Body Mass Index Scores Research Articles

The association of milk and multiple food avoidance with growth parameters in infants and children

BackgroundRecent studies reported that strict avoidance of milk products in cow's milk allergy (CMA) affects growth and bone turnover, causing negative calcium balance and changes in bone metabolism. ObjectiveTo investigate biochemical parameters to predict bone turnover and its relations with height and weight measurements and nutritional intake. MethodsHeight, weight, and body mass index z scores were plotted for age according to the World Health Organization. A 3-consecutive day food record was analyzed for nutritional values of foods. The blood levels of calcium, phosphorus, alkaline phosphatase, vitamin D, and parathyroid hormone (PTH) were determined. ResultsThe study included 69 controls, 66 children with isolated CMA, and 59 children with multiple food allergy (FA). The z scores for weight, height, and body mass index were lower in isolated CMA and multiple FA groups than controls (P < .001, P = .004, and P = .002, respectively). The nutritional intakes of protein, fat, carbohydrates, vitamins B2 and B12, niacin, calcium, and phosphorus were significantly lower in isolated CMA and multiple FA than controls. In infants (≤2 years of age), although blood calcium level was in normal range, it was significantly lower in isolated CMA and multiple FA than in controls (P < .001). In children older than 2 years, PTH level was significantly higher in isolated CMA and multiple FA groups than in controls (P = .003). ConclusionOur study revealed that children with isolated CMA and multiple FA had a high nutrition gap, growth deceleration, and unbalanced bone metabolism, as illustrated by low blood calcium and elevated PTH levels.

Symptom and comorbidity burden in hypertensive patients with obstructive sleep apnea.

Obstructive sleep apnea (OSA) is an important but frequently overlooked risk factor for hypertension (HTN). The prevalence of hypertension is high in patients with OSA, but the differences in clinical symptoms and comorbidities between patients with OSA with hypertension and those with normal blood pressure have not been fully defined. This study retrospectively analyzed OSA patients diagnosed for the first time in Lihuili Hospital Affiliated to Ningbo University from 2016 to 2020. Patients were divided into an OSA group with hypertension and an OSA group without hypertension. The sociodemographic information, clinical symptoms, comorbidities, and polysomnography results of the two groups were compared. The independent risk factors associated with hypertension in patients with OSA were explored. A total of 1108 patients with OSA initially diagnosed were included in the study, including 387 with hypertension and 721 without. Compared with OSA patients without hypertension, OSA patients with hypertension were older; had a higher body mass index (BMI) and Epworth sleepiness score (ESS); a higher incidence of nocturia; and a higher proportion of diabetes mellitus, coronary heart disease, and cerebrovascular disease. Multivariate analysis showed age (odds ratio [OR]:1.06, 95% confidence interval [CI]:1.04-1.08), BMI (OR:1.17, 95% CI:1.11-1.23), ESS score (OR:0.97, 95%CI: 0.94-1.00) and nocturia symptoms (OR:1.64, 95% CI:1.19-2.27) was independently associated with hypertension in OSA patients, and comorbid diabetes (OR: 3.86, 95% CI: 2.31-6.45), coronary heart disease (OR: 1.90, 95% CI:1.15-3.16), and ischemic stroke (OR: 3.69,95% CI:1.31-10.40) was independently associated with hypertension in OSA patients. Compared to OSA patients with normal blood pressure, OSA patients with hypertension had more significant daytime sleepiness, more frequent nocturnal urination, and a higher risk of diabetes, coronary heart disease, and cerebrovascular disease.

Trends in Anthropometric Measurements of Internationally Adopted Children.

The objective of this study was to describe anthropometric measures from internationally adopted children. Internationally adopted children are at risk for poor growth and development and there is no standardized growth chart evaluation for internationally adopted children due to variations in growth, genetics, and environmental exposures. This is a retrospective chart review of 882 patients seen in an international adoption clinic between 2010 and 2017. Anthropometric measurements were converted to Z scores for weight, height, head circumference, and body mass index. A total of 41 countries and 16 subregions were represented. Central America, northern Africa, southern Africa, and southern Europe were the only subregions that had positive mean Z scores for weight, and southeast Asia had the lowest mean Z score for weight (n = 40, -1.76). No subregion had a positive mean Z score for height, and western Asia had the lowest overall mean Z score for height (n = 2, -2.44). Mean Z score for body mass index was positive in several subregions. Growth is an important predictor of health and development, and this study adds to the literature on growth patterns of internationally adopted children.

Abstract PR001: Highlighting the combined effects of BMI and polygenic risk score on endometrial cancer risk

Abstract Obesity is more strongly associated with endometrial cancer risk than any other cancer type. However, the extent to which genetic susceptibility influences the risk of endometrial cancer independent of obesity remains unknown. Thus, this study aimed to evaluate the predictive performance of polygenic risk score (PRS), body mass index (BMI) and other factors in determining endometrial cancer risk, as well as to explore joint effects on endometrial cancer. PRS was generated using 1.1 million HapMap3 variants from the largest published endometrial cancer genome-wide association study. An endometrial cancer prediction model was constructed using established endometrial cancer risk factors (age, BMI, number of live births, ever taken oral contraceptive pill, age of menarche, and predicted age of menopause). Additionally, an integrated prediction model was constructed, combining the endometrial cancer PRS with established risk factors. The ability of models to predict endometrial cancer status was assessed in unrelated participants of European ancestry from the UK Biobank cohort, encompassing 1,867 participants with endometrial cancer (860 incident cases) and 133,322 cancer-free controls. The integrated model including PRS and risk factors had a modest yet statistically significant improvement in prediction of endometrial cancer status, compared with the model using risk factors alone (AUC 0.752 versus 0.741; P = 1.28 × 10−7). When examining incident cases, participants in the middle and top tertiles of the PRS distribution had a 1.96- (95% CI 1.39-2.77; P = 1.28 × 10−4) and 3.03-fold (95% CI 2.01-4.58; P = 1.60 × 10−8) elevated risk of developing endometrial cancer, respectively, in contrast to those in the lowest tertile. As expected, elevated BMI was associated with increased endometrial cancer risk. Compared to participants with a normal BMI, overweight participants (25kg/m2 ≤ BMI &amp;lt; 30kg/m2) had a 1.58-fold increased hazard ratio (HR; 95% CI 1.32-1.90; P = 8.43 × 10−7), while obese participants (BMI ≥ 30kg/m2) a 3.23-fold increased HR (95% CI 2.71-3.85; P &amp;lt; 2.00 × 10−16). Notably, we observed multiplying effects of BMI and PRS on endometrial cancer risk, with obese participants in the top tertile of the PRS distribution having a 7.53-fold increased HR (95% CI 3.78-14.99; P = 9.41 × 10−9). In summary, these findings indicate that higher PRS was associated with endometrial cancer risk, irrespective of BMI. Moreover, the integration of PRS with established risk factors may aid in better stratifying the general population for their susceptibility to endometrial cancer. Citation Format: Tracy A. O'Mara, Xuemin Wang, Laure Dossus, Marc J. Gunter, Emma J. Crosbie, Dylan M. Glubb. Highlighting the combined effects of BMI and polygenic risk score on endometrial cancer risk [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr PR001.

Clinical efficacy of CFTR modulator therapy in people with cystic fibrosis carrying the I1234V mutation

BackgroundThe cystic fibrosis transmembrane conductance regulator (CFTR) mutation I1234V (I1234V, p.Ile1234Val, c.3700A>G), is a missense-mutation that creates a cryptic splice site, with the formation of a protein lacking 6 amino acids, that is misfolded and misprocessed. The in vitro effects of CFTR modulator (CFTRm) therapies on human bronchial cell models and intestinal organoids carrying this mutation are conflicting. The aim of this study was therefore to explore the clinical efficacy of CFTRm in people with cystic fibrosis (pwCF) carrying this mutation. MethodsThis was a retrospective descriptive study of the clinical records of homozygous and compound heterozygous (none F508del) pwCF, for the I1234V mutation, that received CFTRm. Parameters explored were body mass index (BMI), forced expiratory volume in one second percent predicted (FEV1%), lung clearance index (LCI) and quantitative sweat chloride measurements. ResultsMean age was 38.6 ± 14 years (range 21–60). Two subjects were homozygous and five compound heterozygous, with minimal function mutations. Four were pancreatic insufficient and three pancreatic sufficient. The two homozygous subjects received Tezacaftor/Ivacaftor, the remaining Elexacaftor/Tezacaftor/Ivacaftor (ETI); treatment ranged from 6 to 12 months. Mean BMI score increased from 21.7 ± 1.3 to 23.6 ± 2.1 kg/m2 (p = 0.04); FEV1(%pred) increased by 20.14±10.2while mean change in FEV1 in the year prior to CFTRm initiation was -0.14±1.18 (p = 0.0001). Additionally, LCI 2.5% decreased from 18.7 to 14.5 (p = 0.07); sweat chloride decreased from 116±10 to 90±17 mEq/L (p = 0.017) and chronic pseudomonas airway infection was eradicated in one subject. ConclusionsThis study supports a clinical benefit for CFTRm therapy in pwCF carrying the I1234V mutation.

The effect of GnRH analog treatment on BMI in children treated for precocious puberty: a systematic review and meta-analysis.

The purpose of the present meta-analysis was to systematically evaluate the effect of GnRHa treatment on the BMI of children with precocious puberty after GnRHa treatment as compared to before, and to analyze the effect of GnRHa treatment on the body composition of children with precocious puberty at different BMIs by classifying into normal body mass, overweight, and obese groups according to BMI at the time of initial diagnosis. A meta-analysis was performed using Stata 12.0 software by searching PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), and Wan fang database for relevant literature on standard deviation score of body mass index (BMI-SDS) after GnRHa treatment as compared to before in children with precocious puberty. A total of eight studies were included with a total sample size of 715 cases, and the results of meta-analysis showed that BMI-SDS increased in children with precocious puberty after GnRHa treatment as compared to before starting [(weighted mean difference (WMD)=0.23, 95 % CI: 0.14-0.33, p=0.000)] and also increased in children with normal body mass [(WMD=0.37, 95 % CI: 0.28-0.46, p=0.000)], and there was no significant change in BMI-SDS in children in the overweight or obese group [(WMD=0.01, 95 % CI:-0.08-0.10, p=0.775)]. Overall, there was an observed increase in BMI-SDS at the conclusion of GnRHa treatment in children with precocious puberty. Additionally, it was found that the effect of GnRHa treatment on body composition varied among children with different BMI status. Clinicians should emphasize the promotion of a healthy lifestyle and personalized dietary managementfor children.

The effects of acute social ostracism on subsequent snacking behavior and future body mass index in children.

Ostracism may lead to increased food intake, yet it is unclear whether greater reactivity to ostracism contributes to higher body mass index (BMI). We investigated whether children who exhibited greater stress to social exclusion subsequently consume more energy and whether this predicts BMI 6- and 18-months later. Children (8.5 years-old) (N = 262, males = 50.4%; Chinese = 58.4%) completed a laboratory-based manipulation of social exclusion (the Cyberball task) prior to an ad-libitum snack. Heart rate variability (HRV) was measured during the inclusion and exclusion conditions and proportionate changes were calculated as a physiological measure of exclusion-related stress. Social anxiety and social-emotional assets were also measured as moderators. Greater stress (as measured physiologically or by self-report) did not directly, or indirectly via energy intake, predict later BMI (at 9- and 10-years). However, among children reporting higher social anxiety, greater stress as measured by proportionate changes in HRV was associated with increased energy intake (B = 532.88, SE = 226.49, t(255) = 2.35, [CI95 = 86.85,978.92]). A significant moderated mediation was also observed (index: (b = 0.01, bootSE = 0.01, [CI95 = 0.001, 0.036]), such that among children reporting higher social anxiety, greater stress from social exclusion predicted increased energy intake from a subsequent snack, which in turn predicted higher BMI 1.5 years later. This prospective study suggests that a pattern of greater snack intake in response to heightened vulnerability to the effects of ostracism may contribute to increases in child BMI scores.

Accelerometer-Measured Physical Activity, Sedentary Time, and Heart Failure Risk in Women Aged 63 to 99 Years

Heart failure (HF) prevention is paramount to public health in the 21st century. To examine incident HF and its subtypes with preserved ejection fraction (HFpEF) and reduced EF (HFrEF) according to accelerometer-measured physical activity (PA) and sedentary time. This was a prospective cohort study, the Objective Physical Activity and Cardiovascular Health (OPACH) in Older Women study, conducted from March 2012 to April 2014. Included in the analysis were women aged 63 to 99 years without known HF, who completed hip-worn triaxial accelerometry for 7 consecutive days. Follow-up for incident HF occurred through February 2022. Data were analyzed from March to December 2023. Daily PA (total, light, moderate to vigorous PA [MVPA], steps) and sedentary (total, mean bout duration) behavior. Adjudicated incident HF, HFpEF, and HFrEF. A total of 5951 women (mean [SD] age, 78.6 [6.8] years) without known HF were included in this analysis. Women self-identified with the following race and ethnicity categories: 2004 non-Hispanic Black (33.7%), 1022 Hispanic (17.2%), and 2925 non-Hispanic White (49.2%). There were 407 HF cases (257 HFpEF; 110 HFrEF) identified through a mean (SD) of 7.5 (2.6) years (range, 0.01-9.9 years) of follow-up. Fully adjusted hazard ratios (HRs) for overall HF, HFpEF, and HFrEF associated with a 1-SD increment were 0.85 (95% CI, 0.75-0.95), 0.78 (95% CI, 0.67-0.91), and 1.02 (95% CI, 0.81-1.28) for minutes per day total PA; 0.74 (95% CI, 0.63-0.88), 0.71 (95% CI, 0.57-0.88), and 0.83 (95% CI, 0.62-1.12) for steps per day; and 1.17 (95% CI, 1.04-1.33), 1.29 (95% CI, 1.10-1.51), and 0.94 (95% CI, 0.75-1.18) for minutes per day total sedentary. Cubic spline curves for overall HF and HFpEF were significant inverse for total PA and steps per day and positive for total sedentary. Light PA and MVPA were inversely associated with overall HF (HR per 1 SD: 0.88; 95% CI, 0.78-0.98 and 0.84; 95% CI, 0.73-0.97) and HFpEF (0.80; 95% CI, 0.70-0.93 and 0.85; 95% CI, 0.72-1.01) but not HFrEF. Associations did not meaningfully differ when stratified by age, race and ethnicity, body mass index, physical function, or comorbidity score. Results for sedentary bout duration were inconsistent. Higher accelerometer-measured PA (MVPA, light PA, steps per day) was associated with lower risk (and greater total sedentary time with higher risk) of overall HF and HFpEF in a racially and ethnically diverse cohort of older women. Increasing PA and reducing sedentary time for primary HFpEF prevention may have relevant implications for cardiovascular resilience and healthy aging in later life.

Relations between the levels of moderate to vigorous physical activity, BMI, dietary habits, cognitive functions and attention problems in 8 to 9 years old pupils: network analysis (PACH Study).

Physical activity (PA) and dietary habits (DH) play a crucial role on quality of life and health outcomes from various aspects. This study aims to investigate the relations between recommended daily levels of moderate to vigorous physical activity (MVPA) in 8 to 9year old pupils, and their body mass index (BMI), DH, cognitive functions and attention problem scores by network analysis. Study participants were split into two groups based on their MVPA levels on weekdays. Our findings suggest that children who reach recommended MVPA levels consume more vegetables and fruits, eat breakfast more frequently, have better motor speed and lower impulsivity score. The number of interlinkages between various parameters in network structure for children who do not reach recommended MVPA levels is greater and more intense, highlighting the differences between the groups and suggesting that different interventions and approaches to improve/change lifestyle habits might be used.

Risk factors of acute respiratory distress syndrome in sepsis caused by intra-abdominal infections: A retrospective study

BackgroundIntra-abdominal infections are frequently associated with acute respiratory distress syndrome, which significantly affects patient prognosis. However, little is known about the specific risk factors of acute respiratory distress syndrome in sepsis caused by intra-abdominal infections. MethodsThis retrospective study included adult patients with intra-abdominal sepsis admitted to the intensive care unit of a tertiary teaching hospital in China between June 2017 and June 2022. Patients were categorized based on the presence or absence of acute respiratory distress syndrome. Data, including vital signs, laboratory values, and severity scores collected within 24 hours of sepsis diagnosis, as well as outcomes within 90 days, were analyzed. Multivariable logistic regression was used to identify independent risk factors associated with acute respiratory distress syndrome. ResultsA total of 738 patients were included, of whom 218 (29.5%) developed acute respiratory distress syndrome. Patients with acute respiratory distress syndrome were younger, had a higher body mass index and disease severity scores, and exhibited higher proportions of septic shock and hospital-acquired intra-abdominal infections. The mortalities in the intensive care unit and at 28 and 90 days were higher in the acute respiratory distress syndrome group. In the multivariate logistic regression model, age under 65 years (odds ratio [95% confidence interval]: 1.571 [1.093–2.259]), elevated body mass index (2.070 [1.382–3.101] for overweight, 6.994 [3.207–15.255]) for obesity, septic shock (2.043 [1.400–2.980]), procalcitonin (1.009 [1.004–1.015]), hospital-acquired intra-abdominal infections (2.528[1.373–4.657]), and source of intra-abdominal infections (2.170 [1.140–4.128] for biliary tract infection, 0.443 [0.217–0.904] for gastroduodenal perforation) were independently associated with acute respiratory distress syndrome. ConclusionIn patients with intra-abdominal sepsis, age under 65 years, higher body mass index and procalcitonin, septic shock, hospital-acquired intra-abdominal infections, and biliary tract infection were risk factors for acute respiratory distress syndrome.

Epidemiology and outcomes of multidrug-resistant bacterial infection in non-cystic fibrosis bronchiectasis

PurposeMultidrug-resistant (MDR) bacteria impose a considerable health-care burden and are associated with bronchiectasis exacerbation. This study investigated the clinical outcomes of adult patients with bronchiectasis following MDR bacterial infection.MethodsFrom the Chang Gung Research Database, we identified patients with bronchiectasis and MDR bacterial infection from 2008 to 2017. The control group comprised patients with bronchiectasis who did not have MDR bacterial infection and were propensity-score matched at a 1:2 ratio. The main outcomes were in-hospital and 3-year mortality.ResultsIn total, 554 patients with both bronchiectasis and MDR bacterial infection were identified. The types of MDR bacteria that most commonly affected the patients were MDR- Acinetobacter baumannii (38.6%) and methicillin-resistant Staphylococcus aureus (18.4%), Extended-spectrum-beta-lactamases (ESBL)- Klebsiella pneumoniae (17.8%), MDR-Pseudomonas (14.8%), and ESBL-E. coli (7.5%). Compared with the control group, the MDR group exhibited lower body mass index scores, higher rate of chronic bacterial colonization, a higher rate of previous exacerbations, and an increased use of antibiotics. Furthermore, the MDR group exhibited a higher rate of respiratory failure during hospitalization (MDR vs. control, 41.3% vs. 12.4%; p < 0.001). The MDR and control groups exhibited in-hospital mortality rates of 26.7% and 7.6%, respectively (p < 0.001); 3-year respiratory failure rates of 33.5% and 13.5%, respectively (p < 0.001); and 3-year mortality rates of 73.3% and 41.5%, respectively (p < 0.001). After adjustments were made for confounding factors, the infection with MDR and MDR bacteria species were determined to be independent risk factors affecting in-hospital and 3-year mortality.ConclusionsMDR bacteria were discovered in patients with more severe bronchiectasis and were independently associated with an increased risk of in-hospital and 3-year mortality. Given our findings, we recommend that clinicians identify patients at risk of MDR bacterial infection and follow the principle of antimicrobial stewardship to prevent the emergence of resistant bacteria among patients with bronchiectasis.

Treatment of esophageal adenocarcinoma in patients with a history of bariatric surgery

The relationship among obesity, bariatric surgery, and esophageal adenocarcinoma (EAC) is complex, given that some bariatric procedures are thought to be associated with increased incidence of reflux and Barrett's esophagus. Previous bariatric surgery may complicate the use of the stomach as a conduit for esophagectomy. In this study, we presented our experience with patients who developed EAC after bariatric surgery and described the challenges encountered and the techniques used. We conducted a retrospective review of our institutional database to identify all patients at our institution who were treated for EAC after previously undergoing bariatric surgery. In total, 19 patients underwent resection with curative intent for EAC after bariatric surgery, including 10 patients who underwent sleeve gastrectomy. The median age at diagnosis of EAC was 63 years; patients who underwent sleeve gastrectomy were younger (median age, 56 years). The median time from bariatric surgery to EAC was 7 years. Most patients had a body mass index (BMI) score of >30kg/m2 at the time of diagnosis of EAC; approximately 40% had class III obesity (BMI score > 40kg/m2). Six patients (32%) had known Barrett's esophagus before undergoing a reflux-increasing bariatric procedure. Sleeve gastrectomy patients underwent esophagectomy with gastric conduit, colonic interposition, or esophagojejunostomy. Only 1 patient had an anastomotic leak (after esophagojejunostomy). Endoscopy should be required both before (for treatment selection) and after all bariatric surgical procedures. Resection of EAC after bariatric surgery requires a highly individualized approach but is safe and feasible.

A second chance for a new heart? The role of metabolic and bariatric surgery in patients with end-stage heart failure

Obesity is an independent risk factor for heart failure (HF). Substantial weight loss has been shown to reverse obesity-related cardiomyopathy. This study aimed to report our institution's experience with laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity and end-stage HF. Between 2018 and 2022, 26 patients with end-stage HF were referred for LSG. Of 26 patients, 16 underwent an operation, and 10 did not. After institutional review board approval, a retrospective electronic medical record review was performed to evaluate (i) age, (ii) preoperative weight, (iii) decrease in body mass index (BMI) score, (iv) whether the patient underwent heart transplantation, and (v) mortality. Data analysis was performed using Stata/SE (version 17.0; StataCorp). The Wilcoxon rank-sum test was used to compare continuous variables between the cohorts, and the Pearson chi-square test was used for binary variables with Bonferroni correction applied. The LSG and non-LSG cohorts had comparable ages (P=.088) and starting BMI score (P=.918), and a proportion of patients had a ventricular assist device (P=.191). Patients who underwent LSG lost significantly more weight than the patients who did not, with an average decrease in BMI score of 8.9kg/m2 (SD, ±6.13) and 1.1kg/m2 (SD, ±4.10), respectively (P=.040). Of note, 6 patients (37.5%) who underwent LSG eventually underwent transplantation, compared with 2 patients (20.0%) from the matched cohort (P=.884). Of the 26 patients, there were 6 deaths: 2 (12.5%) in the LSG cohort and 4 (40.0%) in the non-LSG cohort (P=.525). LSG may be safe and effective for weight loss in patients with HF. This operation may provide patients affected by obesity with end-stage HF the lifesaving opportunity to achieve transplant candidacy.

Body mass index is associated with health-related quality of life and disease characteristics in young adults with juvenile idiopathic arthritis

BackgroundThere is a growing interest concerning the relationship between obesity and several medical conditions and inflammation. Nevertheless, there is a lack of studies regarding body mass index (BMI) among patients with juvenile idiopathic arthritis (JIA). Our aim was to investigate the impact of BMI on health-related quality of life (HRQoL) measured with a 36-Item Short Form Survey (SF-36), disease activity, and disability in young adults with JIA.MethodsThis study is a part of the population-based Nordic JIA cohort study. All newly diagnosed patients with JIA were recruited consecutively between 1997–2000 in specific regions in the Nordic countries. Patients in this sub-study were enrolled from 434 patients who attended their 18-year follow-up visit. Patients were classified according to the World Health Organization (WHO) into four groups based on their BMI. HRQoL, disease characteristics, disability, fatigue, sleep quality, physical activity, pain, comorbidities, and social status were assessed.ResultsThree hundred fifty-five patients from the original study cohort were enrolled in this study and 72% of them were female. Mean age was 23.9 (± SD 4.4) years. A significant relationship was found between the JIA categories and BMI groups (p = 0.014). A significant relationship was also found between BMI and disease activity scores (DAS28) (p = 0.028), disability (p < 0.001), pain (p = 0.013), fatigue (p = 0.035), and sleep quality (p = 0.044). Moreover, a significant relationship between BMI and HRQoL regarding bodily pain (p = 0.010) and general health (p = 0.048) was revealed when adjusted for sex, age, and JIA subtype.ConclusionWe discovered that BMI was significantly related to HRQoL, disease activity, and disability. BMI deserves more attention considering the treatment options and outcome of JIA in young adults.

The Interaction Between Body Mass Index Genetic Risk Score and Dietary Intake on Weight Status: A Systematic Review.

The escalating global obesity epidemic and the emergence of personalized medicine strategies point to the pressing need to investigate the interplay between genetic risk scores (GRSs), dietary intake, and their combined impact on weight status. This systematic review synthesizes evidence from diverse studies to elucidate how dietary patterns and individual foods interact with genetic predisposition to obesity. Literature searches were conducted in the PubMed, Embase, Science Direct, and Scopus databases until August 2023, following PRISMA guidelines. Out of 575 articles, 15 articles examining the interaction between genetic risk score for body mass index and dietary intake on weight outcomes met the inclusion criteria. All included studies were cross-sectional in design and were assessed for quality using the Newcastle‒Ottawa Scale. Unhealthy dietary intake exacerbated the genetic predisposition to obesity, evident in studies assessing Western diet, sulfur microbial diet, and individual macronutrients, including saturated fatty acids, sugar-sweetened beverages and fried foods. Conversely, adhering to healthier dietary intake mitigated the genetic predisposition to obesity, as observed in studies involving Alternative Healthy Eating Index, Alternative Mediterranean Diet, Dietary Approach to Stop Hypertension scores, healthy plant-based diets, and specific foods such as fruits, vegetables, and n-3 polyunsaturated fatty acids. This is the first systematic review to explore the interaction between genetics and dietary intake in shaping obesity outcomes. The findings have implications for tailored interventions; however, more controlled clinical trials with robust designs are needed to be able to recommend personalized nutrition based on nutrition for obesity prevention and management.

Abstract 99: Association of Life Essential 8 Score With Major Vascular Outcomes. Results of the Hispanic Community Health Study/Study of Latinos

Background: The “Life’s Essential 8” (LE8) score is a new tool to determine cardiovascular health (CVH). This includes diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure levels. Here we investigated the association of LE8 with incident major adverse cardiovascular events (MACE) among Hispanic/Latino adults living in the US. Design/Method: Baseline characteristics (n=13,956) of HCHS/SOL participants were determined between 2008 and 2011. Annual follow-up interviews were conducted from inception until 2016 to determine outcomes of interest. Hospital records were reviewed and incident MACE, defined as the composite of incident stroke, myocardial infarction, or heart failure, was adjudicated using standard criteria. LE8 scores (range 0 to 100, with higher scores denoting better CVH) were determined using published definitions. Incident rate ratios (IRR) of MACE across LE8 (modeled in 20-points increments) were determined using Poisson regression models and adjusting for baseline characteristics. Analyses were weighted for complex survey design and non-response. Results: The mean age (95% CI) at baseline was 40.7 (40.2-41.2) years and 60.6% were females. The mean LE8 score was 68.5 (68.0-69.1). Compared to females, males achieved higher scores in diet (44.9 vs. 36.1, P&lt;0.001), physical activity (82.1 vs. 69.3; p&lt;0.001), and body mass index (60.1 vs. 56.9; p&lt;0.001) and lower scores in nicotine exposure (65.0 vs. 77.1; p&lt;0.001), blood lipids (59.4 vs. 65.1; p&lt;0.001), blood pressure (70.4 vs. 77.5; p&lt;0.001). A total of 181 outcomes occurred during the mean follow-up of 6.8 (6.8-6.9) years. In the fully adjusted model, higher LE8 was associated with a lower incidence of MACE (IRR 0.47, 95% CI 0.30-0.74 for all; IRR 0.44, 95% CI 0.23 to 0.84 in males; IRR 0.49, 95% CI 0.28-0.85 in females). Conclusion: Among Hispanic/Latino adults, better CVH, quantified using LE8, is associated with a lower incidence of stroke, myocardial infarction, or heart failure.

Effect of Nail Disorders on Quality of Life Scale Scores: A Prospective, Cross-sectional Study from a Tertiary Referral Center.

To investigate the relationships among nail disorders, various clinical factors, and commonly used quality of life scales. A prospective cross-sectional study was conducted on 188 patients older than 18 years who applied to the Dermatology and Venereology Department of Ufuk University Hospital (Ankara, Turkey). The Turkish Quality of Life instrument, the Hospital Anxiety and Depression Scale, and the 36-Item Short-Form Health Survey were used for the analyses. Eight groups were formed based on 1) sex, 2) age (18-45 years, >45 years), 3) duration of nail disease (≤1 year, >1 year), 4) number of affected nails (1, 2, ≥3), 5) type of nail disease (nail thickening, ingrown toenail, pincer nail, and other nail diseases), 6) presence of onychomycosis, 7) fingernail involvement, and 8) pain score (0-5, 6-10), and the quality of life scales were compared between these groups. In addition, correlation analyses were performed between age, number of affected nails, duration of disease, presence of onychomycosis, chronic diseases and medications, and body mass index and the quality of life scale scores. Nail disorders were associated with decreased quality of life in affected individuals. Moreover, age, duration of disease, type of nail disorder, body mass index, comorbid conditions, and pain scores had significant effects on quality of life scale scores. Management of nail disorders is challenging, and generally, a long period is necessary to achieve favorable outcomes. Both physcians and patients should be persistent during the treatment process. In addition, emotional and social support should be provided to patients.

Abstract HUP6: Ideal Cardiovascular Health and the Intersectionality of Race/Ethnicity and Sexual Identity

Introduction: Disparities exist in cardiovascular health (CVH) by sexual identity and race/ethnicity separately, however an understanding of the intersectional effect of these identities has been limited. Objective: To evaluate differences in ideal CVH, as captured in the American Heart Association’s Life’s Essential 8 framework, across race/ethnicity and sexual identity. Methods: This study used data from the National Health and Nutrition Examination Survey (NHANES, 2007-2016). Non-institutionalized adults (18-59 years) without a history of cardiovascular disease/stroke and who were not pregnant at the time of the interview were included. Self-reported race/ethnicity was categorized as non-Hispanic Black (hereafter Black), Hispanic, non-Hispanic White (hereafter White), and another race. Self-reported sexual identity was categorized as straight and sexual minority (SM), which encompassed those who identified as lesbian, gay, bisexual, or something else. The primary outcome was total CVH score (range 0 -100), which is the unweighted average of 8 CVH components, assessed using questionnaire, dietary, and physical examination data. Sex-stratified regression models were developed for the overall CVH score and CVH components, adjusting for age and study year. Results: The sample included 12,256 adults (mean age 39.6 years [SD 11.7]). While Black (ß= -4.9, 95% CI -7.7, -2.0), Hispanic (ß= -4.9, 95% CI -9.6, -0.2), and White (ß = -5.9, 95% CI -8.8, -3.0) SM female adults had lower total CVH scores compared to their straight counterparts, female participants of another race and SM male adults of any race/ethnicity did not. Black SM female individuals had less favorable nicotine (ß= -20.9, 95% CI -32.3, -9.4) and blood pressure (ß= -7.2, 95% CI -13.8, -0.6) scores compared with Black straight females. Hispanic SM female individuals had less favorable body mass index scores (ß= -15.6, 95% CI -28.0, -3.2) compared with Hispanic straight females. Conclusions: CVH differed across racial/ethnic identities in SM females but not SM males. Longitudinal studies are needed to identify mechanisms driving CVH disparities in Black and Hispanic SM females.

Age-dependent genes in adipose stem and precursor cells affect regulation of fat cell differentiation and link aging to obesity via cellular and genetic interactions

BackgroundAge and obesity are dominant risk factors for several common cardiometabolic disorders, and both are known to impair adipose tissue function. However, the underlying cellular and genetic factors linking aging and obesity on adipose tissue function have remained elusive. Adipose stem and precursor cells (ASPCs) are an understudied, yet crucial adipose cell type due to their deterministic adipocyte differentiation potential, which impacts the capacity to store fat in a metabolically healthy manner.MethodsWe integrated subcutaneous adipose tissue (SAT) bulk (n=435) and large single-nucleus RNA sequencing (n=105) data with the UK Biobank (UKB) (n=391,701) data to study age-obesity interactions originating from ASPCs by performing cell-type decomposition, differential expression testing, cell-cell communication analyses, and construction of polygenic risk scores for body mass index (BMI).ResultsWe found that the SAT ASPC proportions significantly decrease with age in an obesity-dependent way consistently in two independent cohorts, both showing that the age dependency of ASPC proportions is abolished by obesity. We further identified 76 genes (72 SAT ASPC marker genes and 4 transcription factors regulating ASPC marker genes) that are differentially expressed by age in SAT and functionally enriched for developmental processes and adipocyte differentiation (i.e., adipogenesis). The 76 age-perturbed ASPC genes include multiple negative regulators of adipogenesis, such as RORA, SMAD3, TWIST2, and ZNF521, form tight clusters of longitudinally co-expressed genes during human adipogenesis, and show age-based differences in cellular interactions between ASPCs and adipose cell types. Finally, our genetic data demonstrate that cis-regional variants of these genes interact with age as predictors of BMI in an obesity-dependent way in the large UKB, while no such gene-age interaction on BMI is observed with non-age-dependent ASPC marker genes, thus independently confirming our cellular ASPC results at the biobank level.ConclusionsOverall, we discover that obesity prematurely induces a decrease in ASPC proportions and identify 76 developmentally important ASPC genes that implicate altered negative regulation of fat cell differentiation as a mechanism for aging and directly link aging to obesity via significant cellular and genetic interactions.

The DDD score outperforms the RENAL score in predicting high-grade renal cell carcinoma.

To explore the relationship between Fuhrman grade of renal cell carcinoma (RCC) and the DDD score. We reviewed the records of 527 nonmetastatic RCC patients. Demographic, clinical, and pathologic characteristics were reviewed. Binary logistic regression was used to explore the independent risk factors for high-grade RCC (HGRCC). Sex, BMI (Body Mass Index), RNS, and DDD score were significantly correlated with HGRCC. Based on these independent risk factors, we constructed two predictive models integrating the RNS and DDD scores with sex and BMI to predict tumor grade. The calibration curves of the predictive model showed good agreement between the observations and predictions. The concordance indexes (C-indexes) of the predictive models were 0.768 (95% CI, 0.713-0.824), and 0.809 (95% CI, 0.759-0.859). Receiver operating characteristic (ROC) curves were performed to compare the predictive power of the nomograms, and the prediction model including the DDD score had better prognostic ability (p = 0.01). This study found that RNS, DDD score, BMI, and sex were independent predictors of HGRCC. We developed effective nomograms integrating the above risk factors to predict HGRCC. Of note, the nomogram including the DDD score achieves better prediction ability for HGRCC.