Body Weight Changes In Patients Research Articles

Postoperative body weight change and its influencing factors in patients with gastric cancer.

The high incidence and mortality of gastric cancer (GC) pose a significant threat to human life and health, and it has become an important public health challenge in China. Body weight loss is a common complication after surgical treatment in patients with GC and is associated with poor prognosis and GC recurrence. However, current attention to postoperative weight change in GC patients remains insufficient, and the descriptions of postoperative weight change and its influencing factors are also different. To investigate body weight changes in patients with GC within 6 mo after gastrectomy and identify factors that influence dynamic body weight changes. We conducted a prospective longitudinal study of 121 patients with GC and collected data before (T0) and 1 (T1), 3 (T2), and 6 (T3) mo after gastrectomy using a general data questionnaire, psychological distress thermometer, and body weight measurements. The general estimation equation (GEE) was used to analyze the dynamic trends of body weight changes and factors that influence body weight changes in patients with GC within 6 mo of gastrectomy. The median weight loss at T1, T2, and T3 was 7.29% (2.84%, 9.40%), 11.11% (7.64%, 14.91%), and 14.75% (8.80%, 19.84%), respectively. The GEE results showed that preoperative body mass index (BMI), significant psychological distress, religious beliefs, and sex were risk factors for weight loss in patients with GC within 6 mo after gastrectomy (P < 0.05). Compared with preoperative low-weight patients, preoperative obese patients were more likely to have weight loss (β = 14.685, P < 0.001). Furthermore, patients with significant psychological distress were more likely to lose weight than those without (β = 2.490, P < 0.001), and religious patients were less likely to lose weight 6 mo after gastrectomy than those without religious beliefs (β = -6.844, P = 0.001). Compared to female patients, male patients were more likely to experience weight loss 6 mo after gastrectomy (β = 4.262, P = 0.038). Male patients with GC with high preoperative BMI, significant psychological distress, and no religious beliefs are more likely to lose weight after gastrectomy.

A Retrospective Study of Body Weight Changes in Patients Receiving Cyproheptadine in A Hospital-Based Outpatient Setting in Thailand

Cyproheptadine has been used as an appetite stimulant to increase body weight in various population. This study aimed to determine the effect of cyproheptadine on weight changes in Thai patients. A retrospective longitudinal study was conducted in adult patients who were prescribed with cyproheptadine, having body weight records at 2 times consecutively during 12-month period at the medical outpatient department, the Police General Hospital, Thailand. Of 125 participants, 69.6% were females and the mean age was 78.38 (SD ± 11.68) years. Hypertension, dyslipidemia and diabetes mellitus were the most common underlying conditions. The mean body mass index (BMI) at 1st visit was 21.16 (SD ± 3.64) kg/m2. The mean body weight at 1st and 2nd visit were 52.46 (SD ± 11.11) kg, and 52.61 (SD ± 10.98) kg, respectively. Overall, there was no significant change in body weight between two visits. In underweight patients (BMI &lt; 18.5 kg/m2), the mean BMI decreased significantly in the 2nd visit compared to 1st visit (p = 0.044). At the 2nd visit, older age and high-density lipoprotein cholesterol levels were negatively associated with body weight (p &lt; 0.05). The polypharmacy (odds ratio (OR), 0.778; 95% confidence interval (CI), 0.616 – 0.982), the presence of hypertension (OR, 0.022; 95%. CI, 0.001 – 0.390) and low-density lipoprotein cholesterol levels (OR, 0.969; 95% CI, 0.942 – 0.996) were also negatively associated with abnormal BMI. Cyproheptadine might not improve the body weight of patients in this population. The factors associated with lower body weight in this study may be helpful in further research.

Ambient temperature modulates body weight changes in patients with advanced oncological diseases and anorexia cachexia syndrome.

To assess the impact of ambient temperature (AT) on the evolution of bodyweight in patients with heterogeneous types of cancer in advanced stages of the disease (stages III andIV) and anorexia- cachexia syndrome (ACS). A prospectivenaturalistic multicenter study of patients undergoing oncological treatment at four hospitals during a three-year period (2017-2020) in the Autonomous Community of Extremadura in southwesternSpain with a continentalized Mediterranean climate of mild and relatively rainy winters, and particularly hot and sunny summers. Bodyweight changes were obtained from the medical records of 84 oncological patients (59 men and 25 women, age range 37-91 yrs). Mean monthly AT was used to examine the association of weight changes across cold and warm bimesters -BIMs (December and January, vs. July and August), Trimesters -TRIMs (July to September vs. December to February), and Semesters -SEMs (May to October vs. November to April). Weight changes between two consecutive weight measures were categorized as weight gain, weight loss, or no weight change. Differences across cold and warm seasons were analysed using parametric (ANOVA), and nonparametric statistics (Chi-square and binomial z tests). An alpha-rate of 0.05 was used for all analyses. A weight loss trend was observed during BIMs cold periods in comparison to warm ones (p 0.04). However, differences in average bodyweight were not significant. The negative impact of cold periods was more marked in men than in women, (p = 0.05; p = 0.03, for cold vs. warm BIMs and TRIMs, respectively). In contrast, significantly higher weight gain percentages were found in women during warm TRIMs and SEMs (p = 0.03, and p = 0.01, respectively). As for the number of patients dying during the study (N = 56; 39 men, 17 women), there were a significant interaction between temperature (cold/warm), and mean weight F (1, 499) = 6.06, p = 0.01, which revealed a pattern of weight loss in the cold semester as opposed to weight gain during the warm SEM months. AT temperature modulated body weight changes in patients with advanced oncological disease and ACS. Two main limitations of the study were the absence of information on diets as a moderating factor of weight loss/gain, and the lack of the patients' weight measurements closest to the date of diagnosis prior to admittance to the study. As for the practical implications, it remains to be seen whether an adjunctive heat supply will serve a buffering effect on weight loss during colder seasons for patients with advanced cancer and ACS.

Smoking in post-bariatric patients without regular medical follow-up and associated weight loss and regain: a cross-sectional study

Introduction: Obesity and smoking are associated with an increased risk of cardiovascular disease, reducedquality of life andprematuremortality. The relationship between smoking and body weight changes in patients who underwent bariatric surgery is unclear.Objective: We studiedpost-bariatric patients without any current medical follow-up and compared smokers andnon-smokers with regard to weight loss and regain. Methodology: Ninety-four patients post-Roux-en-Y gastric bypass (n=80) or Sleeve gastrectomy (n=14), aged 42±9 years, body mass index (BMI)=32.9±6.5kg/m2, were recruited in public outpatient care and allocated into two groups according to time since surgery &lt; or ≥5 years (G&lt;5y or G≥5y, respectively). They were further divided into smokers or non-smokers. Clinical history, physical examination, anthropometrics and hemodynamics measurements were obtained. Results: The prevalence of smoking was 12.8%. BMI, neck circumference, pre-surgical BMI, and rate of weight regain (RWR) were higher in the G≥5y group than in the G&lt;5y (p≤0.03) one. No differences in excess weight loss (EWL) were observed between smokers andnon-smokers in both groups (p≥0.15). Higher RWR was detected in non-smokers in G&lt;5y (p=0.03), while no differences between smokers andnon-smokers were found for RWR in G≥5y (p=0.37). Conclusion: Smoking habits do not appear to influence weight loss after surgery. However, a higher weight regain was detected in non-smokers who had less than 5 years since surgery.

Impact of body weight change on clinical outcomes in patients with idiopathic pulmonary fibrosis receiving pirfenidone

There have been limited studies on the association between prognosis and body weight change in patients with idiopathic pulmonary fibrosis (IPF). This single-center retrospective observational study evaluated the impact of weight loss on outcomes in Korean patients with IPF receiving pirfenidone at a tertiary medical institution. We analyzed 215 IPF patients prescribed pirfenidone from January 1st, 2015 to December 31st, 2019. The patients were categorized into maintained weight (MW; weight gain or loss < 5%/year) and reduced weight (RW; weight loss ≥ 5%/year) groups. The mean age was 71.8 years and 175 (81.4%) were male. There were 54 (25.1%) patients in the RW group. All patients showed a decrease in body weight (baseline vs. after 1 year; 64.1 kg vs. 62.8 kg, P < 0.001). Although baseline lung function showed a difference, there was no difference in the rate of change (forced vital capacity [% of predicted]; P = 0.221, diffusing capacity of the lung for carbon monoxide [% of predicted]; P = 0.973). The MW group had a lower risk of all-cause mortality (P < 0.001). Weight loss appeared to be a significant risk factor for mortality in patients with IPF. Not only disease control with antifibrotic agents, but also efforts to prevent weight loss may be necessary.

Short-term Neuropsychiatric and Body Weight Changes in Patients Switching From EVG/Cobi/FTC/TAF to BIC/FTC/TAF (PreEC/RIS69).

We report NP, clinical and laboratory changes in patients switching from EVG/Cobi/FTC/TAF to BIC/FTC/TAF in clinical practice. A group of subjects switching from EVG/Cobi/FTC/TAF to BIC/F/TAF was prospectively followed. A validated sleep quality questionnaire (Pittsburgh Sleep Quality Index), as well as the Hospital Anxiety and Depression Scale (HADS), were administered after 4 weeks from the treatment switch. Adverse events, side effects and discontinuation were recorded at weeks 4 and 24. Pretreatment switch and week 24 body weight and laboratory data were compared. A total of 96 virologically suppressed patients (86% male) were included. All patients received EVG/Cobi/FTC/TAF at least 1 year before the treatment switch. Median (IQR) nadir CD4 was 367 (263). The most common comorbidities were dyslipidemia, HTA and diabetes, 26%, 14% and 7%, respectively. Depression was reported by 8%. Five patients discontinued BIC/FTC/TAF before week 4 due to intolerance (2 insomnia, 1 headache and 2 GI symptoms). No changes in sleep quality, anxiety and depression outcomes were observed at week 4 (p = 0.1, p = 0.1 and p = 0.3, respectively). After 6 months, the median body weight change was statistically significant (0.6 kg, p = 0.003). All patients maintained HIV suppression. Except in a few cases, sleep quality, anxiety and depression symptoms remain stable in HIV virologically suppressed patients on EVG/Cobi/FTC/TAF who switch to BIC/F/TAF. NPAEs are mild and tend to occur in those with previous neuropsychiatric symptoms. Weight gain tends to be small but statistically significant. Long-term follow-up in "real-life" cohorts would be needed to confirm these findings.

Body weight changes in patients with type 2 diabetes and a recent acute coronary syndrome: an analysis from the EXAMINE trial

BackgroundPatients with type 2 diabetes (T2D) may experience frequent body weight changes over time. The prognostic impact of these weight changes (gains or losses) requires further study.AimsTo study the associations between changes in body weight (intentional or unintentional) with subsequent outcomes.MethodsThe EXAMINE trial included 5380 patients with T2D and a recent acute coronary syndrome, who were randomized to alogliptin or placebo. Time-updated Cox models and mixed effects models were used to test the associations between changes in body weight and subsequent outcomes over a median follow-up of 1.6 (1.0–2.1) years.ResultsDuring the post-randomization follow-up period, 1044 patients (19.4%) experienced a weight loss ≥ 5% of baseline weight, 2677 (49.8%) had a stable weight, and 1659 (30.8%) had a ≥ 5 % weight gain. Patients with weight loss were more frequently women and had more co-morbid conditions. In contrast, patients who gained ≥ 5% weight were more frequently men with less co-morbid conditions. A weight loss ≥ 5% was independently associated with a higher risk of subsequent adverse outcomes, including all-cause mortality: adjusted HR (95% CI) = 1.79 (1.33–2.42), P < 0.001. Similar associations were found for cardiovascular mortality, the composite of cardiovascular mortality or heart failure hospitalization, and the primary outcome. A weight gain ≥ 5% was independently associated with an increase in the risk of subsequent cardiovascular mortality or heart failure hospitalization only: adjusted HR (95% CI) = 1.34 (1.02–1.76), P = 0.033.ConclusionsIn patients with T2D who had a recent ACS/MI, a ≥ 5% loss of body weight was associated with a higher risk of subsequent cardiovascular events and mortality.

Patterns of Bodyweight Changes in Patients With Hypothyroidism, a Retrospective Study From Basrah, Southern Iraq.

BackgroundWeight gain is one of the most important hypothyroidism-related concerns in patients with hypothyroidism. However, unexpectedly, levothyroxine replacement does not necessarily result in body weight (BWT) reduction among those patients. The study aimed to assess the patterns of BWT changes through time in patients with hypothyroidism.MethodIn a retrospective database study from Faiha Specialized Diabetes, Endocrine, and Metabolism Center, a total of 346 adult patients with hypothyroidism (192 newly diagnosed and 154 known hypothyroidism patients) who had one visit every three months, five visits in one year were included. Of these, 116 new and 69 known hypothyroidism patients had completed nine visits in two years. Each visit involved thyroid-stimulating hormone (TSH) and BWT measurements. Patients with chronic liver or renal disease, diabetes mellitus, thyroid cancer, or other malignancies, pregnancy, and steroid or hormonal therapies were excluded. The patients were further subdivided based on average TSH levels into controlled (TSH ≤ 4.2 μIU/ml) and uncontrolled (TSH > 4.2 μIU/ml). Repeated measures analysis of variance (ANOVA) with a Greenhouse-Geisser correction and post hoc tests using the Bonferroni correction were used to evaluate TSH and BWT changes through the study.ResultsBoth in newly diagnosed and known hypothyroidism patients with an average TSH > 4.2 μIU/mL, BWT increased significantly through visits over one and two years. For newly diagnosed patients assessed over one year (F(2.41, 321.60) = 3.28, p = 0.03), the mean BWT increase was 1.4 ± 0.38 kg from 3rd to 12th month visits (p = 0.004). For newly diagnosed patients assessed over two years (F(3.10, 263.89) = 9.08, P < 0.0005), the mean BWT increase was 3.02 ± 0.77 kg from 3rd to 24th month visits (p = 0.007). For patients with known hypothyroidism assessed over one year (F(2.56, 187.47) = 7.11, p = 0.0003), the mean BWT increase was 1.97 ± 0.64 kg at 12th month visit, and over two years (F(2.35, 77.56) = 4.67, P = 0.009), the mean BWT increase was 3.78 ± 1.26 kg at 24th month visit. While in all other patients with an average TSH ≤ 4.2 μIU/mL, the BWT changed non-significantly through the visits for newly diagnosed patients over one year and two years (p = 0.10, 0.34, respectively), and known patients over one year and two years (p = 0.47, 0.34, respectively).ConclusionContrary to what is believed, adequate treatment with levothyroxine does not associate with weight reduction. Instead, either the patient kept on the same weight or continued to gain more weight.

Patterns of Body Weight Changes in Patients With Hypothyroidism, a Retrospective Study From Basrah, Southern Iraq

Background: Weight gain is one of the most important hypothyroidism-related concerns among patients with hypothyroidism. However, not as expected, thyroxine replacement does not necessarily result in body weight (BWT) reduction among those patients. The study aimed to assess the patterns of BWT changes through time in patients with hypothyroidism. Method: A retrospective database study from Faiha Specialized Diabetes, Endocrine, and Metabolism Center. A total of 346 adult patients with hypothyroidism, 192 newly diagnosed and 154 known, who had 1 visit every 3 months, 5 visits per one year. From those patients, 116 new and 69 known had completd 9 visits per two years. Each visit involved thyroid-stimulating hormone (TSH) and BWT measurements. Patients with chronic liver or renal disease, diabetes mellitus, thyroid cancer, or other malignancies, pregnancy, and on steroid or hormonal therapies were excluded. The patients were further subdivided based on average TSH levels into controlled (TSH≤4.2 μIU/mL) and uncontrolled TSH>4.2 μIU/mL. Repeated measures ANOVA with a Greenhouse-Geisser correction and Post hoc tests using the Bonferroni correction were used to evaluate BWT changes through the study. Results: Both newly diagnosed and known hypothyroidism, over one and two years, in patients with average TSH>4.2 μIU/mL, BWT increased significantly through visits. For newly diagnosed over one year, (F(2.41, 321.60) = 3.28, p = 0.03), and mean BWT increase = 1.4 ± 0.38 kg from 3rd to 12th month visits, (p = 0.004). For newly diagnosed over two years, (F(3.10, 263.89) = 9.08, P < 0.0005), mean BWT increase = 3.02 ± 0.77 kg from 3rd to 24th month visits, (p = 0.007). And for known hypothyroidism over one year, (F(2.56, 187.47) = 7.11, p = 0.0003), mean BWT increase = 1.97 ± 0.64 kg at 12th month visit, and over two years, (F(2.35, 77.56) = 4.67, P = 0.009), mean BWT increase = 3.78 ± 1.26 kg at 24th month visit. While in all other patients with average TSH≤4.2 μIU/mL, the BWT changed non-significantly through visits. For newly diagnosed patients over one year and two years (p = 0.10, 0.34 respectively), and known patients over one year and two years (p = 0.47, 0.34 respectively). Conclusion: In contrary to what is believed, adequate treatment with thyroxine does not associate with weight reduction. Instead, either the patient kept on the same weight or continued to gain more weight.

Analysis of factors contributing to postoperative body weight change in patients with gastric cancer: based on generalized estimation equation.

AimsThe study aimed to explore factors contributing to body weight change over time in gastric cancer patients after gastrectomy, in order to find risk factors to implement nutritional intervention beforehand.MethodsA cohort of gastric cancer patients who were treated with gastrectomy from January to March 2019 at a university affiliated hospital in Shanghai were consecutively identified in this study. Demographics, disease related information, nutrition knowledge, attitude, and practice score were collected before gastrectomy. In addition, body weight before surgery (T0), body weight at one month (T1), two months (T2), and three months (T3) after gastrectomy were recorded. Generalized estimation equation was used to describe body weight change and analyze factors contributing to body weight change after surgery.ResultsThere were 49 patients recruited in the study. Patient body weight decreased by 9.2% at T1 (Wald χ = 271.173, P <0.001), 11.0% at T2 (Wald χ2 = 277.267, P <0.001), and 11.4% at T3 compared to baseline at T0 (Wald χ = 284.076, P <0.001). The results of GEE for multivariable analysis showed that surgery type (Wald χ = 6.027, P = 0.014) and preoperative BMI (Wald χ = 12.662, P = 0.005) were contributing factors of body weight change. Compared with distal gastrectomy patients, total gastrectomy patients experienced greater body weight loss (β = 2.8%, P = 0.014). Compared with patients with BMI&λτ; 18.5 kg/m2, patients with BMI ≥ 25 kg/m2experienced greater body weight loss (β = 4.5% P = 0.026).ConclusionGastric cancer patients experienced significant weight loss during 3 months after gastrectomy. Total gastrectomy and BMI ≥ 25 kg/m2were risk factors to postoperative body weight loss for GC patients. The results suggested hinted that clinician should pay attention to postoperative nutrition status of patient undergoing total gastrectomy and obesity patients.

Assessment of Body Weight Changes in Patients with Inflammatory Bowel Diseases Initiating Biologic Therapy: A Prospective Cohort Study.

Prior studies have inconsistently suggested that biologic therapy may be associated with weight gain in inflammatory bowel disease patients (IBD). Our aim was to compare weight gain across different biologic therapy classes with distinct mechanisms of action. This prospective cohort study recruited patients with moderate to severe IBD initiating outpatient biologic therapy with anti-TNF (infliximab, adalimumab), vedolizumab, or ustekinumab. Weight measurements were performed at weeks 0, 14, 30, and 54. Changes in weight between baseline and each of the follow-up visits were modeled as a continuous variable, and multivariate regression assessed the independent effect of therapeutic class on this outcome. Our study enrolled 269 patients (163 CD, 106 UC) initiating biologic therapy [99 anti-TNF (37%), 122 vedolizumab (45%), 48 ustekinumab (18%)]. From baseline, the weight significantly increased at week 14 with a mean of 0.36kg (± 3.8kg, p = 0.004) and continued to increase compared to baseline with 0.96kg (± 3.9kg, p < 0.001) and 1.29kg (± 4.2kg, p < 0.001) at week 30 and 54, respectively. On univariate and multivariable analysis, no significant differences between any of the biologic therapies for weight gain were seen at any time point (weight gain anti-TNF: 0.31kg, 1.06kg, 1.33kg; VDZ: 0.30kg, 0.83kg, 1.10kg; UST: 0.63kg, 1.21kg, 2.31kg at wk 14, wk 30, and wk 54, respectively). None of the disease activity parameters showed any statistical association with weight gain. There was no difference in weight gain among the different biologic therapeutic classes.

P490 Assessment of body weight changes in patients with inflammatory bowel diseases initiating biologic therapy: A prospective cohort study

Abstract Background Biologic therapies are effective in inducing sustained clinical and endoscopic remission in inflammatory bowel diseases. While side effects are infrequent, prior studies have inconsistently suggested that tumour necrosis factor α (anti-TNF) therapy may be associated with weight gain. We performed this prospective study to compare weight gain across different biologic therapy classes with distinct mechanisms of action. Methods This prospective cohort study recruited patients with moderate to severe IBD initiating outpatient biologic therapy with anti-TNF (infliximab, adalimumab), vedolizumab or ustekinumab. Weight measurements were performed at weeks 0, 14, 30 and 54. Disease activity at these time points was assessed using the Harvey Bradshaw Index (HBI) for CD and Simple Clinical Colitis Activity Index (SCCAI) for UC. Remission was defined as HBI &amp;lt;4 or SCCAI 2. Changes in weight between baseline and each of the follow-up visits were modelled as a continuous variable and multivariate regression assessed the independent effect of therapeutic class on this outcome. Results Our study enrolled 314 patients (197 CD, 117 UC) initiating biologic therapy with 120 patients starting anti-TNF (38%), 140 patients started vedolizumab (45%) and 54 patients on ustekinumab (17%). All patients provided their weight and height at baseline; 261, 184 and 131 patients provided data on weight at week 14, week 30 and week 54, respectively. The mean baseline body weight was similar among all therapeutic classes. Patients initiating UST were more likely to have Crohn’s disease (CD), have perianal involvement and have prior biologic exposure. From baseline, the weight significantly increased at week 14 with a mean of 0.36 kg ( ± 3.8kg, p = 0.004) and continued to increase compared with baseline with 0.96 kg ( ± 3.9kg, p &amp;lt; 0.001) and 1.29 kg ( ± 4.2kg, p &amp;lt; 0.001) at week 30 and 54, respectively (Figure 1). On univariate and multivariable analysis, no significant differences between any of the biologic therapies for weight gain was seen at any time point (weight gain anti-TNF: 0.31 kg, 1.06 kg, 1.33 kg; VDZ: 0.30 kg, 0.83 kg, 1.10 kg; UST: 0.63 kg, 1.21 kg, 2.31 kg at week 14, week 30, week 54, respectively) (Figure 2). Weight gain at week 14 was significantly higher in those with CD (+1.25 kg, 95% CI 0.19–2.30, p = 0.021) and being on steroids at baseline (+1.07kg, 95% CI 0.03–2.10, p = 0.043). Early weight gain predicted continued weight gain at week 30 (+0.83kg, 95% CI 0.63–1.03, p &amp;lt; 0.001) and week 54 (+0.48, 95% CI 0.21–0.74, p = 0.001). Neither clinical response to therapy nor disease activity parameters showed any statistical association with weight gain. Conclusion There was no difference in weight gain between the different biologic therapeutic classes.

Energy requirements for patients in convalescent rehabilitation using motor scores as in the Functional Independent Measure.

Although appropriate nutrition management could improve rehabilitation outcomes, more than 40 % of patients in a convalescent rehabilitation ward (CRW) suffer from malnutrition. The study was undertaken to investigate whether adequate nutrition for each patient in a CRW could be estimated based on motor scores on the Functional Independence Measure (FIM-M). In 218 patients in our CRW, both basal energy expenditure (BEE) on admission and average energy intake (EI) for 2 weeks were calculated, and EI was divided by BEE to estimate the activity index (e-AI). The patients were classified according to FIM-M to investigate the relationship between the FIM-M and the e-AI. The e-AI tended to increase in proportion to the FIM-M. In the N group, where the increase-decrease rate for body weight was within 2%, the e-AI induced by a FIM-M greater than 60 was significantly higher than that induced by a FIM-M up to 60 (1.3 vs 1.1, p<0.01). Compared to the N group, altering the e-AI caused the same tendency of body weight change in patients with FIM-M greater than 60 and up to 60. The FIM-M could provide a criterial activity index for patients in a CRW when their energy requirement is appropriately estimated, considering the intensity of their physical activity.

Adequacy of nutrition and body weight in patients with early stage dementia: The cognition and aging study

Recent evidence highlights the effects of obesity, diabetes and hypertension in the development of Alzheimer's disease. Involuntary body weight changes in patients with different stages of dementia can be related to clinical factors of the patient per se or support from their caregivers. Understanding the interactions among factors is important to establish a monitoring paradigm to guide treatment strategies. A total of 345 patients with very mild (n=224) and mild stage (n=121) dementia were enrolled from a multi-disciplinary dementia clinic. Clinical data (comorbidities, Mini-Mental State Examination [MMSE] scores, neuropsychiatric inventory [NPI] scores, eating behavior questionnaire), nutritional state (Mini-Nutritional Assessment [MNA] or MNA short form [MNA-SF]) and body mass index (BMI) were recorded. Nutritional state and BMI served as the two major outcome measures, and factors for analysis included diagnosis, dementia severity and clinical data. There was a significant correlation between MNA-SF and MNA (r=.898, p<0.01), but a 24% mismatch in case dislocation was found using the at-risk or malnutrition criteria. Factors related to obesity included male sex, higher MNA-SF and MNA scores, diabetes mellitus and hypertension, while acceptable discrimination for obesity (BMI≧23kg/m2) was obtained with a MNA-SF score of 12/13 or MNA score of 21/22. NPI was the only independent factor related to both MNA-SF (β=-.06, P<0.001) and MNA (β=-.1, P<0.001). A BMI of 22-23kg/m2 was adequate in this group of patients with early stage dementia from nutritional and comorbidity perspectives. After controlling for BMI, the patients with advanced dementia had higher swallowing problem and appetite change scores. In these patients with early stage dementia, a higher BMI indicated adequate nutritional status and higher MMSE, but also higher rates of comorbidities, diabetes mellitus and hypertension.

A comparison of compliance in the estimation of body fluid status using daily fluid balance charting and body weight changes during continuous renal replacement therapy

Abstract Background The risk of fluid overload and mortality is increased in patients with severe acute kidney injury. Charting of daily fluid balance is a key component of fluid assessment but not without problems affecting accuracy. The introduction of electronic bed scales has made routine patient-weighing easier and focused attention on monitoring fluid-related weight changes. Objectives This paper investigated the frequency of compliance in weighing patients daily using electronic bed scales and evaluated the relationship between calculated fluid balance and body weight changes in patients receiving continuous renal replacement therapy (CRRT). Methods A prospective cohort interventional observation study was conducted in a tertiary ICU between June 2015 and February 2016. All patients who required CRRT, >18 years with an admission >24 hours were enrolled. Each patient was able to be weighed daily using electronic bed scales. At the same time daily fluid balances were calculated using paper-based charting. Trends in compliance of recording body weight changes with daily charting of fluid balances was observed until patient no longer required CRRT. Daily differences were compared using Pearson correlation and Bland-Altman analysis. Results A total of 61 patients were recruited. Four hundred and three days of CRRT was recorded with 286 days (71%) accompanied by a measured body weight. One hundred and eighty-one paired comparisons between body weight change and corresponding fluid balance was obtained from 39 patients (64%). Correlation between changes in body weight with fluid balance was weak (r = 0.34, p Conclusion Change in body weight offers an alternative to charting inputs and outputs in monitoring fluid balance. A physical representation of fluid status is provided rather than a calculated value. Lack of compliance in weighing of patients on two consecutive days was shown to reduce utility as a routine monitoring practice. The relationship between fluid balance and changes in body weight was not strong.

Gender differences in the correlation between prognosis and postoperative weight loss in patients with non-small cell lung cancer.

The aim of this study was to investigate gender differences in the relationship between preoperative body mass index (BMI), postoperative body weight change and prognosis in patients with non-small cell lung cancer (NSCLC). Two hundred and sixty-three patients with NSCLC were enrolled in this study. Preoperative BMI was categorized based on WHO definition as follows: underweight (BMI <18.5): 21 patients (8.0%), normal (18.5 ≦ BMI <25): 179 patients (68%), overweight and obese (BMI ≧25): 63 patients (24%). Several factors such as age, sex, cancer stage, body weight change and BMI were recorded and correlated to the postoperative overall survival (OS). For male patients, those in the low-BMI group had the worst prognosis (P < 0.05) whereas female patients with low BMI did not. Male patients with low BMI had statistically significant poorer prognosis compared to corresponding female patients (P < 0.05). Male patients with more than 5% body weight loss within 1 year after operation when compared to preoperative body weight had poorer prognosis than those with less than 5% body weight loss (P < 0.001). Furthermore, these male patients had statistically significant worse prognosis than the corresponding female patients (P < 0.05). In multivariable analysis, gender, more than 5% of body weight loss compared to preoperative body weight, and pathological stage were independent prognostic factors in NSCLC. This study illustrates significant gender differences in the relationship between prognosis and BMI or body weight change in patients with postoperative NSCLC.

Body weight changes in patients undergoing chemotherapy for ovarian cancer influence progression-free and overall survival.

The aim of this study was to evaluate whether body weight changes in patients undergoing chemotherapy for epithelial ovarian cancer (EOC) influence progression-free survival (PFS) and overall survival (OS). An analysis of 190 patients diagnosed with ovarian cancer after first-line chemotherapy was conducted. Changes in body weight were assessed by comparing measurements at baseline to those of the third and sixth cycles of chemotherapy. PFS and OS were calculated with the Kaplan-Meier method and multivariate Cox model. Significant reduction in body weight in advanced EOC was observed with no changes in early EOC. Significant differences in PFS were observed in advanced EOC patients that lost more than 5% of their body weight (6months), maintained weight (13months), or gained more than 5% of their body weight (15months). Similarly, significant differences in OS were noted in advanced EOC at the following time points: 24.3, 42.4, and 66.2months. No effect was reported for early EOC patients. The multivariate Cox analysis showed significant body weight changes from the first to the sixth chemotherapy cycle for PFS (HR=0.97; 95% CI 0.95-0.99) and OS (HR=0.94; 95% CI 0.91-0.97) as well as from the first to the third chemotherapy cycle for OS (HR=0.93; 95% CI 0.88-0.98). Body weight changes can be recognized as a prognostic factor for PFS and OS in advanced EOC patients undergoing chemotherapy. Weight loss is associated with poorer survival while weight gain improved outcomes.

Initiation of Long-term Proton Pump Inhibitor Use Is Not Associated with Weight Gain

Introduction: Proton pump inhibitors (PPIs) are among the most commonly used class of medications in the U.S. We and others have previously reported on the association between PPI use and weight gain or suboptimal weight loss. However, these few prior studies were limited by small sample size or the inability to control for important confounders. The aims of this study were to assess body weight changes in patients who initiate and became long-term PPI users.Figure 2Methods: This was a retrospective cohort study of 157 PPI-naïve outpatients age 18-75y who were prescribed a daily PPI through a primary care provider associated with the University of Colorado Health system from 2012-2013 and continued to regularly take a PPI for at least one year. The electronic medical record was used to extract a variety of clinical (including obesityrelated comorbidities) and demographic data, including all weights collected between 6 months prior to and 18 months following the index PPI prescription. A linear piece-wise mixed-effects model was used to compare the pre-PPI slope of weight change over time to the post-PPI slope of weight change. Stratified analyses by PPI indication (GERD vs. non-GERD), age ( 56y), gender, and BMI category (normal-weight, overweight, and obese) were also performed. The covariance structure for each model was set to auto-regressive to account for greater variation over time within each subject. Results: The findings indicated that there was no statistical difference in weight trajectories after initiating PPIs compared with the same patients' weight trajectories prior to initiation (Figure 1). This finding was demonstrated in for all patients (p=0.12) and for the subset of patients with a GERD indication (P=0.91). Similar non-significant differences in weight trajectories before and after PPI prescription were found for those below (p=0.20) and above (p=0.92) the median age, for men (p=0.23) and women (p=0.35), and for normal-weight (p=0.52), overweight (p=0.67), and obese (p=0.08) patients. Conclusion: Initiation of long-term PPI use in patients naïve to acid suppression medications was not associated with a significant change in body weight trajectory within 18 months after PPI initiation. These findings contradict prior studies. The study was limited by its retrospective design, emphasizing the need for a prospective study to determine if PPI use leads to weight gain as this might alter prescribing and counseling practices.

Determinants of Weight Evolution Among HIV-Positive Patients Initiating Antiretroviral Treatment in Low-Resource Settings.

In resource-limited settings, clinical parameters, including body weight changes, are used to monitor clinical response. Therefore, we studied body weight changes in patients on antiretroviral treatment (ART) in different regions of the world. Data were extracted from the "International Epidemiologic Databases to Evaluate AIDS," a network of ART programmes that prospectively collects routine clinical data. Adults on ART from the Southern, East, West, and Central African and the Asia-Pacific regions were selected from the database if baseline data on body weight, gender, ART regimen, and CD4 count were available. Body weight change over the first 2 years and the probability of body weight loss in the second year were modeled using linear mixed models and logistic regression, respectively. Data from 205,571 patients were analyzed. Mean adjusted body weight change in the first 12 months was higher in patients started on tenofovir and/or efavirenz; in patients from Central, West, and East Africa, in men, and in patients with a poorer clinical status. In the second year of ART, it was greater in patients initiated on tenofovir and/or nevirapine, and for patients not on stavudine, in women, in Southern Africa and in patients with a better clinical status at initiation. Stavudine in the initial regimen was associated with a lower mean adjusted body weight change and with weight loss in the second treatment year. Different ART regimens have different effects on body weight change. Body weight loss after 1 year of treatment in patients on stavudine might be associated with lipoatrophy.

Body weight changes in patients with active Cushing disease after transsphenoidal surgery

Body weight changes in patients with active Cushing disease after transsphenoidal surgery