Increase In BMI Research Articles

The Relationship of Limitations in Daily Living Activities and Other Health-Related Factors with Early Retirement.

The deterioration in health and functionality in older ages, in addition to biological changes, is affected by physical changes. Therefore, early retirement may become an inevitable choice. This study aimed to evaluate the relationship between limitations in daily living activities, mobility, and other health factors with early retirement in workers aged 50-67 in the 4th wave of the SHARE study in Europe. In this prospective cohort study, the working status was examined in 4 waves. The frequency of early retirement was 16.1%; it was higher in male and low-educated people. Those with poor self-perceived health and those with more chronic diseases retired earlier. The frequency of early retirement was 16.0% for those who had no difficulty in basic daily living activities, 22.4% for those who had difficulties (p 0.019), and those who had limitations retired earlier (RR 1.50). Early retirement was higher in those with two or more chronic diseases compared to those without (RR 1.26) and was higher in those who consumed alcohol 5days a week than those who didn't (RR 1.34). A 1-unit increase in BMI increased the risk by 1.02 times. It has been clearly revealed how important basic activities are for early retirement. This new finding is a gain for the literature and will provide new insights intervention studies. Those who had difficulty in instrumental activities and mobility retired early more often, but this wasn't statistically significant. Our findings will contribute to increasing workplace protective approaches, and maintaining a healthy working force for years.

BMI trajectory of 8,155,894 Japanese adults from exhaustive health checkup data: the contributions of age-related changes in height and weight.

This study aimed to clarify the trajectory of BMI alongside age-related changes in height and weight among Japanese adults. Data from annual health checkups between 2015 and 2020 by the Japan Health Insurance Association were retrospectively analyzed. A total of 4,777,891 men and 3,378,003 women (age 35-69 years) were stratified into 14 subgroups based on sex and 5-year age categories. We used linear mixed-effects model to estimate values for each outcome, with six-time points (2015-2020) as the independent variable. Mean BMI changes were positive across all subgroups, indicating a trend of increasing BMI (men, 0.02 to 0.14 kg/m2/year; women, 0.05 to 0.16 kg/m2/year). In younger subgroups, the changed were relatively large, with the weight transitions mirroring those of BMI. However, the mean changes were negative (men, -0.06 kg/year; women, -0.01 kg/year) in the oldest subgroups. Height reduction increased with age across subgroups (men, -0.14 to -0.03 cm/year; women, -0.18 to -0.01 cm/year). In conclusion, BMI tended to increase with age in both sexes across all age groups of Japanese adults. The increase in BMI appeared to be influenced by weight gain in young to middle age, whereas height reduction influenced increased BMI in older age groups.

Metabarcoding analysis of oral microbiome during pregnancy

Pregnancy is a dynamic physiological process involving significant hormonal, immune, and metabolic changes to support fetal growth and development. This study investigates the changes in salivary microbiome and biochemical markers from the second to the third trimester of pregnancy. Saliva samples were collected from 45 pregnant women enrolled in the Qatar Birth Cohort study at two time points (second and third trimesters). DNA was extracted and subjected to 16S rRNA gene sequencing using Oxford Nanopore Technology. Microbial diversity and taxonomic analyses were performed, along with correlation analyses between microbial abundance and clinical parameters. Biochemically, significant increases in BMI, pulse rate, HbA1c, LDL, total cholesterol, and triglycerides were observed in the third trimester compared to the second. Microbial diversity analysis revealed significant changes in microbial richness and composition. Taxonomy analysis showed a significant 3-fold increase in Bacteroidota. Also, a significant decline in Selenomonas and a significant increase in Veillonella, specifically Veillonella dispar and Veillonella atypica, as well as an increase in Granulicatella were observed in the third trimester, along with a significant decrease in Streptococcus sanguinis. Correlation analysis during the second trimester revealed positive associations between BMI, cholesterol, LDL, and Selenomonas, and negative correlations with Streptococcus and Gemella. In the third trimester, BMI was negatively correlated with Campylobacter, glucose levels were negatively correlated with Neisseria, and triglyceride levels were negatively correlated with Prevotella. These findings highlight significant biochemical and microbial shifts during pregnancy, underscoring the importance of monitoring oral health and metabolic changes in pregnant women.

Increased BMI Velocity is Associated with Elevated Patient Health Questionnaire-9 Scores in Adolescents with Obesity.

Existing studies that have demonstrated a positive association between obesity and depression have been among adults, did not utilize the Patient Health Questionnaire (PHQ), or were conducted in a homogenous patient population. In this retrospective longitudinal cohort study of patients >11 and <18 years old with obesity in one health system we analyzed associations between change in BMI between two BMI measurements and PHQ-9 scores using chi-square and Kruskal-Wallis tests. We used PHQ-9 scores dichotomized at </≥5 as the outcome in logistic regression models to calculate the adjusted odds of having a higher PHQ-9 score for each increase in BMI per month. One-unit higher BMI change per month was associated with 2.52 times higher odds of PHQ-9 score over 5 (95% CI: 1.57-4.05) after adjusting for sex, baseline BMI, age, race, ethnicity, language, and insurance. BMI changes are associated with an increased risk of higher PHQ-9 scores. Close attention to depression screening in this population may be an important addition to other routine screening in pediatric patients with obesity.

Residual C-peptide is associated with new and persistent impaired awareness of hypoglycaemia in type 1 diabetes

AimsTo describe the change in impaired awareness of hypoglycaemia (IAH) over time and to identify factors associated with this change in the Dutch Type 1 Diabetes biomarkers cohort (NCT04977635). MethodsA prospective cohort of type 1 diabetes patients, with C-peptide <300 pmol/L, who had completed the Clarke questionnaire, to determine IAH status, at baseline and after 2 years. Changes in awareness status were defined and compares as follows: unchanged normal awareness (NAH) versus unchanged IAH, new IAH versus reversal of IAH. Multivariate logistic regression models were fitted using forward and backward stepwise selection using a 0.10 P-value cut-off, and stepwise backward selection using AIC criteria. ResultsA total of 431 out of 611 participants were included. The baseline prevalence of IAH was 17 % and 20 % after 2 years. The incidence proportion of new IAH and reversal of IAH were, 9.5 % and 31 %, respectively. For every 2.7-fold increase in C-peptide, the odds of IAH decrease by 58 %. A 1-unit increase in BMI over the 2-year follow-up period is associated with a 5.27-fold increase in the odds of reversing IAH. ConclusionsHigher C-peptide levels are protective against new IAH, and an increase in BMI over time is associated with the reversal of IAH.

Comparison of MRI head motion indicators in 40,969 subjects informs neuroimaging study design

Head motion during MRI compromises image quality for clinical assessments and research. Active motion reduction strategies are effective but rarely applied due to uncertainty in their value for a given study. The ability to anticipate motion based on group characteristics would aid effective neuroimaging study design. This study compared putative motion indicators for their association to fMRI head motion in a large UK Biobank cohort (n = 40,969, aged 54.9 ± 7.5 years, 53% male). Body Mass Index (BMI; βadj = .050, p < .001) and ethnicity (βadj = 0.068, p < 0.001) were the strongest indicators of head motion. A ten-point increase in BMI, which is the difference between “healthy” and “obese”, corresponded to a 51% increase in motion. Findings were similar in a subgroup with no lifetime diagnoses (n = 6858). Motion was not significantly increased in individuals with psychiatric disorders, musculoskeletal disorders, or diabetes. The hypertension subgroup exhibited significantly increased motion (p = 0.048). Cognitive task performance (t = 110.83, p < 0.001) and prior scan experience (t = 7.16, p < 0.001) were associated with increased head motion. Our results inform decision making for implementation of motion reduction strategies in MRI. BMI outweighs other motion indicators, while blood pressure, age, smoking and caffeine consumption are relatively less influential. Disease diagnosis alone is not a good indicator of MRI head motion.

A Study of Body Composition as a Predictor of Muscle Quality and Endurance- A Cross-Sectional Study

Background: The alarming rise in sarcopenic obesity is compromising the quality of life for millions, underscoring the urgent need to unravel the factors contributing to muscle decline. Sarcopenic obesity, characterized by the concurrent loss of muscle mass and accumulation of excess fat, is a growing public health concern. This condition, often exacerbated by aging and poor lifestyle, negatively impacts muscle quality and contributes to a multitude of comorbidities. Previous research has demonstrated a significant association between obesity and reduced muscle strength compared to non-obese individuals, hindering activities of daily living such as stair climbing and walking. This study aims to investigate the predictive role of body composition on muscle quality and endurance. Methods: This cross-sectional study was carried out on 385 healthy male and female subjects aged between 18-67 years. The staff and students of JMMC and RI were selected for the study based on the inclusion and exclusion criteria, after obtaining the Institutional Ethical Clearance. Handgrip strength (HGS) and endurance (HE) was measured using handgrip dynamometer while body composition was assessed using Omron body fat analyser. Comparisons were done between age and gender. Statistical analysis was done using Independent T test, One-Way ANOVA and Mann Whitney test on SPSS version 20.Results: As age advances, there is statistically significant increase in BMI and BFP (body fat percentage) in both the genders. Increase in BMI and BFP is more pronounced in females with significant decrease in muscle mass percentage and HGS. Females had significant decline in endurance in all age groups (p&lt;0.001).Conclusion: As the BMI and BFP increase with age, the muscle quality deteriorates. Females have more adiposity, poor muscle strength and endurance even though BMI remains same in both genders. To identify the early onset of decrease in muscle quality and endurance, a combination of parameters like BMI, BFP, HGS and HE should form a part of routine clinical screening.

Evaluation of predisposing factors in patients with ingrown toenails: a prospective, case-control study.

Ingrown toenails (IGTN) are a prevalent, debilitating nail disorder that occurs when the edge of the nail plate grows abnormally to penetrate the periungual dermis. Multiple risk factors have been identified in the etiology. In this study, we aimed to investigate the risk factors that predispose patients to IGTN. This prospective, case-control study consisted of 130 patients with IGTN and 130 age- and sex-matched controls. The sociodemographic data, clinical features, and predisposing factors were questioned. Multivariate logistic regression (Enter and Forward: LR) analysis was applied to determine the risk factors related to IGTN. The IGTN group comprised 63 (48.5%) females and 67 (51.5%) males with a median age of 31 (IQR = 28.25) years. The most common type of IGTN in the study group was distal-lateral ingrowing in 115 (88.5%) patients. The median duration of IGTN was 5.5 (IQR = 10) months. In the multivariate regression analyses, the presence of improper nail trimming (OR: 7.063; 95% CI: 3.604-13.843), presence of hyperhidrosis (OR: 2.648; 95% CI: 1.198-5.853), poor foot hygiene (OR: 4.873; 95% CI: 2.271-10.456), presence of foot/toe deformity (OR: 5.413; 95% CI: 1.508-19.427), presence of increased curvature of the nails (OR: 2.588; 95% CI: 1.024-6.543), presence of onychomycosis (OR: 3.506; 95% CI: 1.267-9.705), increase in BMI (OR: 1.126; 95% CI: 1.038-1.221) were found to be the predisposing factors that increased the risk of IGTN. Improper nail trimming, hyperhidrosis, poor foot hygiene, onychomycosis, increased curvature of the nails, foot/toe deformity and increase in BMI were found to contribute significantly to the etiopathogenesis of the disease. Considering that most of these risk factors were modifiable, informing the public about risk factors will reduce the frequency of IGTN, and modifying risk factors in patients will enable rapid control of the disease and reduce recurrences.

Gastric ultrasound performance time and difficulty: a prospective observational study.

Point-of-care gastric ultrasound is an emerging tool in peri-operative practice. However, data on the technical challenges of gastric ultrasound, which are essential for optimised training, remain scarce. We analysed gastric ultrasound examinations performed after basic training to identify factors associated with difficulty. This was an analysis of data from a prospective observational study evaluating the potential impact of routine pre-operative gastric ultrasound on peri-operative management in adult patients undergoing elective or emergency surgery at a single centre. Before initiation, physicians received extensive structured training with at least 30 supervised gastric sonograms before independent practice. We then used regression models to identify factors associated with deviation from a predefined sonography algorithm, performance time and scan difficulty. Seventy-three trained physicians performed 2003 ultrasound scans. Median (IQR [range]) performance time was 5 (4-6 [1-20]) min, which was achieved after 20-27 scans following structured training. Patient characteristics associated with more difficult and longer duration scans were: increase in BMI per 5 kg.m-2 (odds ratio (95%CI) 1.57 (1.35-1.83), p < 0.001 for difficulty and percentage change coefficient (95%CI) 1.03 (1.02-1.05), p < 0.001 for duration); and male sex (odds ratio (95%CI) 3.31 (2.28-4.88), p < 0.001 for difficulty and percentage change coefficient (95%CI) 1.08 (1.04-1.12), p < 0.001, for duration). Trauma surgery (odds ratio (95%CI) 3.26 (1.88-5.68), p < 0.001), ASA physical status of 3 or 4 (odds ratio (95%CI) 1.86 (1.21-2.88), p = 0.0049) and emergency surgery (odds ratio (95%CI) 1.86 (1.20-2.89), p = 0.006) were associated with deviation from the predefined sonography algorithm. Approximately 50 scans are required to achieve a baseline performance of 5 min per gastric ultrasound. Future training programmes should focus on patients with obesity, male sex, higher ASA physical status and trauma.

Cardiometabolic risk factors of post-bariatric patients two years after COVID-19 pandemic onset: a longitudinal study

The COVID-19 pandemic’s prolonged extension may have had a long-term negative impact on weight and metabolic parameters associated with the effectiveness of bariatric surgery. The aim of this study was to assess the impact of the COVID-19 pandemic on cardiometabolic risk markers and weight outcomes of post-bariatric patients. This is a longitudinal study carried out with patients who underwent bariatric surgery before the COVID-19 pandemic. Anthropometric, lipid, glycemic profile, blood pressure, eating behavior and physical activity parameters obtained through face-to-face consultations from 2019 to 2022 were evaluated. An increase in BMI (p = 0.001), percentage of weight gain (p < 0.001), postoperative weight regain rate (p = 0.002), fasting blood glucose (p < 0.001), and glycosylated hemoglobin (p < 0.001) was identified. There were reductions in the percentages of excess weight loss (p = 0.001) and physically active individuals (p = 0.016). These changes were only triggered after the pandemic years. Uncontrolled eating, emotional eating, and physical inactivity were identified as risk factors for weight gain during the pandemic. Prepandemic weight regain rate was risk factor for increased fasting blood glucose. Two years after the pandemic onset, the study participants exhibited increased rates of weight regain, reduced excess weight loss, and an increase in fasting blood glucose and glycosylated hemoglobin parameters.

COMPONENTS OF METABOLIC SYNDROME AS A RISK FACTOR FOR COVID-19 IN INDIA

Objective: Several patients with components of metabolic syndrome (MetS) like obesity, hypertension, diabetes mellitus and dyslipidemia is a risk factor for COVID-19 in India. Aims of our review to bring together current data about components of metabolic syndrome &amp; COVID 19 infection. It specially looks the relation between components of MetS (Obesity, Diabetes mellitus, Hypertension and dyslipidemia) and COVID 19. At the time of writing the review is updated till time. Methods: Search of literature was done by using google search &amp; PubMed engines for prepare review related to my article. Results: Patients with components of metabolic syndrome like obesity, diabetes, hypertension and dyslipidemia have increased evidence of incidence and severity of COVID-19. COVID-19 has effect on the pathophysiology of all these components of metabolic syndrome. The control of all these components of metabolic syndrome is important not only for patients who are infected with COVID-19, but also for those without the disease. Conclusions: It is commonly known that the existence of comorbidities such as increase in BMI, dyslipidemia, diabetes mellitus and hypertension is associated with additional severe course of COVID-19. So measurement of components of metabolic syndrome parameters is essential to better estimate the risk of COVID-19 and management and control of these components (BMI, blood glucose, blood pressure, lipid profile) of metabolic syndrome parameters will cause less possibility to occur COVID-19.

Balancing risks of surgical complications and positive margins for patients with invasive lobular carcinoma of the breast and elevated BMI: An institutional cohort study

BackgroundThe risks of postoperative complications in breast cancer patients vary by patient and tumor characteristics. Elevated BMI and invasive lobular carcinoma (ILC) increase risks of surgical complications and positive margins, respectively. MethodsWe retrospectively analyzed patients with BMI ≥30 ​kg/m2 from an institutional ILC database. The primary outcome was surgical complication rate by procedure type. The secondary outcome was positive margin rates by surgical approach, stratified by T stage. ResultsOf 154 analyzed patients, standard BCS, lumpectomy with oncoplastic closure, and simple mastectomy had the lowest complication rates (18.2 ​%, 17.0 ​%, 11.8 ​%). Oncoplastic reduction mammoplasty and mastectomy with aesthetic closure had the highest rates (35.5 ​%, 33.3 ​%). The overall positive margin rate was 28.5 ​%, significantly higher in BCS vs. mastectomy (37.4 ​% vs. 15.0 ​%, p ​= ​0.003). Oncoplastic surgery significantly reduced positive margin rates in BCS. ConclusionIn this study, 23.4 ​% of patients experienced surgical complications, with higher rates in oncoplastic/reconstructive approaches. However, oncoplastic surgery reduced positive margins, highlighting the importance of balancing risks for optimal surgical planning.

Switch to Integrase Strand Transfer Inhibitors during the Menopausal Transition is Associated with Accelerated Body Composition Change in Women with HIV.

Integrase strand transfer inhibitors (INSTIs) and the menopausal transition have separately been associated with body composition changes in women with HIV (WWH), but their interaction is unknown. From 2006-2019, 1131 non-pregnant WWH with viral suppression [(419 who switched to INSTI (INSTI+); 712 who did not switch (INSTI-)] and 887 women without HIV (WWOH) from the Women's Interagency HIV Study were included. Mixed effect models were used to evaluate change in waist circumference (WC) and BMI by menopausal phase defined using anti-Müllerian hormone, a biomarker of ovarian reserve. During premenopause, WWH had increases in WC (INSTI+: 0.01cm per 6 month (mo); 95%CI:-0.29,0.32 and INSTI-: 0.22cm per 6mo;95%CI:-0.01,0.44) that were not statistically significantly different from WWOH; there was also little difference by INSTI status. In late perimenopause, INSTI+ had faster increases in WC (0.37cm per 6mo;95%CI:0.15,0.60) while INSTI- had smaller increases (0.14cm per 6mo;95%CI:-0.06,0.34) compared to WWOH. In menopause, INSTI+ had faster increases peaking at 43mo then declining while INSTI- had smaller increases (0.14cm per 6mo;95%CI:-0.02,0.30). Compared to INSTI-, in late perimenopause, INSTI+ had 0.26 cm per 6mo (95%CI:0.02,0.50) faster linear increases in WC and in menopause, INSTI+ was associated with faster increases peaking at 41mo. BMI trajectories were similar to WC in late peri- and menopausal women. Switching to an INSTI-based regimen during late peri- and menopause is associated with faster increases in WC and BMI when compared to women who did not switch. Menopausal status should be considered when switching to an INSTI.

Metabolic syndrome in patients who have been subjected to isolation security measures and treated with atypical antipsychotics.

The main aim of the study was to assess the incidence of metabolic syndrome and its individual components in patients subject to a confinement measure, treated with antipsychotics in mono - or polytherapy. Additional objectives included the analysis of associations between the occurrence of metabolic syndrome and patients' age, psychiatric diagnosis, overweight or obesity, and the presence of addictions to psychoactive substances. The study involved 61 patients of the Department of Forensic Psychiatry, including 9 women and 52 men, subject to a confinement measure from September 2019 to August 2021. All parameters of metabolic syndrome and BMI were measured twice, at the beginning of the stay at the Department and after six months of treatment with atypical antipsychotics. Appropriate statistical comparative analyses were then performed. There was no relationship between the occurrence of metabolic syndrome and the age of the subjects, medical diagnosis, addiction to psychoactive substances, including smoking. It has not been confirmed that the chronic use of atypical antipsychotics with parallel prophylactic and health-promoting effects in conditions of confinement leads to the development of metabolic syndrome and worsens its symptoms, apart from a marked increase in waist circumference and an increase in BMI. Systematic measurements of BMI and waist circumference during treatment with atypical antipsychotics may be accurate tools in assessing the risk of metabolic syndrome. Long-term confinement hospitalizations should include psychoeducational nterventions aimed at minimizing metabolic complications of pharmacotherapy.

Assessment of Metabolic Syndrome in Patients with Chronic Obstructive Pulmonary Disease: A 6-Month Follow-Up Study.

The association between chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS) is a common one, with long-term therapeutic and prognostic impact. In view of the high pulmonary and cardiovascular morbidity and mortality, self-management contributes to decreasing the risk of an acute cardiac event or pulmonary decompensation. We conducted a prospective cohort study on 100 patients admitted to Iasi Clinical Rehabilitation Hospital who were divided into two groups according to the presence (67 patients) or absence (33 patients) of MetS. All patients benefited from multidisciplinary counseling sessions on their active role in improving modifiable cardiovascular risk factors and thus increasing quality of life. The aim of this study was to examine the impact of metabolic syndrome on lung function and the role of self-management in a 6-month follow-up period. The demographic, anthropometric, cardiovascular risk factors, and respiratory function were analyzed at baseline and at 6 months. The presence of MetS was associated with higher fasting blood glucose (p = 0.004) and triglycerides (p = 0.003) but not with higher levels of interleukins or TNF-alpha. At the 6-month follow-up, abdominal circumference, forced expiratory volume in one second (FEV1), dyspnea severity, and blood pressure values improved in male patients with COPD. Systolic and diastolic blood pressure decreased in the COPD group as a whole, but especially in male patients with and without associated MetS. BMI was positively correlated with FEV1 (r = 0.389, p = 0.001) and the FEV1/forced vital capacity (FVC) ratio (r = 0.508, p < 0.001) in all COPD patients and in the MetS subgroup. In the COPD group as a whole. the six-minute walk test (6MWT) results (m) were positively correlated with FEV1 and FVC. The correlation remained significant for FVC in COPD patients with and without MetS. An increase in BMI by one unit led to an increase in TG values by 3.358 mg/dL, and the presence of metabolic syndrome led to an increase in TG values by 17.433 mg/dL. In our study, MetS is a common comorbidity in patients with COPD and is associated with higher BMI, fasting glucose, and triglycerides but not with the inflammatory parameters. A mixed pulmonary-cardiovascular rehabilitation intervention leads to improvement in various parameters in both female and male COPD patients.

The impact of body mass on cardiovascular outcomes in patients with acute coronary syndrome

Abstract Background Patients with acute coronary syndrome (ACS) and extreme body weights exhibit varying risks of bleeding and thrombotic outcomes. Furthermore, extreme body weights can influence the pharmacodynamic response to potent P2Y12 inhibitors (ticagrelor/prasugrel) and clopidogrel. Purpose This study aims to assess the impact of extreme body weights on cardiovascular outcomes, as well as the comparative efficacy and safety of potent P2Y12 inhibitors versus clopidogrel. Methods Data was extracted from the FORCE-ACS registry, a prospective, multicentre, registry, enrolling patients with ACS. Patients were stratified (in kg/m2) into the categories: underweight (body mass index [BMI] ≤20.0), normal weight (20.1–24.9), overweight (25.0–29.9), class 1 (30.0–34.9) and class 2 obesity (≥35.0). The primary thrombotic endpoint was major adverse cardiac events (MACE), a composite of cardiovascular death, myocardial infarction (MI), or stroke. The primary bleeding endpoint was defined as Bleeding Academic Research Consortium (BARC) 2, 3 or 5 bleeding. Cox proportional hazard models and Kaplan-Meier survival curves were used to estimate the risk of clinical events across the BMI categories. Restricted cubic splines were made to assess the continuous association of BMI with the risk of the primary endpoints, stratified for P2Y12-inhibitor therapy (potent vs. clopidogrel) and gender. Results The total included population consisted of 5,864 patients with ACS (mean age 65.2 years, 72.4% men), and were stratified into underweight (N=112 [2%]), normal weight (N=1,627 [28%]), overweight (N=2,697 [46%]), class 1 obesity (N=1,081 [18%]) and class 2 obesity (N=347 [6%]). Compared with normal weight (10.8%), the rate of primary bleeding outcome was higher in underweight (15.2%) patients, but lower in the overweight (8.9%), class 1 obesity (7.9%) and class 2 obesity (6.3%) categories. MACE occurred in 9.8% for the underweight group, 7.9% for normal weight, 7.0% for overweight, 8.0% for class, and 6.1% for class 2 obesity. After adjusting for confounding factors such as age, gender, cardiovascular risk factors, access site, and medical therapy, each unit increase in BMI was associated with a decreased bleeding risk (hazard ratio [HR] 0.97, 95% CI 0.95-0.99, p = 0.02), with no significant association found for MACE. Similar findings are demonstrated in the Kaplan Meier analysis (Figure 1A-1B). Subgroup analysis regarding bleeding risk and BMI did not show a significant interaction for potent P2Y12-inhibitor therapy versus clopidogrel and gender (P-value for interaction: 0.04 and 0.32, respectively)(Figure 2A-2D). Conclusions Our findings indicate a stronger correlation between BMI and bleeding risk compared to thrombotic risk, showing an increased risk for bleeding in patients with a low BMI. These results underscore the importance of careful monitoring and tailored interventions to mitigate bleeding risk in underweight patients.

Telomere length across spectrum of metabolic health

Abstract Introduction Telomere length is a marker of cellular aging and is correlated with various cardiovascular risk factors. Aim To assess the association between obesity, metabolic syndrome (MetS) and telomere length. Methods The LIPIDOGEN study was carried out in the primary care 2015. Patients recruited to LIPIDOGEN cohort (n=1788) were a random subset of patients from LIPIDOGRAM 2015 (n=13,724) study. Patients for LIPIDOGRAM2015/LIPIDOGEN study were recruited in all 16 administrative regions in Poland and physicians were proportionally distributed to the number of inhabitants in each administrative region. Each patient was asked to fill the questionnaire on risk factors, chronic diseases, treatments and lifestyle and also had saliva secured for DNA analyses. Recruited patients were divided into four groups based on the presence of MetS: 1) HS – healthy slim 2) MHO – metabolically healthy obese 3) NOMS – Non-obese with MetS 4) MUO – metabolically unhealthy obese. MetS was diagnosed basing on Joint Interim Statement 2009 criteria. Relative telomere length (rTL) was measured using quantitative polymerase chain reaction. Results DNA quality was sufficient for further analyses in 1606 patients. After removing of outliers, 1342 patients (Females - 59.3%, mean age- 50.2 years) were included for further analyses (HS-488, MHO-180, NOMS-165, MUO-509). Increase in BMI, waist circumference, frequency of diabetes mellitus, hypertension, dyslipidemia and history of myocardial infarction moving from HS to MUO was observed. (Table 1.). MUO group exhibited the highest triglycerides and lowest HDL-C levels. RTL length, an indicator of cellular aging, was inversely correlated with metabolic health, being shortest in the NOMS and MUO groups, which may indicate a link between metabolic health and accelerated biological aging. Conclusions Telomere length is shorter in patients with obesity as compared to lean patients even without the presence of MetS. Telomere length in patients with MetS, regardless of concomitant obesity, is shorter than in patients without MetS. Figure 1. Telomere length across metabolic health categories. Table 1. Clinical characteristics of the study participants.Figure. 1.Table. 1.

Early life social predictors of longitudinal relations between childhood BMI and overeating

Abstract Introduction The progression of obesity is a continuous process involving a complex system of genetic, environmental, and behavioural factors. Socioeconomic disadvantage as well as psychological distress may lead to overeating, subsequently associated with increased energy intake and weight gain. Recent evidence indicated that the association between childhood obesity and overeating might be bidirectional. Therefore, this study aimed to longitudinally investigate the directionality of the association between childhood BMI and overeating and to identify antecedent early childhood predictors. Methods The study sample included 5,777 children from the European Longitudinal Study of Parents and Children (ELSPAC), collected between 18 months and 11 years of child age. The outcomes were child BMI and overeating. Predictors included maternal BMI, maternal education, single-parent households, financial difficulties, and adverse childhood experiences (ACEs). The random intercept cross-lagged panel model (RI-CLPM) was applied. Results The results showed temporal stability in the development of overeating and BMI, with a bidirectional relationship that strengthened over time. The child’s BMI was predicted by maternal BMI (β = 0.37, p &amp;lt; 0.001). The child’s overeating was predicted by maternal BMI (β = 0.13, p &amp;lt; 0.001), but a stronger effect was found for ACEs (β = 0.24, p &amp;lt; 0.001). ACEs mediated the impact of maternal education, financial difficulties, and single parenthood on overeating with indirect effects of β = -0.01 (p = 0.005), β = 0.04, (p &amp;lt; 0.001), and β = 0.07 (p &amp;lt; 0.001), respectively. Conclusions We observed stable bidirectional longitudinal effects, with a stronger association from BMI to overeating. The results suggested two main pathways: one linked to maternal BMI and early childhood BMI increase followed by overeating, and the other associated with ACEs mediating the effect of early childhood socioeconomic factors on overeating, leading to gradual BMI gain. #NGEU Key messages • The study revealed a stable bidirectional association between childhood BMI and overeating, with a stronger association from BMI to overeating. • There are two potential pathways in childhood obesity development, one involving maternal BMI, and the second associated with social disadvantage and ACEs.

Анализ эффективности и безопасности применения CFTR-модулятора лумакафтор/ивакафтор у пациентов с муковисцидозом в разных возрастных группах

Russia’s first registered CFTR-modulator lumacaftor/ivacaftor was developed for patients with cystic fibrosis (CF) with the F508del/F508del genotype. The purpose of this research was to study the efficacy and safety of lumacaftor/ivacaftor therapy in different age groups. Materials and methods used: the data of homozygotes for F508del aged 2 to 18 y/o in the Russian CF Patient Registry who had been treated with lumacaftor/ivacaftor were analyzed. The effectiveness of therapy was evaluated in 3 age groups based on examination data, nutritional status, spirometry, sweat test at the start of therapy and after 12 months. In order to assess the safety, examination data, assessment of adverse events (AE), blood biochemical parameters, blood pressure and lens condition were taken into account in 334 pediatric patients in the first month of therapy and in 180 after 12 months. Results: decrease in sweat conductivity was noted in three age groups (p&lt;0.001), only in the 2 to 6 y/o age group were negative values obtained in 6.8%. An increase in BMI was observed in the 6 to 12 y/o and 12 to 18 y/o age groups (р&lt;0.001) whilst an improvement in FVC was observed only in the 12 to 18 y/o age group (p=0.015). Changes in biochemical parameters were statistically significant, both downward and upward, only in the age groups of 6 to 12 y/o and 12 to 18 y/o, changing not significantly. Withdrawal of the drug was required in only a single patient with a persistent increase in transaminase level. Fluctuations in blood pressure occurred within the normal age limits. Frequency of AE was comparable with the results of other studies, it was noted at the start in all groups and after 12 months more often in the age group of 12 to 18 y/o. The best tolerance was noted in the age group of 2 to 6 y/o. Conclusion: for the first time, the efficacy and tolerability of lumacaftor/ivacaftor in patients with CF in Russia was studied against the age aspect according to the 2022-2024 Registry. In the 2 to 6 y/o age group, the achievement of normal sweat test values and the lowest number of adverse reactions were noted, while in the 12 to 18 y/o age group, the positive dynamics were noted for a greater number of indicators, incl. an increase in FVC.

Neurodevelopmental Pathways to Obesity and Type 2 Diabetes: Insights From Prenatal Exposure to Maternal Obesity and Gestational Diabetes Mellitus: A Report on Research Supported by Pathway to Stop Diabetes.

Incidences of childhood obesity and type 2 diabetes (T2D) are climbing at alarming rates. Evidence points to prenatal exposures to maternal obesity and gestational diabetes mellitus (GDM) as key contributors to these upward trends. Children born to mothers with these conditions face higher risks of obesity and T2D, beyond genetic or shared environmental factors. The underpinnings of this maternal-fetal programming are complex. However, animal studies have shown that such prenatal exposures can lead to changes in brain pathways, particularly in the hypothalamus, leading to obesity and T2D later in life. This article highlights significant findings stemming from research funded by my American Diabetes Association Pathway Accelerator Award and is part of a series of Perspectives that report on research funded by the American Diabetes Association Pathway to Stop Diabetes program. This critical support, received more than a decade ago, paved the way for groundbreaking discoveries, translating the neural programming findings from animal models into human studies and exploring new avenues in maternal-fetal programming. Our BrainChild cohort includes >225 children, one-half of whom were exposed in utero to maternal GDM and one-half born to mothers without GDM. Detailed studies in this cohort, including neuroimaging and metabolic profiling, reveal that early fetal exposure to maternal GDM is linked to alterations in brain regions, including the hypothalamus. These neural changes correlate with increased energy intake and predict greater increases in BMI, indicating that early neural changes may underlie and predict later obesity and T2D, as observed in animal models. Ongoing longitudinal studies in this cohort will provide critical insights toward breaking the vicious cycle of maternal-child obesity and T2D.