Baseline Overweight Research Articles

Incidence of non-alcoholic fatty liver disease in antiretroviral therapy-naïve people with human immunodeficiency virus who start DTG/ABC/3TC compared to BIC/FTC/TAF at 48-week follow-up.

To determine the incidence of non-alcoholic fatty liver disease (NAFLD) by non-invasive methods in people living with HIV (PLWH). Prospective cohort, in PLWH naïve to antiretroviral therapy, starting bictegravir (BIC) or dolutegravir (DTG) at the Hospital de Infectología "La Raza", in Mexico City, from February 2021 to August 2023. We measured at baseline and 48weeks triglycerides and glucose index (TyG), fatty liver index (FLI), hepatic steatosis index (HSI) and liver ultrasonography; relative risk (RR) for developing NAFLD was determined. At 48weeks, TyG index in BIC-group 4.54 (IQR 4.36-4.75), in DTG-group 4.66 (IQR 4.49-4.80), p = .080; HSI in BIC-group 30.30 (IQR 28.12-33.70), in DTG-group 30.85 (IQR 28.02-34.50), p = .650; FLI in BIC-group 14.88 (IQR 7.91-31.80), in DTG-group 19.49 (IQR 8.49-32.28), p = .729; NAFLD was detected by US in 6 [10.3% (95%CI 4.8%-20.7%)] in BIC-group and, 7 [10.9% (95%CI 6.4%-20.9%)] in DTG-group, p = .916. Risk factors for NAFLD development were baseline BMI ≥25kg/m2, baseline HDL-c <40mg/dL, and FIB-4 >1.3 at 48weeks. There is a high incidence of NAFLD in PLWH who start a second generation INSTI at 48weeks; baseline overweight, low HDL-cholesterol and FIB-4 >1.3 at 48weeks of treatment were independent risk factors for NAFLD development.

Prostate Cancer, Treatment and Response of the Hematological System in Mexican Population

Androgen deprivation therapy (ADT) is the basis for the control of prostate cancer. High levels of prostate-specific antigen (PSA) and high Gleason grade correlate, define the aggressiveness of the cancer in order to establish its treatment and prognosis. This work evaluated the response of 910 patients diagnosed with prostate cancer, separated into three groups according to their response to treatment by ADT: (1) sensitive (TSPC); (2) palliative and did not accept treatment, and (3) group with recurrence or treatment resistance (TRPC). All patients with prostate cancer treated with ADT, and regardless of whether or not they had undergone surgery or taken to radiotherapy, presented with anemia. The hematological response due to the leukocyte/lymphocyte index (L/L) is increased at the end of treatment, possibly due to inflammatory processes generated by cancer, and baseline overweight and obesity. Patients with biochemical relapse exhibit a higher platelet count, suggesting that these cells could participate in the recurrence process and in metastasis (78%) in these patients. The coagulation index (INR) could be an indicator of the platelet response to be considered during the treatment and monitoring of patients.

Changes in Body Mass Index in Children and Adolescents with Asthma during the COVID-19 Pandemic.

Background: Increased weight gain in children during the COVID-19 pandemic has been reported. Changes in weight in children with asthma during this period have not been well described. Methods: Retrospective review of children with asthma, 6-18 years of age, seen in 2019 and 2020. Mean monthly rates of change in body mass index (BMI) were compared between years. Demographic and asthma-related factors were examined. Results: Two hundred sixty-seven patients were enrolled. BMI increased by 0.128 ± 0.283 kg/m2/month during the pandemic year as compared with 0.084 ± 0.160 kg/m2/month during the previous year (P = 0.03). Patients with baseline overweight or obesity trended toward higher rates of BMI increase than those starting with normal weight, with the greatest BMI increase occurring in the severely obese. Conclusions: In this single-site study of children with asthma, there was a greater monthly rate of BMI gain during the early pandemic as compared with that observed in the previous year.

Body weight changes and associated predictors in a prospective cohort of young breast cancer survivors.

Weight gain after a breast cancer diagnosis is common and is associated with inferior outcomes. Young survivors may be especially susceptible to weight changes given the impact of treatment on menopausal status. The authors identified women who were diagnosed with stage 0 to III breast cancer at age 40 years or younger between 2006 and 2016 from a multicenter prospective cohort. Self-reported weight was collected at diagnosis and at 1 year and 3 years postdiagnosis. Tumor and treatment data were obtained from medical records and patient surveys. Multinomial logistic regression was used to identify the factors associated with weight gain (≥5%) or weight loss (≥5%) versus stable weight at 1 year and 3 years postdiagnosis. The cohort included 956 women with a median age of 37 years at diagnosis. Mean weight significantly increased over time from 66.54 ± 14.85 kg at baseline to 67.33 ± 15.53 and 67.77 ± 14.65 kg at 1 year and 3 years, respectively (p ≤ .001 for both comparisons). The proportion of women experiencing ≥5% weight gain increased from 24.8% at 1 year to 33.9% at 3 years. At 1 year, less self-perceived financial comfort, Black race, and stage III disease were significantly associated with weight gain; at 3 years, only less self-perceived financial comfort remained significant. Baseline overweight or obesity was significantly associated with weight loss at both time points. Chemotherapy, endocrine therapy, and treatment-related menopause were not associated with weight change. One third of young breast cancer survivors experienced clinically significant weight gain 3 years after diagnosis; however, treatment-related associations were not observed. Age-appropriate lifestyle interventions, including the reduction of financial barriers, are needed to prevent weight gain in this high-risk population.

Longitudinal associations between facets of sleep and adiposity in youth.

Beyond sleep duration, other facets of sleep such as variability and timing may be associated with obesity risk in youth. However, data are limited. Using a longitudinal design, this study tested whether multiple facets of sleep were associated with fat mass gain over 1 year. A convenience sample of non-treatment-seeking youth (age 8-17 years) wore actigraphy monitors for 14 days. Average weekly sleep duration, within-person sleep duration variability, weekend catch-up sleep, bedtime and wake time shift, social jet lag, bedtime, wake time, and sleep midpoint were calculated. The association of each facet of baseline sleep with 1-year fat mass, adjusting for baseline fat mass and height, was examined. A total of 137 youths (54.0% female; mean [SD], age 12.5 [2.6] years; 28.4% non-Hispanic Black or African American; baseline fat mass = 15.3 [8.9] kg; 1-year fat mass = 17.0 [10.0] kg; 28.5% with baseline overweight or obesity) were studied. Wake time (p = 0.03) and sleep midpoint (p = 0.02) were inversely associated with 1-year fat mass, such that earlier wake time and midpoint were associated with higher 1-year fat mass. No other facet of sleep was significantly associated with 1-year fat mass (p > 0.09). Using objective measures, youth with earlier wake times and sleep midpoints had greater gains in fat mass. Additional research is needed to determine whether sleep timing may be a modifiable target to prevent pediatric obesity.

Overweight and Obesity and Progression of ADPKD.

On the basis of earlier observations, we evaluated the association between overweight and obesity and rapid progression of autosomal dominant polycystic kidney disease in participants in the Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes (TEMPO) 3:4 trial. More importantly, we also determined whether efficacy of tolvaptan was attenuated in individuals with baseline overweight or obesity. A total of 1312 study participants with relatively early-stage autosomal dominant polycystic kidney disease (mean eGFR 78±22 ml/min per 1.73 m2) who were at high risk of rapid progression were categorized by body mass index (BMI; calculated using nonkidney weight) as normal weight (18.5-24.9 kg/m2; n=670), overweight (25.0-29.9 kg/m2; n=429), or obese (≥30 kg/m2; n=213). Linear and multinomial logistic regression models were used to determine the association of baseline overweight and obesity with change in total kidney volume (TKV) over the 3-year study period. In fully adjusted models, higher BMI was associated with greater annual percent change in TKV (difference of 1.20 [95% confidence interval (95% CI), 0.85 to 1.55] per five-unit higher BMI). Overweight and obesity were associated with higher odds of annual percent change in TKV of ≥7% versus <5% (overweight: odds ratio, 2.04 [95% CI, 1.45 to 2.87]; obese: odds ratio, 4.31 [95% CI, 2.83 to 6.57] versus normal weight). eGFR decline did not differ according to BMI (fully adjusted difference in decline of -0.95 [95% CI, -2.32 to 0.40] ml/min per 1.73 m2 per year per five-unit higher BMI). The three-way interaction (treatment×time×BMI group) was not statistically significant in linear mixed models with an outcome of TKV (log-transformed estimated coefficient comparing the treatment effect for overweight versus normal weight: 0.56% [95% CI, -0.70% to 1.84%] per year; P=0.38; obese versus normal weight: 0.07% [95% CI, -1.47% to 1.63%] per year; P=0.93) or eGFR (estimated coefficient comparing overweight versus normal weight: -0.07 [95% CI, -0.95 to 0.82] ml/min per 1.73 m2 per year; P=0.88; obese versus normal weight: 0.22 [95% CI, -0.93 to 1.36] ml/min per 1.73 m2 per year; P=0.71). Overweight and particularly obesity are strongly and independently associated with kidney growth, but not eGFR slope, in the TEMPO 3:4 trial, and tolvaptan efficacy is irrespective of BMI categorization. Tolvaptan Efficacy and Safety in Management of Autosomal Dominant Polycystic Kidney Disease and Its Outcomes (TEMPO) 3:4, NCT00428948.

Abstract P407: Association of Obesity at Baseline and Change Over Time With 6 Minute Walk Distance: The Multi-ethnic Study of Atherosclerosis

Introduction: The 6 minute walk distance (6MWD) may be an indicator of frailty and is strongly associated with risk of mortality. Obesity is increasingly shown to be associated with decreased physical function, frailty, and disability, and is also associated with multiple major cardiometabolic comorbidities that cause early mortality. Studies of 6MWD have generally been limited in scope by the use of a single measurement of BMI for obesity, highly selected samples, and by lack of racial/ethnic diversity. Methods: 6MWD was measured in participants at Visit 6 (2016-2018) of the Multi-Ethnic Study of Atherosclerosis (MESA) who were able to ambulate without assistance. MESA participants were diverse with 62% non-white and 50% female, aged 45-84 and free of CVD at Visit 1 (2000-2002). We used multivariable linear regression with robust standard errors that account for within person correlation to investigate the association of baseline BMI categories and BMI change over time (from Visit 1 to Visit 6) with 6MWD. We used normal weight (BMI 18.5 - &lt;25.0kg/m 2 ) and no BMI change (-1 to +1 kg/m 2 ) as reference categories. Results: Among 2525 participants with 6MWD at Visit 6, mean Visit 1 BMI was 28.2 kg/m 2 , mean Visit 6 BMI was 28.4 kg/m 2 , mean BMI change was 0.22kg/m 2 , and mean 6MWD was 410 m. Average time between BMI measurements was 15.8 years. Baseline overweight and obesity were strongly and significantly associated with lower 6MWD, as was increase in BMI over time ( Figure ). Adjustment for potential confounders and mediators did not explain these associations, although significant interaction by age was found for BMI decrease ≥ -4kg/m 2 (p = 0.003) with those over 70 having lower 6MWD (-31.2 (-50.6, -11.8)) and younger participants having non-significantly higher 6MWD (17.2 (-8.2, 42.5)). There was no significant heterogeneity by sex or race/ethnicity. Conclusion: Even modest increase in BMI (1≤ change &lt;4 kg/m 2 ) with aging is associated with lower 6MWD in MESA. Consensus about the impact of weight loss in older adults remains a major challenge.

Early Outcomes From the English National Health Service Diabetes Prevention Programme

To assess weight and HbA1c changes in the Healthier You: National Health Service Diabetes Prevention Programme (NHS DPP), the largest DPP globally to achieve universal population coverage. A service evaluation assessed intervention effectiveness for adults with nondiabetic hyperglycemia (HbA1c 42-47 mmol/mol [6.0-6.4%] or fasting plasma glucose 5.5-6.9 mmol/L) between program launch in June 2016 and December 2018, using prospectively collected, national service-level data in England. By December 2018, 324,699 people had been referred, 152,294 had attended the initial assessment, and 96,442 had attended at least 1 of 13 group-based intervention sessions. Allowing sufficient time to elapse, 53% attended an initial assessment, 36% attended at least one group-based session, and 19% completed the intervention (attended >60% of sessions). Of the 32,665 who attended at least one intervention session and had sufficient time to finish, 17,252 (53%) completed: intention-to-treat analyses demonstrated a mean weight loss of 2.3 kg (95% CI 2.2, 2.3) and an HbA1c reduction of 1.26 mmol/mol (1.20, 1.31) (0.12% [0.11, 0.12]); completer analysis demonstrated a mean weight loss of 3.3 kg (3.2, 3.4) and an HbA1c reduction of 2.04 mmol/mol (1.96, 2.12) (0.19% [0.18, 0.19]). Younger age, female sex, Asian and black ethnicity, lower socioeconomic status, and normal baseline BMI were associated with less weight loss. Older age, female sex, black ethnicity, lower socioeconomic status, and baseline overweight and obesity were associated with a smaller HbA1c reduction. Reductions in weight and HbA1c compare favorably with those reported in recent meta-analyses of pragmatic studies and suggest likely future reductions in participant type 2 diabetes incidence.

Longitudinal quantitative assessment of coronary plaque progression related to body mass index using serial coronary computed tomography angiography.

This study explored the coronary plaque volume change (PVC) according to the change of percent body mass index (BMI) and categorical BMI group using serial coronary computed tomography angiography (CCTA). A total of 1568 subjects who underwent serial CCTA with available BMI at baseline (CCTA1) and follow-up (CCTA2) were included. Median inter-scan period was 3.3 (interquartile range: 2.6-4.6) years. Quantitative assessment of coronary plaque was performed at both scans. All participants were categorized into three BMI (kg/m2) groups: normal: <25.0; overweight: 25.0-29.9; and obesity: ≥30.0. During follow-up, there were no significant differences in annualized PVC according to the 5% change of BMI in all BMI groups. Among 1424 (90.8%) subjects in the same BMI group at CCTA1 and CCTA2, a significant difference in annualized (PVC) was observed among the three groups. In 144 (9.2%) subjects with the change in their BMI group at CCTA2 compared their results at CCTA1, annualized PVC was not different compared with subjects in the same BMI group during follow-up. The percent change of BMI was not significantly related to the annualized PVC after adjusting confounding factors. Male gender [odds ratio (OR): 1.38; 95% confidence interval (CI): 1.05-1.81; P = 0.022], baseline plaque volume (OR: 1.07; 95% CI: 1.05-1.09; P < 0.001), and baseline overweight or obesity (OR: 1.35; 95% CI: 1.04-1.77; P = 0.027) were independently associated with coronary plaque progression. Over the near term, longitudinal small changes in BMI were not associated with changes in coronary plaque volume although baseline BMI was. ClinicalTrials.gov NCT02803411.

Multicomponent Obesity Prevention Intervention in Low-Income Preschoolers: Primary and Subgroup Analyses of the NET-Works Randomized Clinical Trial, 2012-2017.

To evaluate a multicomponent obesity prevention intervention among diverse, low-income preschoolers. Parent-child dyads (n = 534) were randomized to the Now Everybody Together for Amazing and Healthful Kids (NET-Works) intervention or usual care in Minneapolis, MN (2012-2017). The intervention consisted of home visits, parenting classes, and telephone check-ins. The primary outcomes were adjusted 24- and 36-month body mass index (BMI). Compared with usual care, the NET-Works intervention showed no significant difference in BMI change at 24 (-0.12 kg/m2; 95% confidence interval [CI] = -0.44, 0.19) or 36 months (-0.19 kg/m2; 95% CI = -0.64, 0.26). Energy intake was significantly lower in the NET-Works group at 24 (-90 kcal/day; 95% CI = -164, -16) and 36 months (-101 kcal/day; 95% CI = -164, -37). Television viewing was significantly lower in the NET-Works group at 24 (rate ratio = 0.84; 95% CI = 0.75, 0.93) and 36 months (rate ratio = 0.88; 95% CI = 0.78, 0.99). Children with baseline overweight or obesity had lower BMI in the NET-Works group than those in usual care at 36 months (-0.71 kg/m2; 95% CI = -1.30, -0.12). Hispanic children had lower BMI in the NET-Works group than those in usual care at 36 months (-0.59 kg/m2; 95% CI = -1.14, -0.04). In secondary analyses, NET-Works significantly reduced BMI over 3 years among Hispanic children and children with baseline overweight or obesity. ClinicalTrials.gov Identifier: NCT01606891.

Long-term weight-change slope, weight fluctuation and risk of type 2 diabetes mellitus in middle-aged Japanese men and women: findings of Aichi Workers\u2019 Cohort Study

Objective:This study aims to investigate the association of long-term weight-change slopes, weight fluctuation and the risk of type 2 diabetes mellitus (T2DM) in middle-aged Japanese men and women.Methods:A total of 4234 participants of Aichi Workers’ Cohort Study who were aged 35–66 years and free of diabetes in 2002 were followed through 2014. Past body weights at the ages of 20, 25, 30, 40 years, and 5 years before baseline as well as measured body weight at baseline were regressed on the ages. Slope and root-mean-square-error of the regression line were obtained and used to represent the weight changes and the weight fluctuation, respectively. The associations of the weight-change slopes and the weight fluctuation with incident T2DM were estimated by Cox proportional hazards models.Results:During the median follow-up of 12.2 years, 400 incident cases of T2DM were documented. After adjustment for baseline overweight and other lifestyle covariates, the weight-change slopes were significantly associated with higher incidence of T2DM (hazard ratio (HR): 1.80, 95% confident interval (CI): 1.17–2.77 for men; and HR: 2.78, 95% CI: 1.07–7.23 for women), while the weight fluctuation was not (HR: 1.08, 95% CI: 1.00–1.18 for men and HR: 1.02, 95% CI: 0.84–1.25 for women).Conclusions:Regardless of the presence of overweight, the long-term weight-change slopes were significantly associated with the increased risk of T2DM; however, the weight fluctuation was not associated with the risk of T2DM in middle-aged Japanese men and women.

The epidemiology of obesity and the development of disorders of glucose metabolism according to a prospective study in Siberia

Introduction: Persons who are overweight and obese have a higher risk of development of diabetes mellitus. In Russia, the epidemiological trends of glucose metabolism disorders in obese persons are understudied.Aim. To study the prevalence of overweight and obesity in a population sample aged 45–69 (Novosibirsk), and to assess the relationship between body mass index and 3-year dynamics of glucose metabolism disorders in a prospective cohort study.Material and Methods: A representative population sample of men and women 45–69 years old was examined in Novosibirsk in 2003–2005 (baseline survey, HAPIEE Project). In a prospective study 2,787 individuals without baseline diabetes who participated in the first and repeated surveys (2006–2008) were analyzed. The average duration of prospective follow–up comprised 3±0.01 years. Anthropometric measurements, biochemical assessment including lipids and carbohydrate metabolism were performed. Diabetes mellitus was defined by epidemiological criteria in patients with established diabetes history and in individuals with fasting blood glucose level ≥7,0mmol/l (WHO, 1999). The classification of obesity by BMI value was used according to WHO (1997).Results: In a population sample aged 45–69 in 2002–2006 the proportions of persons with BMI value ≥25 and 30kg/m2 was 37.5%, and with BMI≥30kg/m2 – 35%. Among persons with baseline overweight, the rate of new diabetes cases was 2.5 times higher than among those with normal body weight. In persons with baseline obesity the rate of new diabetes cases was 6 times higher than in those with normal body weight. Men with BMI ≥25 and 30 kg/m2 had a frequency of new diabetes 3.4 times higher, and in persons with BMI≥30 kg/m2 – 8.5 times higher than in men with normal BMI. Women with excess body weight had a rate of newly emerged diabetes mellitus 1.7 times higher, and women with obesity – 6 times higher than in a group with normal body weight.Conclusion: The prevalence of obesity in a Siberian population aged 45–69 years comprises 35%. In studied population sample, person with excess body weight have a 3-year incidence of new-onset diabetes 2.5 times higher compared to those with normal body weight. In obese persons the frequency of new diabetes was 6 times higher compared to those with BMI ≤25 kg/m2. Among persons with obesity, the frequency of new diabetes is 2 times higher in men than in women

Predictors Associated With Changes of Weight and Total Cholesterol Among Two Occupational Cohorts Over 10 Years

To ascertain worker health characteristics and psychosocial factors associated with changes in body weight and total cholesterol (TC) among two production operation populations. We performed descriptive and predictive analysis of questionnaire data and biomedical measurements from two prospective cohort studies. Our key outcomes were changes in weight, and TC over 5 to 10 years between baseline and exit assessments. A total of 146 subjects were analyzed. Increases in weight were associated with belief in being overweight and baseline overweight and obesity. Increases in TC levels were associated with female sex, belief that TC levels were "not good," and feeling depressed. Most of the reported associations with increases in weight and TC levels are amenable to interventions and may be a target for workplace intervention programs.

Abstract P207: Incidence of Hypertension in Colombia Similar to That Observed Decades Ago in Developed Countries: An Observation From the Chicamocha Cohort Study

Background: Overweight is a modifiable risk factor for high blood pressure (BP). Despite the increasing prevalence of both conditions in the Latin American population, there are no estimates of either the incidence of hypertension or the impact of overweight on it that inform the design and evaluation of individual and community-based preventive interventions in the region. Methods: We conducted a prospective cohort study in a sample of normotensive, blood donors from Bucaramanga, Colombia, who were free of transfusion-transmitted infectious and cardiovascular diseases at baseline. Participants were re-evaluated after a median follow-up of 12 years to determine the incidence of hypertension defined as: 1) Self-reported diagnosis with evidence of pharmacological treatment; 2) Systolic BP &gt;140 mmHg or diastolic BP &gt;90 mmHg (average of two measures in seated position); or 3) Current systolic/diastolic BP &gt;120/80 mmHg with evidence of increments &gt;10/5 mmHg from baseline. We estimated crude incidence rates of hypertension and age- and sex-adjusted hazard ratios (HRs) for baseline overweight (body mass index ≥25 kg/m2) using Cox regression analysis. The population attributable fraction (PAF) for overweight was also assessed. Results: We followed 594 participants (baseline mean age = 38.0 years; 64% male; adherence rate = 78%) at risk of hypertension among which we observed 164 incident cases: Cumulative incidence of 27.6%; incidence rate of 23.4 cases per 1,000 person-years. Incidence rate was similar in men and women (23.4 vs. 23.2 per 1,000 person-years; p&gt;0.05) and tended to increase with age (17.4, 21.2, and 27.8 per 1,000 person-years among participants &lt;30, 30-39, and ≥40 years old, respectively; p&gt;0.05). Participants with overweight at baseline had twice the risk of developing hypertension than participants with normal weight (adjusted-HR = 2.00, 95%CI: 1.11, 3.61). The estimated PAF was 25.7%, considering a national prevalence of overweight equal to 34.6%. Conclusion: The incidence of hypertension in our study is similar to that reported two decades ago in cohorts from developed countries, which is consisting with the ongoing epidemiological transition in Latin America. We also confirmed the role of overweight as a risk factor for hypertension, accounting for about 1 out 4 incident cases. This finding highlights the importance of addressing overweight in our population.

Factors associated with weight change up to 12 months postpartum in HIV‐infected women: findings from the HIV prevention of mother‐to‐child transmission (PMTCT) Kesho Bora trial

Data on postpartum weight change (PWC) in HIV‐infected women are sparse and inconsistent. This study analyzed, according to antiretroviral prophylaxis (ARV), clinical and infant feeding (IF) characteristics, PWC from 1 to 12 months in HIV‐infected women participating in a PMTCT trial in 5 study sub‐Saharan African sites.Women with 200–500 CD4+ cells/mm3 were randomized to receive from 28–36 weeks gestation either a triple ARV (3 ARV), continued up to 6 months postpartum (PP) or a standard ARV (STANDARD) until 1 week PP.Among 792 women, 78% breastfed for a median duration of 5.1 months (IQR: 2.8–6.0). At delivery, viral load (VL) was undetectable in 64% of 3 ARV women vs. 30% in STANDARD group (P&lt;0.0001) and median CD4 count was 463 and 414 cells/mm3, respectively (P&lt;0.0001). At 1 month PP, less than 3% were underweight while 49% were overweight or obese. Mean PWC at 12 months was +1.4kg in 3 ARV group and −0.7kg in STANDARD group (P&lt;0.0001). In mixed linear model analyses, 3 ARV, baseline overweight or obesity and C‐section were independently associated with PWC (+65, +54 and +56 g/month, P&lt;0.0001, &lt;0.001 and =0.02, respectively). No association was found between either IF or CD4 count or VL and PWC.3 ART increased weight gain over the first year PP and IF had no impact on PWC among these HIV‐infected women with intermediate advanced disease.Funding: ANRS, DFID, ECDTP, Trasher Research Fund, GSK Fund, CDC, NIH, WHO

The weight change impact on metabolic syndrome: a 17-year follow-up study

AbstractIntroduction: Data on long-term patterns of weight change in relation to the development of metabolic syndrome (MetS) are scarce. The aim of the study was to evaluate the impact of weight change on the risk of MetS in men. Material and Methods: Prospective longitudinal observation (17.9 ± 8.1 years) of apparently healthy 324 men aged 18–64 years. Metabolic risk was assessed in weight gain (⩾ 2.5 kg), stable weight (&gt; −2.5 kg and &lt; 2.5 kg) and weight loss (⩽ −2.5 kg) groups. Adjusted relative risk (RR) of MetS was analyzed using multivariate logistic regression. Results: The prevalence of MetS over follow-up was 22.5%. There was a strong relationship between weight gain and worsening of MetS components among baseline overweight men. Long-term increase in weight was most strongly related with the risk of abdominal obesity (RR=7.26; 95% CI 2.98–18.98), regardless of baseline body mass index (BMI). Weight loss was protective against most metabolic disorders. Leisure-time physical activity (LTPA) with energy expenditure &gt; 2000 metabolic equivalent/min/week was associated with a significantly lower risk of MetS. Conclusions: Reducing weight among overweight and maintaining stable weight among normal-weight men lower the risk of MetS. High LTPA level may additionally decrease the metabolic risk regardless of BMI.

Obesity and Prevalent and Incident CKD: The Hypertension Detection and Follow-Up Program

Obesity is associated with increased single-nephron glomerular filtration rate, which may increase the risk for chronic kidney disease (CKD), especially when combined with hypertension. However, epidemiological data supporting an association between overweight and obesity and risk for CKD currently are limited. We used data from the Hypertension Detection and Follow-Up Program (HDFP) to test the hypothesis that overweight and obesity are associated with incident CKD in 5,897 hypertensive adults. Serum and spot urine samples were collected at baseline and year 5. CKD is defined as the presence of 1+ or greater proteinuria on routine urinalysis and/or an estimated glomerular filtration rate less than 60 mL/min/1.73 m2 (<1.0 mL/s). In HDFP participants without CKD at baseline, the incidence of CKD at year 5 was 28% in the ideal-body-mass-index group, 31% in the overweight group, and 34% in the obese group. After adjustment for all covariates, including diabetes mellitus, mean baseline diastolic blood pressure, and slope of diastolic blood pressure, both baseline overweight (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.05 to 1.41) and obesity (OR, 1.40; 95% CI, 1.20 to 1.63) were associated with increased odds of incident CKD at year 5. Similar results were noted after exclusion of participants with baseline diabetes mellitus, with both overweight (OR, 1.22; 95% CI, 1.05 to 1.43) and obesity (OR, 1.38; 95% CI, 1.17 to 1.63) remaining significantly associated with incident CKD. These results suggest that obese adults with hypertension have an increased risk for CKD.

Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults

STUDY OBJECTIVETo determine whether long term weight gain and weight loss are associated with subsequent risk of type 2 diabetes in overweight, non-diabetic adults.DESIGNProspective cohort. Baseline overweight was defined as...

Predictors of overweight and overfatness in a multiethnic pediatric population. Child and Adolescent Trial for Cardiovascular Health Collaborative Research Group

The goal of the study was to determine whether overweight or overfatness were predicted from sex, race or ethnicity, school site, and intervention or control status for children who were 9 y old at the outset of the Child and Adolescent Trial for Cardiovascular Health (CATCH). In this ethnically and geographically diverse group of 5106 students, height, weight, and triceps skinfold thickness were measured at 9 (baseline) and 11 y (follow-up) of age. The strongest predictors of status at follow-up were baseline overweight (odds ratio: 69.0; 95% CI: 54.9, 96.3) and overfatness (odds ratio: 27.4; 95% CI: 22.4, 33.4); site, African American race or ethnicity, and male sex were also significant independent associations. Children in the overweight (> 85th percentile for body mass index) group had significantly higher adjusted means for total blood cholesterol, higher apolipoprotein B concentrations, lower mean HDL-cholesterol concentrations, and lower performance on the 9-min run than those in other groups (< 15th, 15-49th, or 50-85th body mass index percentiles). Similar results were found for these factors for those subjects with greater triceps skinfold-thickness measurements. Groups of children who were overweight and overfat at baseline were more likely to be overweight and overfat at follow-up and to have more cardiovascular risk factors than their peers.