón, Spain
| | - Enrique J. Cobos
- Department of Pharmacology and Neurosciences Institute (Biomedical Research Center), Universidad de Granada, Granada, Spain
- Biosanitary Research Institute ibs.GRANADA, Granada, Spain
- Teófilo Hernando Institute for Drug Discovery, Madrid, Spain
| | - Carlos Goicoechea
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada de I+D+i al Instituto de Química Médica (IQM) CSIC-URJC, Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Universidad Rey Juan Carlos (PHARMAKOM), Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor (i+DOL), Alcorcón, Spain
| | - Miguel Molina-Álvarez
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada de I+D+i al Instituto de Química Médica (IQM) CSIC-URJC, Alcorcón, Spain
- High Performance Experimental Pharmacology Research Group, Universidad Rey Juan Carlos (PHARMAKOM), Alcorcón, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor (i+DOL), Alcorcón, Spain
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Campanile AA, Eckel LA, Keel PK. Elevated interleukin-6 in women with binge-eating spectrum disorders. Int J Eat Disord 2024. [PMID: 38445571 DOI: 10.1002/eat.24183] [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: 10/03/2023] [Revised: 01/22/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Binge-eating spectrum disorders (BESD) involve large eating episodes accompanied by a sense of loss of control that occur in individuals with body weights spanning the full body mass index (BMI) spectrum. While research links BESD with peripheral inflammation, this literature is limited by underpowered studies and a failure to control for confounding variables that could promote inflammation independent of dysregulated eating, specifically elevated body adiposity and depression. Our study examined plasma interleukin-6 (IL-6), a marker of peripheral inflammation, in a sample of women with BESD and non-eating disorder controls, controlling for BMI, body adiposity, and depression. METHOD Participants (N = 94) included women with BESD (n = 73) or no eating disorder (n = 21) who completed structured clinical interviews in a larger study, selected to represent BMI categories ranging from underweight to obese in both groups. Fasting blood samples were processed for plasma IL-6 concentration via enzyme-linked immunosorbent assays. In addition to assessing group differences in plasma IL-6, exploratory analyses examined associations between IL-6 and biological and clinical markers of BESD. RESULTS Significantly elevated plasma IL-6 was found in women with BESD, relative to controls, that was not accounted for by BMI, adiposity, or depression. Plasma IL-6 was positively correlated with plasma leptin concentration, clinical assessments of eating disorder severity, and participants' largest self-reported eating episode. DISCUSSION Peripheral inflammation is specifically linked to presence of dysregulated eating independently from weight, adiposity, and depression in BESD. Future research should probe the potential role of neuroinflammation in altered eating behavior. PUBLIC SIGNIFICANCE This study provides the first demonstration that inflammation, characterized by elevated plasma IL-6 concentration, is uniquely associated with dysregulated eating in a transdiagnostic group of individuals with BESD. A better understanding of whether immune factors contribute to dysregulated eating could help identify novel biological targets for intervention.
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Affiliation(s)
- Alexis A Campanile
- Division of Pharmacology and Toxicology, College of Pharmacy, University of Texas at Austin, Austin, Texas, USA
| | - Lisa A Eckel
- Program in Neuroscience, Florida State University, Tallahassee, Florida, USA
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Stavres J, Aultman RS, Brandner CF, Newsome TA, Vallecillo-Bustos A, Graybeal AJ. Fat-free mass is associated with exercise pressor responses, but not cold pressor responses, in humans: influence of maximal voluntary contraction. Front Sports Act Living 2024; 6:1352192. [PMID: 38510524 PMCID: PMC10952834 DOI: 10.3389/fspor.2024.1352192] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Objective This study examined the contributions of fat mass (FM) and fat-free mass (FFM) to the magnitude of exercise pressor responses in humans. Methods The cumulative blood pressure responses (blood pressure index; BPI) to handgrip exercise (BPIhg), post-exercise-circulatory-occlusion (BPIpeco), and cold-pressor activation (BPIcpt) were collected from 67 individuals grouped by BMI (27.8 ± 7.3 kg/m2), FFM index (FFMi, 29.1 ± 3.8 kg/m2), and FM index (FMi 12.5 ± 4.8 kg/m2) quartiles. BPI responses to HG were also normalized to the time-tension index of HG, providing a relative index of exercise pressor response magnitude (BPInorm). Results BPIhg and BPIpeco were significantly elevated in the third FFMi quartile (p ≤ 0.034), while BPInorm significantly decreased in the second and fourth quartiles (p ≤ 0.029). In contrast, no differences in BPIcpt were observed across any FFMi, BMI, or FMi quartiles (p ≥ 0.268). FFM was independently associated with BPIhg, BPI-peco, and BPInorm (all p ≤ 0.049), however, FFM was eliminated as an independent predictor when maximal voluntary contraction (MVC) was included in these regression models (all p ≥ 0.495). Neither FFM nor MVC was associated with BPIcpt (p ≥ 0.229). Conclusions These findings indicate that exercise pressor responses, but not cold-pressor responses, are significantly associated with FFM in humans, and that this association is driven by FFM related differences in MVC.
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Affiliation(s)
- Jon Stavres
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Ryan S. Aultman
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Caleb F. Brandner
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Ta’Quoris A. Newsome
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Anabelle Vallecillo-Bustos
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Austin J. Graybeal
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, United States
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Schenone CV, Ashley Cain M, Schenone AL, Smith T, Tsalatsanis A, Louis JM, Crousillat DR. Changes in rate-pressure product associated with pregnancy. Am J Obstet Gynecol MFM 2024; 6:101338. [PMID: 38453019 DOI: 10.1016/j.ajogmf.2024.101338] [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: 12/29/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND In nonpregnant individuals, the rate-pressure product, the product of heart rate and systolic blood pressure, is used as a noninvasive surrogate of myocardial O2 consumption during cardiac stress testing. Pregnancy is considered a physiological cardiovascular stress test. Evidence describing the impact of pregnancy on myocardial O2 demand, as assessed by the rate-pressure product, is limited. OBJECTIVE This study aimed to describe changes in the rate-pressure product for each pregnancy trimester, during labor and delivery, and the postpartum period among low-risk pregnancies. STUDY DESIGN This was a retrospective cohort study that assessed uncomplicated pregnancies delivered vaginally at term. We collected rate-pressure product (heart rate × systolic blood pressure) values preconception, during pregnancy for each trimester (at ≤13 weeks + 6/7 days, at 14 weeks + 0/7 days through 27 weeks + 6/7 days, and at ≥28 weeks + 0/7 days), during the labor and delivery encounter (hospital admission until complete cervical dilation, complete cervical dilation until placental delivery, and after placental delivery until hospital discharge), and during the outpatient postpartum visit at 2 to 6 weeks after delivery. We calculated the percentage change at each time point from the preconception rate-pressure product (delta rate-pressure product). We used a mixed-linear model to analyze differences in the mean delta rate-pressure product over time and the influence of prepregnancy age, prepregnancy body mass index, and neuraxial anesthesia status during labor and delivery on these estimates. RESULTS Our cohort comprised 316 patients. The mean rate-pressure product increased significantly from preconception starting at the third trimester of pregnancy and during labor and delivery (P≤.05). The mean delta rate-pressure product peaked at 12% and 38% in the third trimester and during labor and delivery, respectively. Prepregnancy body mass index was inversely correlated with the mean delta rate-pressure product changes (estimate, -0.308; 95% confidence interval, -0.536 to -0.80; P=.008). In contrast, neither the prepregnancy age, nor neuraxial anesthesia status during labor had a significant influence on this parameter. CONCLUSION This study validates the transient but significant increase in the rate-pressure product, a clinical estimate of myocardial O2 demand, during uncomplicated pregnancies delivered vaginally at term. Pregnant individuals with lower prepregnancy body mass index experienced a sharper increase in this parameter. Patients who receive neuraxial anesthesia during labor and delivery experience similar changes in the rate-pressure product as those who did not.
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Affiliation(s)
- Claudio V Schenone
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL (Drs C Schenone, Cain, Louis, and Crousillat).
| | - M Ashley Cain
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL (Drs C Schenone, Cain, Louis, and Crousillat)
| | - Aldo L Schenone
- Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, NY (Dr A Schenone)
| | - Teagen Smith
- Department of Research Methodology and Biostatistics Core, University of South Florida Morsani College of Medicine, Tampa, FL (Ms Smith)
| | - Athanasios Tsalatsanis
- Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL (Dr Tsalatsanis)
| | - Judette M Louis
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL (Drs C Schenone, Cain, Louis, and Crousillat)
| | - Daniela R Crousillat
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL (Drs C Schenone, Cain, Louis, and Crousillat); Division of Cardiovascular Sciences, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL (Dr Crousillat)
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de Sousa IM, Fayh APT, Gonzalez MC, Silva FM. Prevalence of low calf circumference in hospitalized patients classified by raw or body mass index-adjusted values. Nutr Clin Pract 2024. [PMID: 38443160 DOI: 10.1002/ncp.11138] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Adiposity can influence the estimation of muscle mass using calf circumference (CC) and underestimate the frequency of low CC. An adjustment for CC using body mass index (BMI) was proposed to reduce this effect. We aimed to compare the low CC frequency in hospitalized patients when considering raw and BMI-adjusted values and explore data by sex, age, and race (white and non-white). METHODS Secondary analysis from two cohort studies conducted with adult hospitalized patients using BMI and CC data collected in the first 72 h after hospital admission. We classified low CC by two approaches: (1) raw CC; (2) BMI-adjusted CC for patients with BMI ≥ 25. Cutoff values for low CC were ≤34 cm (men) and ≤33 cm (women). RESULTS Among 1272 patients (54.1 ± 15.3 years old; 51.7% women; 82.1% White race), low CC frequency was 30.6% and low BMI-adjusted CC was 68.9%. For all elevated BMI categories, the low CC frequency was higher when considering BMI-adjusted values (P < 0.001). Low CC was more frequent (P < 0.001) in older adults (38.7% by raw; 79.1% by BMI-adjusted value) than in younger adults (27.6% by raw; 65.2% by BMI-adjusted value) and it was not associated with race. Low CC by raw values was more frequent in men than in women (35.0% versus 26.4%; P = 0.001), but did not differ between sexes when classified by BMI-adjusted values (70.7% versus 67.1%; P = 0.184). CONCLUSION Low CC BMI adjusted was 2.2 times more frequent in comparison with raw CC values, and it was identified in >60% of patients with BMI ≥ 25.
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Affiliation(s)
- Iasmin M de Sousa
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Flávia M Silva
- Nutrition Science Postgraduation Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Ma L, Zhang H, Jia Q, Bai T, Yang S, Wang M, Li Y, Shao L. Facial Physiological Characteristics and Skin Microbiomes Changes are Associated with Body Mass Index (BMI). Clin Cosmet Investig Dermatol 2024; 17:513-528. [PMID: 38463558 PMCID: PMC10921894 DOI: 10.2147/ccid.s447412] [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: 10/31/2023] [Accepted: 02/22/2024] [Indexed: 03/12/2024]
Abstract
Background Overweight and obesity have become public health problems worldwide. An increasing number of research works are focusing on skin physiology and the manifestations of obesity-associated skin diseases, but little is known about the correlations between body mass index (BMI), facial skin physiological parameters, and the facial skin microbiome in healthy women. Objective To investigate the correlations between BMI, facial skin physiological parameters and facial bacteria and fungi in 198 women aged 18 to 35 years in Shanghai. Methods According to the international BMI standard and Chinese reference standard, subjects were divided into three groups, "lean" B1, "normal" B2 and "overweight" B3, and the physiological parameters of facial skin were measured by non-invasive instrumental methods, and the skin microbiota was analyzed by 16S rRNA and ITS high-throughput sequencing. Results Compared with the skin physiological parameters of the normal group, those of the overweight group exhibited a significant increase in trans-epidermal water loss (TEWL), which indicated that the skin barrier was impaired. The skin haemoglobin content was significantly increased, and skin surface pH was significant decreased in those with a high BMI. Furthermore, α-diversity, analysed using the Shannon, Chao, Sobs, and Ace indexes, was increased in the overweight group, suggesting that the diversity and species abundance of facial bacterial and fungal microbiota were also increased. Moreover, the overweight group had higher abundances of Streptococcus, Corynebacterium, Malassezia, and Candida. Notably, skin surface pH was significantly and negatively correlated with the relative abundances of Malassezia, Candida, and Cladosporium. Besides, the abundance of Malassezia was positively associated with the abundances of Staphylococcus and Corynebacterium. Conclusion These results indicate that BMI is associated with differences in the biophysical properties and microbiome of the facial skin. A high BMI affects the integrity of skin barrier and changes the skin flora diversity and species composition.
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Affiliation(s)
- Laiji Ma
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China
| | - Huan Zhang
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China
| | - Qingwen Jia
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People's Republic of China
| | - Tianming Bai
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People's Republic of China
| | - Suzhen Yang
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People's Republic of China
| | - Man Wang
- Department of Nutrition, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, People's Republic of China
| | - Yan Li
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People's Republic of China
| | - Li Shao
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China
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Hermassi S, Ketelhut S, Konukman F, Sellami M, Al-Marri S, Nigg CR, Schwesig R. Comparative Analysis of Physical Activity, Performance-Related Health, and Academic Achievements in 11-to-13-Year-Old Schoolchildren in Qatar. Healthcare (Basel) 2024; 12:588. [PMID: 38470699 PMCID: PMC10930824 DOI: 10.3390/healthcare12050588] [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: 01/28/2024] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
Age-related differences in physical activity (PA), maturity status (PHV), physical performance (PP), and academic achievement (AA) among schoolchildren in Qatar were examined. Sixty-nine students from a school in Doha were categorized into three equal (n = 23) groups: 11-year-old students (U11; male: n = 14), 12-year-old students (U12: male: n = 7), and 13-year-old students (U13: male: n = 11). The testing process comprised a medicine ball throw, Stork balance test, hand grip strength test, the T-half test (PP), GPA in Arabic, mathematics, science (AA), International Physical Activity Questionnaire Short Form (PA), and Moore's equations (PHV). Relevant age-related differences (p < 0.001) were identified in mathematics, science, the T-half test, maturity, and arm span. Notably, differences between adjacent age groups were evident between U11 and U12, concerning arm span, maturity, mathematics, and science, and between U12 and U13 (the T-half test, mathematics, science). Concerning AP, the performance maxima were calculated for U12 (mathematics, science) and U11 (Arabic). Regarding PP, performance maxima were only observed for U13. Except for the moderate level, the highest levels of PA were detected in U13. Maturity status and anthropometric parameters did not differ significantly between age groups. However, AA demonstrated the most notable age-related differences. Specifically, mathematics showed substantial differences between adjacent age groups.
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Affiliation(s)
- Souhail Hermassi
- Physical Education Department, College of Education, Qatar University, Doha 2713, Qatar; (F.K.); (M.S.); (S.A.-M.)
| | - Sascha Ketelhut
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (S.K.); (C.R.N.)
| | - Ferman Konukman
- Physical Education Department, College of Education, Qatar University, Doha 2713, Qatar; (F.K.); (M.S.); (S.A.-M.)
| | - Maha Sellami
- Physical Education Department, College of Education, Qatar University, Doha 2713, Qatar; (F.K.); (M.S.); (S.A.-M.)
| | - Senaid Al-Marri
- Physical Education Department, College of Education, Qatar University, Doha 2713, Qatar; (F.K.); (M.S.); (S.A.-M.)
| | - Claudio R. Nigg
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (S.K.); (C.R.N.)
| | - René Schwesig
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle (Saale), Germany;
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Choy CC, Johnson W, Braun JM, Soti-Ulberg C, Reupena MS, Naseri T, Savusa K, Lupematasila VF, Arorae MS, Tafunaina F, Unasa F, Duckham RL, Wang D, McGarvey ST, Hawley NL. Associations of childhood BMI traits with blood pressure and glycated haemoglobin in 6-9-year-old Samoan children. Pediatr Obes 2024:e13112. [PMID: 38439600 DOI: 10.1111/ijpo.13112] [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: 11/09/2023] [Revised: 01/17/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Prevalence and risk factors for elevated glycated haemoglobin (HbA1c) and blood pressure (BP) are poorly understood among Pacific children. We examined associations of HbA1c and BP in 6-9 year-olds with body mass index (BMI) at ages 2, 5, and BMI velocity between 2-9 years in Samoa. METHODS HbA1c (capillary blood) and BP were measured in n = 410 Samoan children who were part of an ongoing cohort study. Multilevel models predicted BMI trajectory characteristics. Generalized linear regressions assessed associations of childhood characteristics and BMI trajectories with HbA1c and BP treated as both continuous and categorical outcomes. Primary caregiver-reported childhood characteristics were used as covariates. RESULTS Overall, 12.90% (n = 53) of children had high HbA1c (≥5.7%) and 33.17% (n = 136) had elevated BP. BMI at 5-years and BMI velocity were positively associated with high HbA1c prevalence in males. A 1 kg/m2 per year higher velocity was associated with a 1.71 (95% CI: 1.07, 2.75) times higher prevalence of high HbA1c. In females, higher BMI at 5-years and greater BMI velocity were associated with higher BP at 6-9 years (95% CI: 1.12, 1.40, and 1.42, 2.74, respectively). CONCLUSION Monitoring childhood BMI trajectories may inform cardiometabolic disease screening and prevention efforts in this at-risk population.
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Affiliation(s)
- Courtney C Choy
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
- Department of Epidemiology, International Health Institute, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - William Johnson
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Joseph M Braun
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | | | | | - Take Naseri
- Department of Epidemiology, International Health Institute, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Kima Savusa
- Samoa Obesity, Lifestyle, and Genetic Adaptations (OLaGA) Study Group, Apia, Samoa
| | | | - Maria Siulepa Arorae
- Samoa Obesity, Lifestyle, and Genetic Adaptations (OLaGA) Study Group, Apia, Samoa
| | - Faatali Tafunaina
- Samoa Obesity, Lifestyle, and Genetic Adaptations (OLaGA) Study Group, Apia, Samoa
| | - Folla Unasa
- Samoa Obesity, Lifestyle, and Genetic Adaptations (OLaGA) Study Group, Apia, Samoa
| | - Rachel L Duckham
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia
| | - Dongqing Wang
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA
| | - Stephen T McGarvey
- Department of Epidemiology, International Health Institute, School of Public Health, Brown University, Providence, Rhode Island, USA
- Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
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Goon S, Slotnick M, Leung CW. Associations Between Subjective Social Status and Health Behaviors Among College Students. J Nutr Educ Behav 2024; 56:184-192. [PMID: 38244011 DOI: 10.1016/j.jneb.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] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Examine the associations between subjective social status (SSS), diet, and health outcomes in college students. METHODS Cross-sectional study of 841 students enrolled at a large Midwestern university. Subjective social status within the US, as well as within the university, was measured using the MacArthur Scale of SSS. Outcomes included dietary intake (assessed using the Dietary Screening Questionnaire), body mass index, sleep, physical activity, alcohol use, and vaping behavior. Generalized linear models adjusting for students' sociodemographic characteristics were used to assess associations between SSS and outcomes of interest. RESULTS Higher SSS-US was associated with 4%, 3%, and 1% higher intake of fruits, whole grains, and fiber, respectively (P < 0.05). Higher SSS-US and SSS-university rankings were both significantly associated with lower body mass index and better sleep duration (P < 0.05). Higher SSS-university rankings were also associated with more days of physical activity and alcohol consumption (P < 0.05). CONCLUSIONS AND IMPLICATIONS In this exploratory study, higher SSS, apart from alcohol intake, was associated with more favorable health outcomes. More research is needed to consider additional psychological and biological mediators and dynamic aspects of SSS, examine potential interactions between SSS and racial and ethnic identities, and explore potential mechanisms underlying the observed associations.
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Affiliation(s)
- Shatabdi Goon
- Allegheny County Health Department, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Melissa Slotnick
- Department of Nutritional Sciences, School of Public Health, University of Michigan, MI
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
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de Melo GASC, Fernandes VDO, Costa HS, Lacerda ACR, Nobre LN, F de M Vitorino D, de Carvalho Bastone A. Urinary incontinence in middle-aged and older women with hip and knee osteoarthritis: An outpatient study of frequency and risk factors. Neurourol Urodyn 2024; 43:672-679. [PMID: 38247352 DOI: 10.1002/nau.25395] [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: 10/15/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024]
Abstract
AIMS To investigate the frequency and the factors associated with urinary incontinence (UI) in a sample of middle-aged and older women with lower limb osteoarthritis (OA). METHODS Women aged 50 years or older with clinical hip/knee OA diagnoses were recruited for this cross-sectional study. Self-reported UI and type, sociodemographic characteristics, medical conditions, physical activity level, anthropometric and body composition measurements, muscle strength, and physical function were assessed. Uni and multivariable logistic regression were used to investigate the factors associated with UI. RESULTS Among 100 middle-aged and older women (mean 67.27 ± 8.77 SD years), 67% reported UI. In the UI group, 33% reported stress UI, 36% reported urgency UI, and 31% reported mixed UI. In the univariate analysis, age, level of physical activity, pulmonary disease, number of medications, body mass index (BMI), number of deliveries, and activity limitation were significantly associated with UI. In the multivariable analysis, older age (60-69 years OR: 4.91, 95% CI: 1.25-19.36; ≥70 years OR: 8.06, 95% CI: 1.96-33.22), compared to 50-59 years, morbid obesity (OR: 14.10, 95% CI: 1.36-146.48), compared to BMI < 30 kg/m2 , and activity limitation (OR: 5.31, 95% CI: 1.61-17.54), assessed as short physical performance battery ≤8, remained significantly associated with UI. CONCLUSIONS UI was highly frequent among middle-aged and older women with hip/knee OA. Older age, activity limitation, and morbid obesity were independently associated with UI. Interventions targeting physical function and weight management must be considered to prevent and treat UI in this population.
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Affiliation(s)
- Gisele A S C de Melo
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
| | - Vanessa de O Fernandes
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
| | - Henrique Silveira Costa
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
| | - Luciana N Nobre
- Department of Nutrition, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
| | - Débora F de M Vitorino
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
| | - Alessandra de Carvalho Bastone
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Diamantina, Brazil
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Hindi J, Fréchette-Le Bel M, Rouleau JL, de Denus S. Influence of Weight and Body Size on the Pharmacokinetics of Heart Failure Pharmacotherapy: A Systematic Review. Ann Pharmacother 2024; 58:255-272. [PMID: 37338205 DOI: 10.1177/10600280231179484] [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: 06/21/2023] Open
Abstract
OBJECTIVE To conduct a review of studies evaluating the influence of body size and weight (WT) on the pharmacokinetics (PK) of drugs recommended for heart failure (HF) treatment. DATA SOURCES A systematic search of the MEDLINE (1946 to April 2023) and EMBASE (1974 to April 2023) databases was conducted for articles that focused on the impact of WT or body size on the PK of drugs of interest used in HF patients. STUDY SELECTION AND DATA EXTRACTION Articles written in English or French related to the aim of our study were retained for analysis. DATA SYNTHESIS Of 6493 articles, 20 were retained for analysis. Weight was associated with the clearance of digoxin, carvedilol, enalapril, and candesartan as well as the volume of distribution of eplerenone and bisoprolol. There was no documented direct impact of WT on the PK of furosemide, valsartan, and metoprolol, although these studies were limited or confounded by the small sample size, adjustment of PK factors by WT, or the use of the Cockroff-Gault equation for the evaluation of creatinine clearance, which includes WT. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE This review highlights and summarizes the available data on the importance of WT on the PK of HF treatment. CONCLUSION Considering the significant impact of WT on most HF drugs in this review, it may be important to further investigate it in the context of personalized therapy, particularly in patients presenting extreme WTs.
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Affiliation(s)
- Jessica Hindi
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
- Montreal Heart Institute, Montreal, QC, Canada
- Beaulieu-Saucier Pharmacogenomics Center, Université de Montréal, Montreal, QC, Canada
| | | | - Jean Lucien Rouleau
- Montreal Heart Institute, Montreal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Simon de Denus
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
- Montreal Heart Institute, Montreal, QC, Canada
- Beaulieu-Saucier Pharmacogenomics Center, Université de Montréal, Montreal, QC, Canada
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Sekyi E, Agyapong NAF, Eshun G. Food consumption by NOVA food classification, metabolic outcomes, and barriers to healthy food consumption among university students. Food Sci Nutr 2024; 12:1983-1994. [PMID: 38455168 PMCID: PMC10916562 DOI: 10.1002/fsn3.3894] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 03/09/2024] Open
Abstract
The NOVA food classification system is a simple tool that can be used to assess the consumption levels of different categories of foods based on their level of processing. The degree to which food is processed has a significant impact on health outcomes. In Ghana, no study exists on the consumption of the different NOVA food groups among tertiary students and how it relates to their metabolic outcomes. This study assessed the frequency of food intake according to the NOVA classification and how they relate to body mass index, waist circumference, and blood pressure. The barriers to the consumption of healthy foods among students were also assessed. This was a cross-sectional study conducted among 352 students of the Takoradi Technical University. Questionnaire was used to obtain sociodemographic information as well as data on perceived barriers to healthy food consumption. Food frequency questionnaire was used to obtain data on dietary intake. The weight, height, waist circumference, waist-to-hip ratio, and blood pressure of all participants were measured. Chi-square was used to compare categorical variables between males and females and to determine the association between the frequency of food intake according to the NOVA classification and metabolic indicators. The prevalence of overweight and obesity was 23.8%. More than half (51.1%) of the students had elevated blood pressure. The majority of study participants (54.2%) had a high frequency of consumption of both unprocessed and ultra-processed foods. Male students who frequently consumed ultra-processed foods (1-6 times/day) had significantly high blood pressure. High consumption of both ultra-processed and unprocessed foods was also associated with elevated blood pressure among male students. Limited time to prepare healthy meals and the high cost of unprocessed foods were among barriers to which most students strongly agreed to. Establishment of canteens that provide affordable healthy foods, teaching students time management, and nutrition education can mitigate barriers to healthy food consumption.
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Affiliation(s)
- Elizabeth Sekyi
- Department of Hospitality ManagementTakoradi Technical UniversityTakoradiGhana
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
| | - Nana Ama Frimpomaa Agyapong
- Department of Clinical Nutrition and Dietetics, College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana
| | - Guy Eshun
- Department of Food and Nutrition Education, Faculty of Home Economics EducationUniversity of EducationWinnebaGhana
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Joseph ME, D'Alonzo KT, Btoush R, Fitzgerald N. The Impact of Social Determinants of Health on the Diagnosis of Type 2 Diabetes Mellitus (T2DM) Among Asian Indians (AIs) in New Jersey: A Secondary Analysis of the BRFSS Survey From 2013 to 2017. J Transcult Nurs 2024; 35:125-133. [PMID: 38111158 DOI: 10.1177/10436596231217662] [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: 12/20/2023] Open
Abstract
INTRODUCTION Asian Indians (AIs), the second largest immigrant population in the United States, are disproportionately affected by type 2 diabetes mellitus (T2DM) at a lower age and body mass index (BMI). The purpose of this study was to examine the relationship between social determinants of health (SDOH) and the diagnosis of T2DM among AIs in New Jersey (NJ). METHODOLOGY This was a secondary data analysis of the Behavioral Risk Factor Surveillance System (BRFSS) in NJ from 2013 to 2017. Statistical analyses included descriptive and inferential statistics. RESULTS Among 1,132 AIs, 16% had T2DM or prediabetes (PDM) and 69.2% were overweight or obese. The risk for T2DM was significantly associated with internet use, older age, having medical check-ups, and having a personal doctor (p ≤ .05). DISCUSSION These findings inform culturally congruent care by underscoring the importance of weight management, earlier screening, and provider involvement in diabetes prevention strategies for AIs.
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Belay B, Kraus EM, Porter R, Pierce SL, Kompaniyets L, Lundeen EA, Imperatore G, Blanck HM, Goodman AB. Examination of Prediabetes and Diabetes Testing Among US Pediatric Patients With Overweight or Obesity Using an Electronic Health Record. Child Obes 2024; 20:96-106. [PMID: 36930745 PMCID: PMC10505239 DOI: 10.1089/chi.2022.0209] [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] [Indexed: 03/19/2023]
Abstract
Background: Youth with excess weight are at risk of developing type 2 diabetes (T2DM). Guidelines recommend screening for prediabetes and/or T2DM after 10 years of age or after puberty in youth with excess weight who have ≥1 risk factor(s) for T2DM. Electronic health records (EHRs) offer an opportunity to study the use of tests to detect diabetes in youth. Methods: We examined the frequency of (1) diabetes testing and (2) elevated test results among youth aged 10-19 years with at least one BMI measurement in an EHR from 2019 to 2021. We examined the presence of hemoglobin A1C (A1C), fasting plasma glucose (FPG), or oral glucose tolerance test (2-hour plasma glucose [2-hrPG]) results and, among those tested, the frequency of elevated values (A1C ≥6.5%, FPG ≥126 mg/dL, or 2-hrPG ≥200 mg/dL). Patients with pre-existing diabetes (n = 6793) were excluded. Results: Among 1,024,743 patients, 17% had overweight, 21% had obesity, including 8% with severe obesity. Among patients with excess weight, 10% had ≥1 glucose test result. Among those tested, elevated values were more common in patients with severe obesity (27%) and obesity (22%) than in those with healthy weight (8%), and among Black youth (30%) than White youth (13%). Among patients with excess weight, >80% of elevated values fell in the prediabetes range. Conclusions: In youth with excess weight, the use of laboratory tests for prediabetes and T2DM was infrequent. Among youth with test results, elevated FPG, 2hrPG, or A1C levels were most common in those with severe obesity and Black youth.
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Affiliation(s)
- Brook Belay
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily M. Kraus
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Public Health Informatics Institute, Atlanta, GA, USA
| | - Renee Porter
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- McKing Consulting Corporation, Atlanta, GA, USA
| | - Samantha Lange Pierce
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth A. Lundeen
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Giuseppina Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- United States Public Health Service, Atlanta, GA, USA
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Hashimoto I, Kano K, Suematsu H, Yamada T, Watanabe H, Kanematsu K, Nagasawa S, Aoyama T, Ogata T, Rino Y, Saito A, Oshima T. Survival Predictors Before Preoperative Adjuvant Chemotherapy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma. In Vivo 2024; 38:881-889. [PMID: 38418152 PMCID: PMC10905439 DOI: 10.21873/invivo.13514] [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: 10/14/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Radical resection after preoperative adjuvant chemotherapy (NAC) is a standard treatment for patients with locally advanced esophageal squamous cell carcinoma (LAESCC), but its outcome remains unsatisfactory. In order to develop a personalized treatment program for LAES, we herein compared the survival prediction utility of five pre-NAC nutritional, inflammatory, and immune indexes in patients with LAESCC. PATIENTS AND METHODS We evaluated the survival of 203 patients with LAESCC who underwent radical resection after NAC from January 2011 to September 2019 for the following representative pre-NAC nutritional, inflammatory, and immune indices: modified Glasgow Prognostic Score, Prognostic Nutritional Index, C-reactive protein/albumin ratio, serum neutrophil/lymphocyte ratio, and Geriatric Nutrition Risk Index (GNRI) were evaluated for their impact on survival. RESULTS Of the five indices, GNRI was the best predictor of survival as determined by the area under the curve (p<0.05). When patients were divided into three groups according to the nutritional risk assessment of Bouillanne et al. using the pre-NAC GNRI, the 5-year overall survival (OS) and recurrence-free survival (RFS) were significantly stratified (p<0.001). On multivariate analysis, the GNRI independently identified a poor OS group [group 1: hazard ratio (HR)=2.598, p=0.002; group 2: HR=6.257, p<0.001] and a high recurrence risk group (group 1: HR=1.967, p=0.016; group 2: HR=4.467, p<0.001). CONCLUSION In patients with LAESCC, GNRI may be the most accurate, reliable, and useful prognostic factor among the five major systemic inflammatory and nutritional indices.
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Affiliation(s)
- Itaru Hashimoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kazuki Kano
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hideaki Suematsu
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takanobu Yamada
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Hayato Watanabe
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Kyohei Kanematsu
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinsuke Nagasawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Toru Aoyama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Ogata
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Yasushi Rino
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Aya Saito
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan;
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Öztürk Şahin Ö, Topan A, Aközlü Z, Kolukisa T. Evaluation of factors affecting body mass index of children with intellectual disability. J Intellect Disabil 2024; 28:185-195. [PMID: 36046922 DOI: 10.1177/17446295221123866] [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] [Indexed: 06/15/2023]
Abstract
This study was conducted to evaluate the BMI of the children with intellectual disability and the factors affecting their BMI. This descriptive and cross-sectional study was carried out between March 2016 and April 2016 in Turkey and consisted of 135 children. Children's anthropometric measurements were and their BMI values were calculated. Categorization of children by BMI percentile according to AAP reference values was performed. There was a significant difference between the BMI categories of the children (p < 0.05) and the education level of children's father (x2 = 8.960; p = 0.028), the degree of intellectual disability (x2 = 16.113; p = 0.008), the presence of other disabilities (x2 = 22.013; p = 0.000), type of disability (x2 = 21.359; p = 0.001), the nutrient intake (x2 = 38.935; p = 0.000) and the presence of nutritional problems (x2 = 7.687; p = 0.042). Father's education level, children's degree of disability, child's having presence of other disabilities, child's being dependent in the view of nutrient intake, and child's having nutritional problems were determined as factors affecting BMI.
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Affiliation(s)
- Özlem Öztürk Şahin
- Karabük University, Faculty of Health Sciences Department of Pediatric Nursing, Karabük, Turkey
| | - Aysel Topan
- Zonguldak Bülent Ecevit University, Faculty of Health Sciences Department of Pediatric Nursing, Zonguldak, Turkey
| | - Zeynep Aközlü
- Maltepe University, School of Nursing, Ístanbul, Turkey
| | - Tuğçe Kolukisa
- Karabuk University, Safranbolu Şefik Yılmaz Dizdar Vocational School Department of Child Care and Youth Services Child Development Programme, Karabük, Turkey
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Chen L, Huang J, Jiang T, Luo H, Wei C, Wu H, Shao J, Li W. Comparing Sleep Patterns and Clinical Features between Preschool and School-Age Children with OSA. Laryngoscope 2024; 134:1472-1478. [PMID: 37812391 DOI: 10.1002/lary.31051] [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: 08/14/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE This study aimed to evaluate sleep patterns and investigate differences in clinical features among young individuals with snoring and obstructive sleep apnea (OSA). METHODS Data from 213 children and adolescents who underwent polysomnography (PSG) for primary snoring or OSA were collected between July 2017 and December 2021. To analyze differences in sleep architecture, hypoxia levels, and other clinical features, the participants were divided into two age groups: a preschool group and a school-age group. RESULTS The school-age group had significantly higher apnea-hypopnea index, obstructive apnea index, oxygen desaturation index, and body mass index than the preschool group. Both the lowest and average oxygen saturation levels were lower in the school-age group. Adenoid hypertrophy was more prevalent in the preschool group. The rate of overweight or obesity was 35.6% in the preschool group and even 94.2% in the school-age group. There were higher percentages of N1 and N2 sleep stages, and lower percentages of N3 and REM sleep stages in the school-age group. The groups exhibiting moderate to severe OSA demonstrated significant alterations in the difference between sleeping and waking diastolic blood pressure. CONCLUSION There is a higher frequency of respiratory events among school-age children compared with their preschool peers. Moreover, alterations in sleep structure are more prominent in the school-age group. Adenoid hypertrophy may serve as the primary instigator of OSA in preschool children, whereas the predominant causes in school-age children may be obesity or excessive weight. LEVEL OF EVIDENCE Retrospective chart review, 3 Laryngoscope, 134:1472-1478, 2024.
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Affiliation(s)
- Le Chen
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Jingjing Huang
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Sleep Disordered Medical Center, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Tao Jiang
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Huiping Luo
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Sleep Disordered Medical Center, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Chunsheng Wei
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Sleep Disordered Medical Center, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Haitao Wu
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Sleep Disordered Medical Center, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Jun Shao
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Sleep Disordered Medical Center, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Wenyan Li
- Department of Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
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Takeda J, Morisaki N, Itakura A, Aoki S, Sago H, Nagamatsu T, Masuyama H, Matsubara S, Umazume T, Mitsuda N, Itoh H, Ikeda T. Investigation of optimal weight gain during pregnancy: A retrospective analysis of the Japanese perinatal registry database. J Obstet Gynaecol Res 2024; 50:403-423. [PMID: 38163757 DOI: 10.1111/jog.15863] [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: 04/01/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
AIM This study aimed to determine the weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy body mass index (BMI) and make recommendations for optimal weight gain in Japan. METHODS The Japan Society of Obstetrics and Gynecology perinatal database for 2015-2017 was used. From the 719 723 deliveries included in this database, parturients with underlying diseases or missing data were excluded, and 419 114 deliveries were analyzed. A questionnaire survey was also conducted to weigh each perinatal adverse event. For each of the nine outcomes, a restricted cubic spline model was made to estimate the association between the "expected gestational weight gain at 40 weeks" and the outcome risk. RESULTS Since the classes of medical facilities were generally the same, weights were assigned according to the mean of the questionnaires rather than by the class of the facility. For each pre-pregnancy BMI, the weight gains during pregnancy that minimized the predicted probability of various adverse perinatal events were 12-15, 10-13, 7-10, and upper limit of 5 kg for the underweight, normal-weight, obese 1, and obese ≥2 groups, respectively. CONCLUSIONS The weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy BMI was established.
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Affiliation(s)
- Jun Takeda
- Faculty of Medicine, Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuo Itakura
- Faculty of Medicine, Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takeshi Nagamatsu
- Faculty of Medicine, Department of Obstetrics and Gynecology, International University of Health and Welfare, Chiba, Japan
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takeshi Umazume
- Department of Obstetrics, Hokkaido University Hospital, Sapporo, Japan
| | - Nobuaki Mitsuda
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Hiroaki Itoh
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoaki Ikeda
- Faculty Medicine, Department of Obstetrics and Gynecology, Mie University, Tsu, Mie, Japan
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50
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Su L, Wang F, Qin C, Wang Z, Yang X, Ye J. Association between energy-adjusted dietary inflammatory index and total immunoglobulin E: A cross-sectional study. Food Sci Nutr 2024; 12:1627-1634. [PMID: 38455225 PMCID: PMC10916634 DOI: 10.1002/fsn3.3854] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 03/09/2024] Open
Abstract
The relationship between a pro-inflammatory diet, assessed by the dietary inflammatory index (DII), and allergic diseases has attracted attention. However, the association between DII and immunoglobulin E (IgE) remains uncertain. We aim to investigate the association between energy-adjusted DII (E-DII) and total IgE. We analyzed data from the 2005 to 2006 National Health and Nutrition Examination Survey. The relationship between E-DII and total IgE was assessed using linear regression and logistic regression analysis. Meanwhile, we conducted a subgroup analysis stratified by body mass index (BMI) and analyzed the mediating role of BMI. We included 3614 adult participants. After controlling for confounding factors, there was no statistical association between E-DII and total IgE (β 0.023, 95% CI -0.01 to 0.057, p = .173) and the risk of high total IgE (OR 1.036, 95% CI 0.977 to 1.099, p = .233). We conducted subgroup analysis stratified by BMI. After controlling for confounding factors, only in overweight groups, E-DII was statistically associated with total IgE (β 0.076, 95% CI 0.017 to 0.135, p = .012) and the risk of high total IgE (OR 1.124, 95% CI 1.015 to 1.246, p = .025). Generalized additive models and smooth curve fittings showed a positive linear relationship between E-DII and total IgE in overweight participants. No statistical association was noted for the mediation effect of BMI on the association between E-DII and total IgE in the overweight group (p = .23). Overweight participants with higher E-DII were potentially at risk of elevated total IgE.
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Affiliation(s)
- Liang Su
- Department of Dermatology The First Affiliated Hospital of Yunnan University of Chinese Medicine Kunming China
- Department of Dermatology Yunnan Provincial Hospital of Traditional Chinese Medicine Kunming China
| | - Fang Wang
- The First Clinical School of Yunnan University of Chinese Medicine Kunming China
| | - Cheng Qin
- The First Clinical School of Yunnan University of Chinese Medicine Kunming China
| | - Zhimin Wang
- The First Clinical School of Yunnan University of Chinese Medicine Kunming China
| | - Xuesong Yang
- Department of Dermatology The First Affiliated Hospital of Yunnan University of Chinese Medicine Kunming China
- Department of Dermatology Yunnan Provincial Hospital of Traditional Chinese Medicine Kunming China
| | - Jianzhou Ye
- Department of Dermatology The First Affiliated Hospital of Yunnan University of Chinese Medicine Kunming China
- Department of Dermatology Yunnan Provincial Hospital of Traditional Chinese Medicine Kunming China
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