Body Mass Index Research Articles

Antidiabetic Medication and Asthma Attacks

ImportanceElevated body mass index (BMI) and type 2 diabetes are prevalent in asthma and are associated with an increase in the risk of asthma attacks. In experimental studies, the diabetes medications metformin and glucagon-like peptide-1 receptor agonists (GLP-1RA) have mitigated airway inflammation, hyperresponsiveness, and remodeling. However, epidemiological evidence is limited.ObjectiveTo estimate the association of metformin and add-on antidiabetic medications (GLP-1RA, dipeptidyl peptidase-4 inhibitors, sulphonylureas, sodium-glucose cotransporter-2 inhibitors, and insulin) with asthma attacks.Design, Setting, and ParticipantsThe study used data from the UK Clinical Practice Research Datalink (CPRD) Aurum linked hospital admissions and mortality data from 2004 to 2020. A triangulation approach was used that applied 2 distinct approaches to enhance robustness: a self-controlled case series (SCCS) and a metformin new user cohort with inverse probability of treatment weighting (IPTW). Eligible participants were new users of metformin with type 2 diabetes. To evaluate the association between metabolic phenotypes (BMI, glycemic control) and asthma phenotypes (type 2 inflammation, asthma severity), interaction analyses were conducted. Negative control analyses were conducted to assess for bias.ExposureThe primary exposure was metformin; secondary exposures included add-on antidiabetic medications.Main OutcomesThe primary outcome was first asthma exacerbation (short course of oral corticosteroids, unscheduled asthma-related hospital attendance, or death) during 12-month follow-up. Incidence rate ratios (IRRs) with 95% CIs were estimated using fixed-effect conditional Poisson models in the SCCS, and hazard ratios (HRs) were estimated using weighted Cox proportional hazards models in the cohort.ResultsOf more than 2 million adults with asthma, 4278 patients (2617 women [61.2%]; mean [SD] age, 52.9 [13.6] years) were identified for the SCCS and 8424 patients (4690 women [55.7%]; unexposed: mean [SD] age, 61.6 [13.2] years; exposed: mean [SD] age, 59.7 [13.7] years) for the IPTW cohort. Metformin was found to be associated with fewer asthma attacks of similar magnitude in both approaches (SCCS: IRR, 0.68; 95% CI, 0.62-0.75; IPTW: HR, 0.76; 95% CI, 0.67-0.85). Negative control analyses did not find evidence of significant bias. Hemoglobin A1c levels, BMI, blood eosinophil cell counts, and asthma severity did not modify the association. The only add-on antidiabetic medication to have an additive association was GLP-1RA (SCCS: IRR, 0.60; 95% CI, 0.49-0.73).Conclusions and RelevanceThe results of this cohort study suggest that metformin was associated with a lower rate of asthma attacks, with further reductions with the use of GLP-1RA. This appeared to be associated with mechanisms other than through glycemic control or weight loss and occurred across asthma phenotypes.

Interrogating the Antiobesity Efficacy of Flacourtia Inermis Roxb. Fruits in High Fat Diet-induced Obese Rats

Background Flacourtia inermis Roxb. (Salicaceae) is an underutilized edible fruit known for its antioxidant-rich bioactive compounds. This study explores the antiobesity potential of F. inermis ethanolic fruit extract (FF2) in a high-fat diet (HFD) induced obesity model using Wistar albino rats. Materials and Methods Wistar albino rats were randomly assigned into five groups (n = 6). Group 1 served as the normal control and received a normal diet (ND), while Groups II–V were induced with obesity by being fed an HFD for 10 weeks. Group II acted as the obese control, receiving 100% HFD throughout the study. Groups III, IV, and V also received HFD throughout the study but were supplemented with Orlistat (30 mg/kg b.w), and FF2 extract at doses of 200 mg/kg, and 400 mg/kg, respectively, from week 11 until week 15. Treatment impact of FF2 on body weight, body mass index (BMI), serum lipid levels, glucose levels, liver function parameters, and histopathological evaluations of liver and adipose tissue were investigated. Results The study unveiled that F. inermis fruits exerted potent antiobesity effects, with FF2 treatment (at 200 mg/kg and 400 mg/kg) substantially decreasing body weight gain and BMI in comparison to the HFD group. Supplementation of FF2 alongside an HFD reduced body weight gain, glucose levels, and serum lipid profile. Both doses of FF2 counteracted the adverse effects induced by HFD, with lower triglycerides (TG), total cholesterol, and LDL cholesterol levels, and higher HDL cholesterol levels in the treated groups compared to the positive control. Additionally, FF2 extract showed dose-dependent improvements in serum lipid and glucose levels, as well as, hepatic profile, indicated by decreased AST, ALP, and ALT levels, suggesting potential benefits in managing dyslipidemia, hyperglycemia, and liver health associated with obesity. Histological examination of white adipose tissue provided further evidence of the antiobesity effect. Conclusion The study highlights FF2’s therapeutic potential in managing obesity and associated metabolic disorders. Further investigations into FF2’s mechanisms and clinical application are essential for its development as an antiobesity therapeutic agent in functional food formulations.

Associations between Sensitivity to Thyroid Hormones and Visceral Adiposity in Euthyroid Adults

Abstract Objectives The study aimed to explore the association between thyroid hormone (TH) sensitivity and obesity assessed by body mass index (BMI) and visceral adiposity index (VAI) in euthyroid adults. Methods This cross-sectional study used the thyroid feedback quantile-based index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotrophic T4 resistance index (TT4RI) to indicate central TH sensitivity, and VAI to assess visceral obesity. Participants were categorized according to tertiles. We used logistic and linear regressions to explore the association stratified by sex. Results The study enrolled 5411 men and 5749 women with normal thyroid function. Men with the highest tertile of TT4RI had 1 kg/m2 higher BMI compared with men with the lowest tertile of TT4RI (P=0.001) after adjustment for age, hypertension, hyperlipidemia, diabetes, hyperuricemia, and renal function. There was no significant difference in BMI across tertiles of TFQI and TSHI in men, and TFQI, TSHI, and TT4RI in women after adjustment for other risk factors. TH sensitivity indices were positively related to VAI after adjustment for confounders in women but not in men. There were 1.21 (95%CI:1.02-1.44, P=0.03), 1.43 (95%CI: 1.20-1.70, P<0.001), and 1.47 (95%CI: 1.23 - 1.75, P<0.001) times higher odds of having high VAI among women in the highest TFQI, TSHI, and TT4RI tertiles respectively, compared to women in the lowest tertile. Conclusions Reduced central TH sensitivity was associated with increased visceral adiposity in women but not men. Our findings supplemented the evidence of the importance of TH sensitivity to metabolic disorders, especially among women.

The Influence of X Chromosome Parent-of-Origin on Glycemia in Individuals with Turner syndrome

Introduction: The cause of increased diabetes mellitus (DM) risk in individuals with Turner syndrome (TS) is poorly understood. Parent-of-origin effects related to whether the maternal or paternal X chromosome (Xchr) remains intact have been found for several TS phenotypes, including hypercholesterolemia. Therefore, Xchr parent-of-origin may impact DM risk in TS. The aim of this study was to determine whether Xchr parent-of-origin affects glycemia, as measured by oral glucose tolerance test (OGTT), in TS. Methods: A total of 81 individuals with 45,X karyotype from the TS: Genotype Phenotype study had Xchr parent-of-origin assessment and completed a 3-hour OGTT. Parallel-slopes multiple linear regression modeling was used to test whether Xchr parent-of-origin, age, and/or body mass index (BMI) significantly predicted incremental area under the glucose curve (iAUC). A second analysis included 62 additional individuals with 45,X mosaicism. Results: All three factors predicted iAUC glucose in the 81 individuals with 45,X karyotype (age: B = 0.36, p = 0.0004; BMI: B = 0.33, p = 0.001; Xchr parent-of-origin: B = 0.21; p = 0.01). The overall model remained statistically significant when including individuals with 45,X mosaicism, but Xchr parent-of-origin was no longer significant. Conclusions: Maternal Xchr monosomy predicts higher glucose concentration than paternal Xchr monosomy in response to oral glucose in 45,X individuals. This effect is obscured when including individuals who are mosaic, potentially due to the presence of both parent Xchrs in the non-45,X cell line.

Real-world safety of spesolimab in generalized pustular psoriasis: Evidence from an expanded access program in Argentina

Introduction: Generalized pustular psoriasis (GPP) is a heterogeneous, systemic, neutrophilic, inflammatory disease associated with chronic symptoms and periods of flaring. Spesolimab is an anti-interleukin-36 receptor monoclonal antibody approved for the treatment of flares in adult patients with GPP in Argentina (17 Aug 2023).1 Here, we present safety data from a real-world expanded access program (EAP: 22 Feb 2023–10 Jan 2024) in Argentina which provided early access to spesolimab intravenous (IV) for GPP patients presenting with a flare with no other treatment options. Methods: Patients (18–75 years old) diagnosed with GPP received a 900mg dose of spesolimab IV for flare treatment, with an optional second dose after 1 week for persistent flare symptoms. Adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs) were recorded for up to 16 weeks after the last spesolimab infusion.Results: Six female patients were treated with spesolimab IV (1 dose, n=2; 2 doses, n=4).Mean (standard deviation [SD]) age: 49.3 (11.5) years (range: 30–60 years), mean (SD) body mass index: 28.1 (5.8) kg/m2, and mean (SD) follow-up: 3.85 (0.11) months. At baseline, GPP had been diagnosed within ≤1 year (n=2), >1–≤5 years (n=1), and >10 years (n=3). Reported flare triggers were stress (n=2), treatment withdrawal (n=1), heat (n=1), lack of current treatment efficacy (n=1), and unknown (n=1). At baseline, 4 patients had ≥1 comorbidity, including hypertension (n=2), tachycardia, hypothyroidism, chronic gastritis, arthritis, and epilepsy (each n=1). Five patients reported use of ≥1 concomitant medication (including immunosuppressants and corticosteroids) during the EAP; 1 patient had discontinued ustekinumab (biologic). Three patients had signs of plaque psoriasis within the past year and had received treatment for plaque psoriasis; 1 patient had ongoing plaque psoriasis. In total, 4 patients had any AEs (all 4 patients had mild AEs [influenza, catarrh, pruritis, rash, pain] and 1 of these patients also had a moderate AE [headache]). Two drug-related AEs (pruritus and rash) were reported in 1 patient. The hypersensitivity event (rash) was non-serious. There were no reports of SAEs, AESIs, or AEs that led to discontinuation/death. Conclusion: Spesolimab showed a favorable safety profile in patients with GPP, including patients with comorbidities and those taking concomitant medication. Findings were comparable with a Phase 2a randomized controlled trial in patients with GPP flares (EFFISAYIL 1).

Causal association of obesity-related anthropometric traits with myopia and the mediating role of educational attainment: a Mendelian randomization study

AIM: To study the causal relationship between obesity-related anthropometric traits and myopia and the mediating role of educational attainment (EA). METHODS: Univariable Mendelian randomization (UVMR) was performed to evaluate the causal association between body mass index (BMI), height, waist-hip ratio (WHR, adjusted for BMI), and mean spherical equivalent (MSE). BMI was divided into fat and fat-free mass and included in multivariable Mendelian randomization (MVMR) to explore the roles of different BMI components in the causal relationship between BMI and MSE. A mediation analysis based on two-step Mendelian randomization (MR) was carried out. Specifically, UVMR was conducted to estimate the causal effect of BMI on EA. The direct effect of EA on MSE was estimated from MVMR. The mediation effect of EA in the BMI-EA-MSE model was calculated by the product of coefficients method. Expression quantitative trait loci (eQTL)-MR, reverse MR, and Linkage Disequilibrium Score Regression (LDSC) were performed to assess the robustness. RESULTS: Genetically predicted higher BMI had a positive total effect on MSE (βIVW=0.26 D, 95%CI=0.14 to 0.37 D, P<0.001), whereas there was no significant association between height, WHR, and MSE. Fat mass was found to play a significant role in the effect of body mass on MSE (βIVW=0.50 D, 95%CI=0.21 to 0.78 D, P=0.001), but there was no significant association between fat-free mass and MSE. The causal effect of BMI on EA was -0.14 (95%CI=-0.16 to -0.11, P<0.001), and the direct effect of EA on MSE was -0.63 D (95%CI=-0.81 to -0.44 D, P<0.001). The mediating effect of EA in the BMI-EA-MSE model was 0.09 D (95%CI=0.06 to 0.12 D), with a mediation proportion of 33% (95%CI=22.1% to 44.6%). No reverse causal associations were detected except for BMI on EA. The results of eQTL-MR and LDSC were consistent with each MR analysis. CONCLUSION: Genetically predicted higher BMI decreases the degree of myopia with a 33% mediation proportion by EA, and fat mass provides a dominant protective role in body mass-myopia. As a supplement to previous observational studies, it provides strong evidence for the relationship between anthropometric traits and refractive errors and offers a theoretical basis for future measures to prevent and control myopia.

Clinical significance of visual cardiac 18F-FDG uptake in advanced non-small cell lung cancer

Abstract Background Two-deoxy-2-[fluorine-18]-fluoro-d-glucose (18F-FDG) positron emission tomography (PET) is useful for detecting malignant lesions; however, the clinical significance of cardiac 18F-FDG uptake in patients with cancer remains unclear. This preliminary study explored the relationship between cardiac 18F-FDG uptake and advanced diseases such as cancer cachexia in non-small cell lung cancer (NSCLC). Methods Forty-three patients with advanced NSCLC who underwent 18F-FDG PET and complained of weight loss before the first-line systemic therapy were retrospectively included in this study. Visual assessment using a 5-point scale based on 18F-FDG uptake was performed; a cut-off score of 3 was determined, a low score was 1, 2, or 3, and a high score was 4 or 5). Results High and low visual cardiac 18F-FDG uptakes were observed in 27 (62.8%) and 16 (37.2%) patients, respectively. Of the 43 patients, 17 (39.5%) definitely had cachexia, and 26 (60.5%) did not. A low visual score and standardized uptake valuemax for cardiac 18F-FDG uptake were significantly associated with high metabolic tumor activity (p = 0.009, and p = 0.009, respectively) and a high neutrophil-to-lymphocyte ratio (p = 0.016, and p = 0.047, respectively), whereas a low visual score for cardiac 18F-FDG uptake and high metabolic tumor activity were significantly associated with cachexia (p = 0.004). The amount of cardiac 18F-FDG accumulation depicted a close relationship with body mass index, low weight loss, and inflammation. The combination of cachexia and low visual cardiac 18F-FDG uptake was identified as a significant predictor for poor overall survival (OS) (p = 0.034). Conclusion Decreased visual cardiac 18F-FDG uptake was associated with poor nutritional status and OS, and cachexia in patients with advanced NSCLC.

Incidence and risk factors of adverse events after distal radius fracture fixation with volar locking plates: retrospective analysis of 2,790 cases

Background and purpose: 12–18% of patients encounter adverse events after distal radius fracture (DRF) surgery with volar locking plates (VLPs). Risk factors for which preventive measures could be administered are currently scarce. We aimed to examine the incidence of postoperative adverse events and assess the causes and risk factors for the adverse events after VLP fixation of DRFs.Methods: We performed a single-center retrospective cohort study evaluating all adult DRF patients treated with VLP fixation between 2009 and 2019 at Helsinki University Hospital. Patients with previous disabilities or ulnar fractures, other than styloid process fractures, in the affected extremity were excluded. We examined each patient’s treatment using the electronic medical records system and identified postoperative adverse events defined as any deviation from the ordinary postoperative course, showcasing clinical symptoms. We used multivariable binary logistic regression to assess the risk for adverse events.Results: 2,790 cases of DRF were included. The incidence of adverse events was 16%. Hardware complications (8.3%), predominantly intra-articular screws (4.9%), were the most commonly encountered adverse events. Other frequent adverse events included carpal tunnel syndrome (2.8%), tendon complications (2.8%), and surgical site infections (1.5%). In the multivariable analysis, smoking, higher body mass index (BMI), alcohol abuse, C-type fractures, residual intra-articular displacement, and dorsal tilt were found as risk factors for adverse events.Conclusion: The incidence of adverse events was 16% after VLP fixation of DRFs. We identified several new risk factors for adverse events, which included residual dorsal tilt, intra-articular dislocation, insufficiently corrected inclination, smoking, alcohol abuse, and higher BMI.

Diurnal Profiles of the Endocrine Stress Response in Internet Gaming Disorder

Background: Differences in subjective stress perception and acute response of the hypothalamic-pituitary-adrenal axis have been reported in internet gaming disorder (IGD). The present study aimed to further investigate alterations in diurnal profiles of the endocrine stress response system in IGD compared to healthy controls (HCs). Methods: The diurnal course of endocrine markers (salivary cortisol and α-amylase) was investigated in a clinical sample of n = 29 adolescents with IGD compared to n = 26 HC. Further, the effect of unrestricted gaming versus restricted gaming was examined within the IGD group. Results: No significant differences in salivary cortisol and α-amylase were observed comparing adolescents with IGD and HC. In addition, in the IGD group, there were no significant differences in salivary cortisol and α-amylase between conditions of unrestricted gaming versus restricted gaming. Compared to the HC group, the IGD group showed a significantly higher body mass index. Conclusions: Our results indicate no alteration in diurnal profiles of the endocrine stress response in IGD.

Modulation of Serum Metabolic Profiles by Bifidobacterium breve BBr60 in Obesity: A Randomized Controlled Trial

Obesity, a prevalent metabolic disorder in youth, leads to complications and economic strain. Gut dysbiosis significantly contributes to obesity and metabolic issues. Bifidobacterium breve, a probiotic strain, may help regulate gut dysbiosis and benefit obese individuals. However, more research is needed on its effect on serum metabolism. A total of 75 overweight or obese young adults (aged 19–45) participated in the current study, and were randomly divided into probiotic and placebo groups using a random number table. Both groups received dietary guidance and underwent twelve weeks of intervention with either oral Bifidobacterium breve BBr60 (BBr60) or a placebo. After the intervention, collection and analysis of fasting serum samples were conducted using mass spectrometry coupled with liquid chromatography. Analyses of associations were conducted in order to determine the correlations between key serum metabolites and clinical obesity indicators, aiming to understand the influence of BBr60. Due to 10 participants dropping out for personal reasons, the study included 32 and 33 participants in the placebo and the BBr60 groups, respectively. The BBr60 intervention significantly regulated 134 serum metabolites and influenced crucial metabolic pathways in obesity management (p < 0.05), including ascorbate and aldarate metabolism for oxidative stress reduction, cholesterol metabolism for lipid regulation, parathyroid hormone synthesis, secretion and action for the endocrine system, oxidative phosphorylation for enhanced energy efficiency, and glycolysis/gluconeogenesis for glucose metabolism. Analysis showed a positive relationship between fasting blood glucose (FBG), aspartate aminotransferase (AST), total protein (TP), and the content of 5-Methyl DL-glutamate (p < 0.05). Similarly, body mass index (BMI), weight, and body fat percentage (BFP) were positively linked to serum metabolites (1-Hydroxycyclohexyl) acetic acid, and 5-Oxooctanoic acid (p < 0.05). Significant associations of AST levels with key serum metabolites in cholesterol metabolism pathways further suggest BBr60’s potential to improve liver function and overall metabolic health in overweight or obese individuals. These findings support BBr60’s effectiveness in modulating serum metabolic profiles and suggest it may improve liver function and BMI in overweight or obese individuals by regulating key serum metabolites.

Cesarean Section and Its Impact on Uterine Artery Resistance and the Risk of Pre-eclampsia in Subsequent Pregnancies

Background: The purpose of the current study was to compare the color Doppler findings of uterine arteries and perinatal outcomes in pregnant women with and without previous cesarean section (C/S). Methods: This cohort study enrolled 308 pregnant women aged 20-35 without underlying diseases, with at least one previous pregnancy and childbirth. The participants were divided into two groups: 154 women without C/S and 154 women with C/S. Baseline data were collected, followed by uterine artery Doppler scans. Then, the perinatal outcomes, including pre-eclampsia, intrauterine growth restriction (IUGR), premature delivery, and birth weight were evaluated. Results: The average age of patients in the C/S group was 30.46±3.81, which was significantly higher than the non-C/S group (28.86±4.64). It was found that uterine artery resistance was higher in women with C/S history (1.11±0.44, p<0.001) compared to those without (1.00±0.37, p<0.001). Pre-eclampsia incidence was also higher in C/S group (16.1%, p=0.042) compared to non-C/S group (9.1%, p=0.042). The incidence of preterm birth in the C/S group (p=0.209), the incidence of IUGR (p= 0.791), and the average birth weight (p=0.291) in the two groups did not differ significantly. The average gestational age in the C/S group was 37.54±1.4, and in the non-C/S group was 38.01±1.99 weeks. The results were not affected by potential confounders such as age, the time interval between pregnancies, and also body mass index. Conclusion: Previous cesarean section can significantly increase the uterine artery resistance in subsequent pregnancy.

Abstract A024: Tissue biomarkers in the tumor microenvironment predicting the development of cachexia in pancreatic cancer patients

Abstract Pancreatic ductal adenocarcinoma (PDAC) poses significant challenges due to its aggressive nature and the limited efficacy of existing treatments. The complex interactions within the tumor microenvironment (TME) and tumor cell itself remain poorly understood, particularly in relation to cancer cachexia, which is characterized by weight loss, muscle wasting, systemic inflammation, and metabolic disturbances, and has a profound impact on PDAC outcomes. This study investigated the role of the TME in the development of cachexia in PDAC patients, focusing on the potential of cachexia-related proteins as tissue biomarkers in the TME. In this retrospective study, tissue samples from 13 PDAC patients obtained via Endoscopic Ultrasound-Guided Fine Needle Aspiration at the time of diagnosis were analyzed using immunofluorescence staining, supplemented by epidemiological data. The initial classification of cachexia based on epidemiological data, including patients body mass index and three-month weight changes, was further refined through body composition trend analysis during 180 days after the diagnosis with consecutive computed tomography images. These detailed classification criteria allowed for a more realistic classification of cachexia compared to the conventional classification of cachexia based on weight change, resulting in 5 patients being classified as cachexia and 8 as non-cachexia. We selected NAMPT (nicotinamide phosphoribosyl transferase) as a candidate tissue biomarker, a rate-limiting enzyme crucial in the NAD+ salvage pathway, due to its significant role in cellular metabolism, and the regulation of energy depletion and consumption in muscle cells. We hypothesized that NAMPT is closely linked to the mechanisms of cachexia because NAD+ is essential for muscle regeneration. Additionally, PTHLH (Parathyroid Hormone-Like Hormone), selected as another candidate marker, plays a critical role by being secreted from tumor cells, promoting cancer cell growth and metastasis. The overexpression of PTHLH can lead to malignant hypercalcemia, which may trigger severe systemic inflammatory responses in cancer patients, contributing to the development of cachexia. We utilized the coordinated expression of these two proteins as potential tissue biomarkers predicting cachexia at the time of diagnosis of PDAC. In our study, PTHLH expression was significantly elevated in the cachexia group, while NAMPT expression was higher in the non- cachexia group. Although both markers are known to be overexpressed in most metastatic pancreatic cancers, their correlations vary depending on the presence of cachexia. These findings suggest that even in metastatic pancreatic cancer, these markers can serve as precise biomarker signatures that determine the possibility of developing cachexia. To further validate our findings, we are currently testing a larger validation set (cachectic PDAC patients=100, non-cachectic PDAC patients=100) to determine whether the expression of these two markers can be utilized as biomarkers for the early detection of cachexia. Citation Format: Hyun Jung Kee, Jinhee Lee, Ju Young Bae, Hia Jung, Jeehoon Kim, Galam Leem, Hee Seung Lee, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Moon Jae Chung. Tissue biomarkers in the tumor microenvironment predicting the development of cachexia in pancreatic cancer patients [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr A024.

Estimating Meaningful Differences in Measures of Neuropathic Impairment, Health‐Related Quality of Life, and Nutritional Status in Patients With Hereditary Transthyretin Amyloidosis

ABSTRACTIntroduction/AimsThe degree of change in neuropathic impairment and quality of life (QoL) that is clinically meaningful to patients with hereditary transthyretin amyloidosis with polyneuropathy (ATTRv‐PN) is not established. This study aimed to estimate the magnitude of treatment differences that are meaningful to patients in measures of neuropathy and QoL and to determine whether eplontersen achieved a meaningful improvement versus placebo.MethodsData from the NEURO‐TTRansform trial on patients with ATTRv‐PN treated with eplontersen (n = 141) or historical placebo (n = 59) were used. Anchor‐based approaches were used to estimate thresholds for meaningful differences in the modified Neuropathy Impairment Score +7 (mNIS+7) composite score, Norfolk QoL‐Diabetic Neuropathy (Norfolk QoL‐DN) total score, Neuropathy Symptoms and Change (NSC) total score, and modified body mass index (mBMI). Differences between the least squares means of the treatment groups were analyzed.ResultsMeaningful improvement in mNIS+7 was estimated as −4.0 points and deterioration as 1.8 points. The estimated ranges of meaningful improvement and deterioration in Norfolk QoL‐DN were −12.8 to −4.0 points, and 5.9 to 14.7 points, respectively. For NSC, ranges were −2.4 to −1.3 points for meaningful improvement, and 0.6 to 5.8 points for deterioration. The estimated meaningful improvement in mBMI was 9.8 kg/m2 × g/L and deterioration was −40.9 kg/m2 × g/L. Improvements in each measure with eplontersen versus placebo were greater than the estimates of meaningful differences.DiscussionEplontersen demonstrated a clinically meaningful effect on neuropathic impairment, QoL, and nutritional status. Such estimates have implications for clinical practice and trials.

Adolescent Blood Pressure and Early Age Stroke.

Underdiagnosis of relevant risk factors has contributed to the increasing stroke incidence in young adults. Blood pressure cut-off values for adolescents are neither sex specific nor based on cardiovascular outcomes. This nationwide, population-based, retrospective cohort study included all Israeli adolescents 16-19 years of age who were medically evaluated before compulsory military service from 1985 to 2013, including routine blood pressure measurements. The primary outcome was the first occurrence of a stroke (ischemic or hemorrhagic) at a young age (≤52 years), as documented in the Israeli National Stroke Registry. Cox proportional hazard models were stratified by sex and adjusted for birth year, sociodemographic variables, and adolescent body mass index. The cohort comprised 1,897,048 adolescents (42.4% women). During 11,355,476 person-years of follow-up, there were 1470 first stroke events at a young age. In men, an adolescent diastolic blood pressure value of ≥80 mmHg, compared with the reference group (diastolic blood pressure value of <70 mmHg), was associated with an increased risk of stroke (adjusted hazard ratio 1.28; 95% confidence interval [CI], 1.04 to 1.58), while a diastolic blood pressure value of 70-79 mmHg was not associated with an increased risk of stroke (adjusted hazard ratio 1.11; 95% CI 0.90 to 1.34). Among women, an adolescent diastolic blood pressure value of ≥80 mmHg, compared with the reference group (diastolic blood pressure value of <70 mmHg) was associated with an increased risk of stroke at a young age (adjusted hazard ratio 1.38; 95% CI 1.03 to 1.88), as was a diastolic blood pressure value of 70-79 mmHg (adjusted hazard ratio 1.41; 95% CI 1.09 to 1.81). Elevated adolescent systolic blood pressure values (≥120 mmHg) were not associated with an increased risk of stroke. Diastolic blood pressure values of ≥80 mmHg in adolescence were associated with an increased risk of stroke at a young age in both men and women. No similar association was observed for elevated systolic blood pressure.

Exploring the impact of body mass index on the accuracy of vertebral bone quality in determining bone mineral density in patients undergoing lumbar fusion surgery

Exploring the impact of body mass index on the accuracy of vertebral bone quality in determining bone mineral density in patients undergoing lumbar fusion surgery

Thyroid Ultrasonography Screening of a Cohort of Male University Students

Objective: To assess thyroid ultrasonographic (US) findings from a male cohort of asymptomatic Saudi Arabian university students. Materials and Methods: Sixty-three university students were enrolled in a quantitative prospective study from February 2024 to April 2024. They were conveniently selected, excluding females. A MyLab40 US equipment system was used with a 7 MHz transducer. The thyroid was evaluated with US for size, echotexture, and abnormalities. The chi-square test, correlations, and descriptive statistics were applied for the data analysis. Results: The mean age of the participants was 21.5 ± 1.1 years, and the mean body mass index (BMI) was 27.03 ± 6.6. 95.2% of participants had normal findings; positive findings were found in 4.8 % of the participants. Of these, 1.6 % had multiple nodules, and 3.2 % had signs of thyroiditis. The statistical analysis revealed no significant association between right and left thyroid lobe lengths compared to BMI ( p = .7 right and left 0.3). Moreover, there was no association between the thyroid echo pattern and the BMI ( p = .4). Conclusion: This cohort study concluded that the thyroid US findings were very limited. There was no statistical correlation between the thyroid lobe length, thyroid echo pattern, compared to participants’ BMI.

Influence of Age and Weight Change Patterns on Knee Osteoarthritis

Background: Knee osteoarthritis is a globally alarming condition. People are now dependent and adapting to new living standards and not taking all the necessary precautions to lead day-to-day life, somehow this is accelerating the degenerative process in the body. So, aiming to find out the prevalence of knee osteoarthritis will help improve the activity of daily living performance and reduce the economic burden of society due to knee osteoarthritis. Methodology: An observational descriptive analytic study, the target population was individuals between the age group 25 to 50 years of both genders. Results: From a total of 5514 individual participants, those aged &lt;40 years had a 7.28%, and ages &gt;40 years had a 16.32% prevalence of knee osteoarthritis. Participants with BMI level &lt;25 kg/m2 had 5.08%, and others having BMI of &gt;25 kg/m2 had a 22.23% prevalence of knee osteoarthritis. Conclusion: The participants of the age group ≥40 years and with BMI ≥25 kg/m2 reported a high prevalence of knee osteoarthritis.Abbreviations: Knee osteoarthritis (KOA), &amp; body mass index (BMI).

The effect of clinically significant weight loss prior to open ventral hernia repair.

The study aim was to assess the impact of clinically significant weight loss (CSWL; ≥5% weight reduction) on postoperative complications following abdominal wall reconstruction with the component separation technique (CST). A retrospective review of patients who underwent open ventral hernia repair (VHR) with CST from November 2008 to January 2022 was performed. Cohorts were stratified by presence of CSWL from baseline weight at preoperative consultation. Of 180 total patients, 40 (22.2%) achieved CSWL prior to VHR. Mean age was 59.6 ± 11.2 years. Patients in the CSWL cohort represented a higher average body mass index (BMI) (33.6 vs. 31.7kg/m2, p = 0.076), and were obese more frequently (80.0% vs. 56.4%, p = 0.007). The CSWL cohort had a higher proportion of patients in Ventral Hernia Working Group (VHWG) classification II (82.5% vs. 63.6%) while the non-CSWL cohort had more VHWG classification III/IV (20.0% vs. 10.0%, p = 0.078). Mean follow-up duration was 6.1 ± 13.4 months. Complications, including 30- and 90-day surgical site occurrence (SSO), return to operating room, readmission, and hernia recurrence (CSWL: 5.0% vs. non-CWL 1.4%, p = 0.179), were comparable between cohorts. BMI was an independent predictor of any complication (OR 1.07, p = 0.044) and 90-day SSO (OR 1.10, p = 0.043). Achievement of CSWL prior to open VHR utilizing CST results in similar post-reconstruction outcomes to patients who maintained a comparable BMI at baseline. Higher day-of-surgery BMI was more consequential to postoperative complications than percent weight loss.

Work-Related Muscluskeletal Disorders and Work Ability Among Hospital Employees in Southeast of Iran

Background: The Work Ability Index (WAI) evaluates how well workers cope with the physical and mental demands of their jobs. Objectives: This study aims to explore how demographic factors and work-related musculoskeletal disorders (WMSDs) influence work ability among employees at the largest specialized hospital in southeast Iran. Methods: This cross-sectional study was conducted at the largest specialized hospital in Zahedan. A sample of 194 clinical staff and support personnel, including nurses, nursing assistants, patient transporters, and cleaning staff, were randomly selected through a stratified random sampling method. Work ability and musculoskeletal discomfort were assessed using the Persian versions of the WAI and Cornell Questionnaires. Quantitative data were presented as mean ± SD, while qualitative data were expressed as numbers and percentages. Pearson correlation, Kruskal-Wallis, Mann-Whitney U, and one- and multi-factor General Linear Models were used for data analysis in SPSS version 19. Results: Work ability decreased with age (P &lt; 0.001). Significant associations were found between work ability and age, job category, education, and Body Mass Index (BMI) (P &lt; 0.05). After adjusting for age, job, education, and BMI, lower back pain (P = 0.002), thigh pain (P = 0.004), and knee pain (P = 0.026) were significantly linked to work ability. There was a notable negative correlation between work ability and discomfort score (r = -0.337, P &lt; 0.001), with nursing assistants reporting higher discomfort scores compared to nurses, cleaning staff, and patient transporters (P &lt; 0.05). Conclusions: Our findings suggest a potential link between musculoskeletal disorders (MSDs) and work ability. Therefore, it is recommended to implement a program focused on identifying and addressing the risk factors associated with MSDs.

Cell-free pregnancy-associated microRNAs in blood plasma as potential biomarker in early diagnosis of ectopic pregnancy.

Ectopic pregnancy (EP) is one of the life-threatening disorders in early pregnancy and current strategies are inadequate in its clinical management. There is a need to identify more accurate biomarkers for early diagnosis of ectopic pregnancy. This case-control study was conducted in a group of 35 women diagnosed with ectopic pregnancy and 31 women with a normal singleton pregnancy. Patients' characteristics including the level of β-hCG, age, body mass index (BMI), and gestational age have been recorded. The plasma levels of cell-free hsa-miR-411, hsa-miR-433, and hsa-miR-524 were examined by qRT-PCR using specific primers. There was no statistically significant difference in maternal age, gestational age, and BMI between the two groups. β-hCG concentrations in EP were significantly lower than normal pregnancy group. Cell-free hsa-miR-411 and hsa-miR-433 had statistically significant differences in concentrations in women with EP and normal pregnancy. hsa-miR-411 and hsa-miR-433 had better diagnostic values for discriminating EP from normal pregnancy. Moreover, hsa-miR-411 and hsa-miR-433 showed a specificity of 61% and 53%, and a sensitivity of 72% and 79%, respectively. hsa-miR-411 and hsa-miR-433 microRNAs concentrations in plasma have potential as a predicting biomarker for early diagnosis of EP. However, further research is needed before using miRNAs in clinical practice for both diagnostic and therapeutic goals.