Body Weight Loss Research Articles

Nutritional disorders as a predictor of rapid diagnosis and disease progression in patients with amyotrophic lateral sclerosis

Background: One of the symptoms of amyotrophic lateral sclerosis (ALS) is progressive loss of body weight. Moreover, in various forms of ALS, regardless of the presence of dysphagia at the onset of the disease, there are similar changes in nutritional status. The problem of nutritional support in patients with ALS, as well as monitoring nutritional status over time in this group of patients remains relevant. Purpose: to evaluate the severity and rate of increase in nutritional disorders in patients with ALS and their relationship with the rate of disease progression, as well as the life expectancy of these patients. Materials and methods: The study included 49 patients diagnosed with ALS who died from 2018 to 2023. All participants underwent a neurological examination, measurement of anthropometric parameters, and laboratory blood tests; 61 % (n=30) of the patients underwent bioimpedance analysis of body composition over time. Results: The highest rate of body weight loss was recorded in the group of patients with quickly diagnosed ALS: it accounted for 1.9 (1.6; 2.2) kg/month. The highest rate of loss of skeletal muscle mass was noted in the same group of patients at 0.4 (0.38;0.46) kg/month. In the group with a quickly diagnosed disease, only 20 % of the patients underwent gastrostomy insertion; in the group with a slow diagnosis rate, 25 % of the patients underwent gastrostomy; only 50 % of the patients received special therapeutic nutrition. Conclusions: Patients with rapid disease progression have a short period of ALS diagnosis and rapidly increasing nutritional disorders, reflected in higher rates of losing weight and skeletal muscle mass. However, patients with rapid diagnosis of the disease had the lowest level of nutritional support. Lack of time to make the difficult decision to insert a gastrostomy tube and perform the necessary preoperative examination is the main reason for the low rate of gastrostomy tube placement in patients with rapidly progressing disease. In this regard, the development of new measures and algorithms for dynamic monitoring of the nutritional status of patients with ALS, as well as increasing awareness of the need for timely gastrostomy, is required. Bioimpedance analysis of body composition can be one of the methods for monitoring the patient’s nutritional status, allowing one to assess the dynamics of decrease in skeletal muscle mass as the most labile component of body composition in patients with ALS.

Blunted inflammatory response is associated with a lower response to a weight loss dietary intervention in liver recipients

Background & AimsObesity is associated with chronic low-grade inflammation, and adipose tissue inflammation is required for fatty tissue remodeling. Interestingly, immunosuppressed patients, as liver transplant recipients, often experience excessive weight gain. We investigated how liver recipients' inflammatory response affects body weight loss induced by dietary treatment. MethodsOverweight liver recipients were paired with non-transplanted subjects to compare their peripheral immune profiles. ResultsTransplanted patients had similar profiles of peripheral blood mononuclear cells compared to controls but lower CD8lowCD56+CD16+NK cells and higher B lymphocytes. Patients showed lower serum concentrations of IFN-γ, TNF, IL-4, IL-2, and IL-10 and lower inflammatory responsiveness of peripheral blood mononuclear cells under inflammatory stimuli. Liver recipients paired with non-transplanted subjects followed a weight loss dietary plan for 6 months to verify body composition changes. After 3 and 6 months of nutritional follow-up, the control group lost more body weight than the liver recipient group. The control group decreased fat mass and waist circumference, which was not observed in transplanted patients. ConclusionTherefore, liver recipients under immunosuppressant treatment responded less to different inflammatory stimuli. This impaired inflammatory milieu might be implicated in the lack of response to weight loss dietary intervention. Inflammation may be essential to trigger the weight loss induced by dietary prescription. Clinical trial registryClinicalTrials.gov identification number: NCT03103984

Pentachlorophenol Exposure Delays the Recovery of Colitis in Association With Altered Gut Microbiota and Purine Metabolism.

Pentachlorophenol (PCP) was used widely as preservative and biocide and has been banned due to with various harmful effects, such as carcinogenicity and teratogenicity. However, the effects of PCP on colitis induced by dextrose sodium sulfate (DSS) remain largely unknown. Serum metabolomics and gut microbiota were investigated to elucidate the underlying mechanisms. Exposure to 20 μg/L PCP aggravated DSS-induced body weight loss, colon shortening, severe histological injuries, and upregulation of TNFα, iNOS, IL-1β, and IL-6. Serum metabolomics showed that both DSS and PCP could significantly disrupted tryptophan metabolism in normal mice. Interestingly, PCP exposure intensified the disturbance in purine metabolism but not tryptophan metabolism caused by DSS. Quantitative analysis of tryptophan and metabolites further confirmed that PCP exposure significantly increased the serum contents of serotonin, adenine, guanine, guanosine, inosine monophosphate (IMP), inosine, and hypoxanthine in DSS-treated mice. The overall gut microbial community was significantly modified by PCP and DSS treatment alone. Rikenellaceae_RC9_Gut_group, Colidextribacter, and Desulfovibrio were more abundant in colitis mice following PCP exposure. Further integrative analysis of differential bacteria and purine metabolites highlighted a significant correlation between Desulfovibrio and several purine metabolites, including guanine, guanosine, hypoxanthine, IMP, and inosine. Adenosine ribonucleotides de novo biosynthesis, inosine-5'-phosphate biosynthesis I, and urate biosynthesis/inosine 5'-phosphate degradation pathways were depleted in colitis mice upon PCP treatment. Taken together, PCP exposure delayed the recovery of colitis induced by DSS in association with altered gut microbiota and serum metabolites, which were enriched in tryptophan and purine metabolism.

Effects of fasting on golden pompano Trachinotus ovatus: Physiological and biochemical responses

In practice, golden pompano (Trachinotus ovatus) reared in offshore cages may experience short-term fasting during extreme weather conditions, yet their physiological and biochemical responses remain poorly understood. To investigate the responses of this species to fasting, golden pompano weighing 138.0 ± 2.1 g were deprived of food for 0, 7, 14, 21 and 28 days, followed by assessments of body mass, somatic parameters, proximate composition, muscle glycogen, intestinal digestive enzymes, muscle amino acid and fatty acid profiles, nutritional value, and muscle texture and water holding capacity. Lower condition factor, hepatosomatic index, viscerosomatic index, hepatic glycogen, and intestinal activities of amylase, lipase and trypsin were found in the fasted fish than in the non-fasted fish, while a sharp decline in these parameters occurred on the first week of fasting. Fresh mass, dry mass, whole body and muscle contents of crude protein and lipid tended to decrease with prolonged fasting, while no statistical differences were found in these parameters between fish fasted for 7 days and the non-fasted fish. Furthermore, the decline rate of whole body crude lipid was consistently higher than that of whole body crude protein throughout the different stages of the 28-day fasting period, with the exception of the second week of fasting. No statistical differences were found in the total essential amino acids (∑EAA), non-essential amino acids (∑NEAA), ratio of ∑EAA to∑NEAA, chemical score, amino acid score, and essential amino acid index in the fasted fish compared to the non-fasted fish of group 0d. Fasting altered the muscle profile of SFA, MUFA and PUFA, sometimes reducing muscle springiness (groups 7d and 14d) and hardness (group 21d). Compared to non-fasted fish, fish fasted for 7 and 14 days exhibited statistically lower or equal drip loss, water loss rate, storage losses, and frozen exudate rate, whereas higher cooked meat rate. The above results indicate that during the 28-day fasting period, the visceral fat and hepatic glycogen are initially metabolized, followed by body proteins and lipids, to maintain the normal metabolism in fasted fish. Fasting has beneficial effects on the nutritional value of amino acids and fatty acids in muscle, although it modifies the muscle SFA, MUFA and PUFA composition and sometimes has negative effects on muscle texture. Considering the balance between body weight loss and flesh quality improvement, the duration of fasting for cultured golden pompano prior to harvesting should not exceed 14 days.

Formononetin ameliorates dextran sulfate sodium-induced colitis via enhancing antioxidant capacity, promoting tight junction protein expression and reshaping M1/M2 macrophage polarization balance

Ulcerative colitis (UC) is a complex, refractory inflammatory bowel disease characterized impared intestinal mucosal barrier and imbalanced M1/M2 macrophage polarization mediating its progression. Formononetin (FN), a bioactive isoflavone with established anti-inflammatory and immunomodulatory properties, shows promise in mitigating UC, yet its therapeutic and underlying mechanisms remain unclear. In this study, colitis was induced in mice by administering 2.5% (w/v) dextran sulfate sodium (DSS) solution for 7 days. Oral (25, 50, and 100 mg/kg) FN for 10 days significantly ameliorated colitis symptoms in a dose-dependent manner, by mitigating body weight loss, reducing disease activity index (DAI), colonic weight, and colonic weight index, while enhancing survival rates and colonic length. Histological analysis revealed FN remarkably suppressed inflammatory damage in colonic tissues. Furthermore, FN modulated the expression of pro- and anti-inflammatory cytokines and enhanced antioxidant capacity. Notably, FN treatment significantly enhanced the expression of tight junction (TJ) proteins (claudin-1, ZO-1, occludin) at both protein and mRNA levels in the colon tissues, suggesting improved intestinal barrier function. Crucially, FN inhibited macrophage infiltration in colonic tissues and rebalanced M1/M2 macrophage polarization. While, macrophage depletion largely abrogated FN’s protective effects against colitis, indicating a crucial role for macrophages in mediating FN’s therapeutic response. Overall, FN effectively alleviated colitis primarily via modulating inflammatory cytokine expression, enhancing antioxidant capacity, upregulating TJs proteins expression, and remodeling M1/M2 macrophage polarization equilibrium. These findings suggest that FN could be the next candidate to unlocking UC’s treatment challenge.

227 Moderate body weight loss reduces total antioxidant capacity in pregnant beef heifers and one-carbon metabolite supplementation does not mitigate this response

Abstract In beef heifers, body weight (BW) gain and physiological stress are important considerations for reproductive outcomes and whole herd production efficiencies. The objective of this study was to determine if dietary one-carbon metabolite (OCM) supplementation in moderate BW loss pregnant heifers alters circulating total antioxidant capacity, superoxide dismutase, and glutathione peroxidase activity. In a replicated 2 × 2 factorial, Angus-cross heifers (n = 81) were stratified by BW to gain 0.45 kg/d (CON) or lose 0.23 kg/d (RES) and receive corn carrier with OCM supplements (+OCM) or without (−OCM). The OCM supplements consisted of vitamin B12 (20 mg) and folate (320 mg) injections weekly and dietary rumen-protected methionine (7.4 g/d) and choline (44.4 g/d) from breeding (d 0) to d 63 of gestation. The four treatment groups were: CON−OCM (n = 20), CON+OCM (n = 21), RES−OCM (n = 21), and RES+OCM (n = 19). Heifers underwent estrus synchronization and were bred via artificial insemination using female sexed semen to a single sire. Pregnancy was diagnosed and fetal sex was verified on d 35 of gestation. Blood was collected and assayed for total antioxidant capacity, superoxide dismutase, and glutathione peroxidase activity on d −2 (baseline), 35, and 63 of gestation for all three replicates. Data were analyzed using the MIXED procedure of SAS with repeated measures to determine the effect of gain, supplement, day, and their two-way and three-way interactions. The gain × supplement interaction remained in all models, but other interactions were removed if P > 0.10. Replicate and heifer BW were included in the model as covariates and covariance structure was determined by lowest AIC and BIC. Statistical significance was considered at P ≤ 0.05 and tendencies at 0.05 < P ≤ 0.10. There was no BW gain × supplement interaction, or main effect of OCM supplements in total antioxidants. There was a gain × day effect (P ≤ 0.01), in which total antioxidants were increased on d 35 and further increased on d 63 in CON compared with RES treatments. There was no gain × supplement interaction, or main effect of gain or OCM supplements in superoxide dismutase and glutathione peroxidase. However, both superoxide dismutase and glutathione peroxidase were decreased (P ≤ 0.01) on d 63 compared with d 0 and 35. These data suggest that moderate BW loss reduces total antioxidant capacity in pregnant beef heifers, which could affect redox homeostasis. However, OCM supplements did not affect total antioxidant capacity, superoxide dismutase, or glutathione peroxidase. These findings are somewhat surprising considering oxidative stress has been well characterized in nutrient-restricted pregnancies, and given the interconnection between energy metabolism and one-carbon metabolism. Future research is warranted to fully elucidate the therapeutic effects of one-carbon metabolites.

Role of the intestinal microbiota in contributing to weight disorders and associated comorbidities.

SUMMARYThe gut microbiota is a major factor contributing to the regulation of energy homeostasis and has been linked to both excessive body weight and accumulation of fat mass (i.e., overweight, obesity) or body weight loss, weakness, muscle atrophy, and fat depletion (i.e., cachexia). These syndromes are characterized by multiple metabolic dysfunctions including abnormal regulation of food reward and intake, energy storage, and low-grade inflammation. Given the increasing worldwide prevalence of obesity, cachexia, and associated metabolic disorders, novel therapeutic strategies are needed. Among the different mechanisms explaining how the gut microbiota is capable of influencing host metabolism and energy balance, numerous studies have investigated the complex interactions existing between nutrition, gut microbes, and their metabolites. In this review, we discuss how gut microbes and different microbiota-derived metabolites regulate host metabolism. We describe the role of the gut barrier function in the onset of inflammation in this context. We explore the importance of the gut-to-brain axis in the regulation of energy homeostasis and glucose metabolism but also the key role played by the liver. Finally, we present specific key examples of how using targeted approaches such as prebiotics and probiotics might affect specific metabolites, their signaling pathways, and their interactions with the host and reflect on the challenges to move from bench to bedside.

Sex-Specific Adherence to the Mediterranean Diet in Obese Individuals.

Adherence to the Mediterranean diet (MedDiet) has long been associated with several health benefits, including a reduced risk of heart disease, diabetes, and obesity. The MedDiet is characterized by a high consumption of foods such as fruits, vegetables, whole grains, fish, and olive oil, along with a moderate intake of red meat and red wine with meals. Some studies report significant differences between men and women in susceptibility to obesity, with women at a higher prevalence of obesity than men. One unexplored aspect, however, concerns the sex difference in MedDiet adherence, which could be influenced by various factors, such as health perceptions, food preferences, and cultural influences. The aim of this study is to assess the effectiveness and impact of MedDiet adherence in men and women, with a focus on its influence on health and well-being, as well as its ability to promote sex equity in healthcare outcomes. Moreover, we aim to measure the overall health improvements in men and women participating in a MedDiet program, including changes in body composition and overall quality of life. This study highlights that the MedDiet is associated with more significant body weight loss in women, although their increase in MedDiet adherence was lower than in men. Trial registration: NCT01890070. Registered 24 June 2013.

Evolution and biological characteristics of H11 avian influenza viruses isolated from migratory birds and pigeons

ABSTRACT The emergence of novel avian influenza reassortants in wild birds in recent years is a public health concern. However, the viruses that circulate in migratory birds are not fully understood. In this study, we summarized and categorized global H11 avian influenza viruses and reported that waterfowl and shorebirds are the major reservoirs of the identified H11 viruses. The surveillance data of the 35,749 faecal samples collected from wild bird habitats in eastern China over the past seven years revealed a low prevalence of H11 viruses in birds, with a positive rate of 0.067% (24 isolates). The phylogenetic analysis of the twenty viruses indicated that H11 viruses have undergone complex reassortment with viruses circulating in waterfowl and shorebirds. These tested viruses do not acquire mammalian adaptive mutations in their genomes and preferentially bind to avian-type receptors. Experimental infection studies demonstrated that the two tested H11N9 viruses of wild bird origin replicated and transmitted more efficiently in ducks than in chickens, whereas the pigeon H11N2 virus isolated from a live poultry market was more adapted to replicate in chickens than in ducks. In addition, some H11 isolates replicated efficiently in mice and caused body weight loss but were not lethal. Our study revealed the role of waterfowl and shorebirds in the ecology and evolution of H11 viruses and the potential risk of introducing circulating H11 viruses into ducks or chickens, further emphasizing the importance of avian influenza surveillance at the interface of migratory birds and poultry.

Creatine Supplementation Prior to Strength Exercise Training Is Not Superior in Preventing Muscle Mass Loss Compared with Standard Nutritional Recommendations in Females After Bariatric Surgery: A Pilot Study.

This study examines whether creatine supplementation combined with strength training mitigates muscle mass loss in women during early rehabilitation post-bariatric surgery, as its effectiveness remains untested in this context. Fifteen women (37.8 ± 9.6 years; BMI, 38.8 ± 5.6 kg/m2) completed the intervention (creatine group = 7; placebo group = 8). Both groups followed a strength training program three times a week for 8 weeks. The dosage for both the creatine and placebo was 8 g prior to each exercise session. Body weight, skeletal muscle mass, fat mass, handgrip strength, and physical activity levels were measured before and after the intervention. The creatine group showed a reduction of 9.5 ± 1.5 kg in body weight, with a 0.72 ± 0.6 kg decrease in muscle mass and an 8.64 ± 1.2 kg reduction in fat mass. The placebo group had a reduction of 9.6 ± 3.5 kg in body weight, with a 0.6 ± 1.2 kg decrease in muscle mass and an 8.88 ± 3.2 kg reduction in fat mass, without significant differences between groups (p > 0.05). The pre-session strength exercise training creatine supplementation is not superior to placebo regarding body weight and fat mass losses and the attenuation of muscle mass loss during the first weeks of rehabilitation following bariatric surgery.

The Effect Of Weight Loss With Lifestyle Changes On LDL Cholesterol: Retrospective Cohort Study

Aim: This study aimed to investigate the rate of decrease in lipid levels with effective lifestyle changes (LC) and the minimum body weight loss necessary for effective lipid reduction in obese patients. Method: The study is a retrospective cohort study. The study included 71 patients who were followed up in the obesity clinic, who were diagnosed with hyperlipidemia but did not use any hyperlipidemia treatment. The patients' high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglyceride, body fat ratio and mass, body mass index (BMI), height and weight information were recorded at the first visit and the 6th month. In our study, patients were divided into two groups (based on the weight loss rates in the 6-month follow-up) those who lost less than 10% of their previous weight and those who lost 10% or more weight and their lipid parameters were compared. Results: LDL-C reduction rates of patients classified according to their weight loss rates were found to be statistically significantly (p=0.011) higher in those with 10% or more weight loss than (group 1=18.48%) in those with less than 10% weight loss (group 2=13.04%). Total cholesterol reduction rates were also significantly (p=0.015) higher in the 1st group than in the 2nd group. According to the findings of our study, at least 10% weight loss is required to decrease total cholesterol and LDL-C significantly. Conclusion: Implementation of primary and secondary prevention strategies to reduce the risk of cardiovascular disease is important in the context of primary care. To reach the targeted LDL-C values, the weight monitoring of obese patients should be considered, and the importance of losing at least 10% of weight as one of the first steps should be emphasized.

Proanthocyanidins and β-Glucan Synergistically Regulate Intestinal Inflammation in Dextran Sulfate Sodium-Induced Colitis Mice.

Proanthocyanidins (PA) have been proven to have an anti-inflammation effect in multiple models by regulating oxidative stress. β-glucan (BG) could alleviate colitis from the perspectives of intestinal permeability and gut microbiota. In the present study, the synergistic anti-inflammatory function of PA and BG was explored from multiple aspects including immune response, intestinal barrier, gut microbiota, and differential metabolites. The results showed that the supplementation of PA and BG improved the colitis symptoms including atrophy of the colon, body weight loss, and organ index increase. Additionally, inflammatory cytokine levels and oxidative stress status were significantly regulated with the intake of PA and BG. Moreover, PA and BG intervention improved intestinal permeability and promoted the expression of barrier proteins. The microbiome and metabolic profile of cecal contents showed that PA and BG supplementation increased the abundance of anti-inflammatory bacteria and decreased the abundance of pro-inflammatory bacteria. Furthermore, some beneficial metabolites involved in amino acid metabolism, carbohydrate metabolism, and biosynthesis of other secondary metabolite pathways were increased. Overall, these findings have demonstrated the regulation of the inflammatory response and remodel of metabolite profiles by PA and BG complexes, indicating that it may serve as a new strategy for inflammatory bowel disease treatment in the future.

Knockdown of the glucosamine-6-phosphate N-acetyltransferase gene by RNA interference enhances the virulence of entomopathogenic fungi against rice leaffolder Cnaphalocrocis medinalis

Insect cuticle acts as a first line of defense and a physical protective barrier against entomopathogens. Chitin biosynthesis pathway plays a crucial role in chitin formation in the cuticle of insects. Glucosamine-6-phosphate N-acetyltransferase (GNA) is a key enzyme in insect chitin biosynthesis that regulate the chitin formation. However, how GNA-mediated cuticle metabolism influences virulence of entomopathogenic fungi is still unknown. In this study, CmGNA gene was cloned and characterized from the rice leaffolder Cnaphalocrocis medinalis. The CmGNA contains an open read frame (ORF) 600 nucleotides, encoding 199 amino acids with an isoelectric point of 8.65 and a molecular weight of 22.30 kDa. The expression profile showed that CmGNA was highly expressed in 4th instar larvae and in the cuticle. Here, we also reported the impact of CmGNA gene and entomopathogenic fungi, Metarhizium anisopliae and Beauveria bassiana, on expression pattern of chitin biosynthesis genes, feeding behavior, survival rate and average body weight of infected larvae, phenotypic deformities, rate of pupation, and adult emergence. Our results showed that knockdown of CmGNA and application of M. anisopliae and B. bassiana three days after RNA interference (RNAi) significantly decreased the expression of CmGNA and other associated genes, reduced feeding efficiency and survival rate, and caused loss of average body weight, less rate of pupation and adult emergence of infected larvae. Knockdown of CmGNA gene also increased the lethality of larvae caused by M. anisopliae and B. bassiana and resulted in significantly phenotypic deformities of infected larvae. Our findings illustrated that RNAi-mediated CmGNA knockdown disturbed the chitin synthesis genes that led to enhancing the virulence of M. anisopliae and B. bassiana, which can provide us new insights to develop novel biocontrol strategies against C. medinalis.

MINIMALLY INVASIVE TREATMENT OF MECHANICAL STOMACH SUTURE FAILURE IN PATIENTS AFTER LONGITUDINAL RESECTION FOR OBESITY (A CLINICAL CASE)

Sleeve gastrectomy has now become one of the most popular operations in the treatment of morbid obesity. We present a clinical case of minimally invasive treatment of early suture failure after sleeve gastrectomy, from the archive of the authors’ clinical observations. Suture failure occurred on the day 4 after surgery. Endogastroscopy revealed a defect of 12 mm in diameter with infiltration at the edges. The technique of endoscopic sanitation of the abscess cavity and transcutaneous drainage of the abdominal cavity was used. After 14 days, the drainage in the abdominal cavity stopped functioning. Fistulography showed that it was not in the abscess cavity; according to endoscopic fistulography, hermetic sealing was achieved. After 2 months the fistula was completely closed. The patient was discharged with complete recovery. After 6 months, EGD revealed cicatrical changes; body weight loss: 55 kg. This clinical case demonstrated the possibility of combined minimally invasive treatment of a postoperative complication – gastric suture failure after sleeve gastrectomy.

Intradermal Injection of a Thermoresponsive Polymeric Dexamethasone Prodrug (ProGel-Dex) Ameliorate Dermatitis in an Imiquimod (IMQ)-Induced Psoriasis-like Mouse Model.

Psoriasis is a chronic immune-mediated inflammatory skin disease, affecting ∼ 3% of the US population. Although multiple new systemic therapies have been introduced for the treatment of psoriatic skin disease, topical and intralesional glucocorticoids (GCs) continue to be used as effective psoriasis therapies. Their clinical utility, however, has been hampered by significant adverse effects, including skin atrophy and pigmentation as well as elevated blood glucose levels and hypertension. To mitigate these limitations, we have developed a N-(2-hydroxypropyl) methacrylamide (HPMA) copolymer-based thermoresponsive dexamethasone (Dex) prodrug (ProGel-Dex) and assessed its therapeutic efficacy and safety in an imiquimod (IMQ)-induced psoriasis-like (PL) mouse model. ProGel-Dex was intradermally administered once at three dosing levels: 0.5, 1.0, and 2.0 mg/kg/day Dex equivalent at the beginning of the study. PL mice were also treated with daily topical saline or Dex, which were used as control groups. Treatment of PL mice with ProGel-Dex dosed at 0.5 mg/kg/day resulted in a significant reduction in scaling and erythema. Improvement in gross pathology scores, skin histological scores, and serum cytokine levels was also observed. Interestingly, for mice treated with ProGel-Dex at 1.0 and 2.0 mg/kg/day Dex equivalent, only improvement in skin erythema was observed. GC-associated side effects, such as elevation of serum alanine aminotransferase (ALT) and amylase levels and body weight loss, were not observed in mice treated with ProGel-Dex at 0.5 and 1.0 mg/kg/day Dex equivalent. Collectively, these results demonstrate the efficacy and improved safety of ProGel-Dex in treating psoriatic skin lesions when compared to topical Dex treatment, supporting its translational potential for clinical management of lesional skin psoriasis.

Segmental multi-frequency bioelectrical impedance analysis indicates dehydration status after exercise

AimHydration status monitoring is critical to help those in exercise training to avoid serious dehydration. Bioelectrical impedance analysis (BIA) is a convenient and timely method to monitor body composition in resting conditions. The study obtained bioelectrical impedance (BI) from different segments at multi-frequency before and after exercise aiming to evaluate whether segmental multi-frequency (SMF)-BIA can indicate exercise dehydration in humans. MethodsA total of 43 young adults were recruited. Body weight (BW) and segmental BI at frequencies of 1, 5, 50, 250, 500, and 1000 kHz from each subject were measured before and after each bout of exercise. Hydration status was assessed by body weight loss (BWL), indicated by changes in body weight (ΔBW) and the percentage of body weight change (ΔBW%). Each subject participated in 3 to 4 exercise sessions on different days. ResultsA total of 143 pieces of data were collected with various degrees of dehydration: BWL ranging from 0.2–4.2 kg (0.4 %–5.8 %) in participants (aged 24.40 ± 6.47). Correlation analysis revealed that the changes of BI (ΔZ) in arms and legs during exercise were correlated with the BWL. Multivariate regression and machine learning analysis showed that predicted values of dehydration were correlated with true values of dehydration (ΔBW: R2 = 0.4471, R2 = 0.5502; ΔBW%: R2 = 0.4469, R2 = 0.5073). When the diagnosis of dehydration is based on BWL > 1 %: the AUC of the SMF-BIA regression model was 0.7262 (p < 0.001) and the specificity and sensitivity were 85.19 %, 60 %. When the diagnosis of dehydration is based on BWL > 2 %: the AUC of the SMF-BIA regression model was 0.8757 (p < 0.0001) and the specificity and sensitivity were 77.22 %, 81 %. ConclusionThese results suggested that SMF-BIA can indicate exercise dehydration in humans.

Anabolic deficits and divergent unfolded protein response underlie skeletal and cardiac muscle growth impairments in the Yoshida hepatoma tumor model of cancer cachexia.

Cancer cachexia manifests as whole body wasting, however, the precise mechanisms governing the alterations in skeletal muscle and cardiac anabolism have yet to be fully elucidated. In this study, we explored changes in anabolic processes in both skeletal and cardiac muscles in the Yoshida AH-130 ascites hepatoma model of cancer cachexia. AH-130 tumor-bearing rats experienced significant losses in body weight, skeletal muscle, and heart mass. Skeletal and cardiac muscle loss was associated with decreased ribosomal (r)RNA, and hypophosphorylation of the eukaryotic factor 4E binding protein 1. Endoplasmic reticulum stress was evident by higher activating transcription factor mRNA in skeletal muscle and growth arrest and DNA damage-inducible protein (GADD)34 mRNA in both skeletal and cardiac muscles. Tumors provoked an increase in tissue expression of interferon-γ in the heart, while an increase in interleukin-1β mRNA was apparent in both skeletal and cardiac muscles. We conclude that compromised skeletal muscle and heart mass in the Yoshida AH-130 ascites hepatoma model involves a marked reduction translational capacity and efficiency. Furthermore, our observations suggest that endoplasmic reticulum stress and tissue production of pro-inflammatory factors may play a role in the development of skeletal and cardiac muscle wasting.

Weight loss after Roux-en-Y gastric bypass and single anastomosis duodenoileostomy following failed sleeve gastrectomy.

While sleeve gastrectomy (SG) results in sustained weight loss for the majority of patients, some will experience inadequate weight loss or weight regain requiring revision. The objective of this study was to evaluate differences in weight loss over time between patients undergoing Roux-en-Y gastric bypass (RYGB) or single anastomosis duodenoileostomy (SADI) after SG. We queried a single institution's bariatrics registry to identify patients who underwent RYGB or SADI after previous SG over a three-year period. Demographics, operative characteristics, and post-operative complications were evaluated. Interval total body weight loss (TBWL) and excess body weight loss (EBWL) were calculated from available follow-ups within 2years. We identified 124 patients who underwent conversion to RYGB (n = 61) or SADI (n = 63) following previous SG. There were no differences in sex, age, or medical comorbidities between groups. The median initial BMI was higher in the SADI group (44.9 vs. 41.9 for RYGB, p = 0.03) with greater excess body weight (56.7 vs. 64.3kg, p = 0.04). The SADI group had a shorter median operative duration (157 vs. 182min for RYGB, p < 0.01) and lower readmission rates (0 vs. 14.75%, p < 0.01). There was no difference in post-operative complications or need for rehydration therapy between the groups. Among 122 patients (98.4%) that had follow-up weights available, there were no differences in TBWL between groups. RYGB patients had a higher EBWL at 2, 3, and 6months (p < 0.05 for all comparisons), but there were no differences between RYGB and SADI at 1 or 2 years. Both RYGB and SADI conversions proved effective for further weight loss following failed SG at our academic center. While neither demonstrated clear superiority in long-term (> 1year) weight loss, RYGB's restrictive gastric pouch may explain its early weight loss advantage.

376. COMPARISON OF POST-SURGICAL NUTRITIONAL STATUS BETWEEN IVOR-LEWIS ESOPHAGECTOMY AND PROXIMAL GASTRECTOMY

Abstract Background In our institution, the surgical approach for esophagogastric junction cancer (EG) is determined based on the tumor location and the extent of esophageal invasion, opting for either Ivor-Lewis esophagectomy (IL) or proximal gastrectomy (PG). Both procedures necessitate the mitigation of postoperative weight loss, with nutritional therapy using Elemental diet 300 kcal/day initiated postoperatively and nutritional guidance provided by dietitians before discharge, and at 1, 3, 6, and 12 pos-operative months (POM). Additionally, quality of life (QOL) assessment using the PGSAS-37 questionnaire is conducted, and feedback is provided to patients. Methods The aim of this study is to compare the weight changes up to 12 POM and the temporal changes in PGSAS-37 scores following IL and PG procedures in our institution. We analyzed 45 cases who underwent IL or PG in our institution between January 2019 and December 2022, excluding cases of early recurrence within 12 months and those without questionnaire responses. Patient demographics, postoperative complications, anastomotic strictures, duration of Elemental intake (months), percentage of body weight loss (BWL) at 1, 3, 6, and 12 POM, and PGSAS-37 scores were extracted from electronic medical records. Results There were 27 IL cases and 18 PG cases. Postoperative complications of Grade 3 or higher were observed in 3 of IL group and 1 of PG group. Anastomotic strictures were observed in 1 of IL group and 6 of PG group. Duration of Elemental intake (months) was 4.5 (0-39) in IL group and 0 (0-8) in PG group (p=0.001). Median BWL (%) at 1/3/6/12 POM was IL: 4.5/8.3/10.3/13.8 and PG: 3.8/8.5/8.7/10.6. Temporal changes in total symptom score were similar in both IL and PG groups, but esophageal reflux subscale at 12 POM was significantly better in PG group (p=0.04). Conclusion The questionnaire response rates were approximately 80% at 12 months for both groups, but below 12 months ranged from 22.2% to 50%, indicating difficulty in assessing temporal changes in QOL. At 12 months, the IL group exhibited a greater percentage of weight loss than the PG group (p=0.027), but QOL evaluations, except for reflux symptoms SS, were comparable between the two groups. Both IL and PG groups experienced rapid weight loss up to 3 POM, with continued decline up to 12 months. However, improving questionnaire response rates is deemed necessary for investigating the relationship with QOL.

A randomized, double-blind, placebo-controlled trial of weight loss using liraglutide 3.0 mg for weight recurrence after Roux-en-Y gastric bypass

BackgroundBariatric surgery, such as Roux-en-Y gastric bypass (RYGB) remains the gold standard for treating obesity. Most people regain weight from postsurgery nadir. ObjectivesLiraglutide 3.0 mg is approved for weight management. This study will examine the effects on liraglutide 3.0 mg on weight regain post-RYGB. SettingUniversity Hospital, United States. MethodsA 56-week, double-blind, placebo-controlled study was conducted in 132 subjects, who achieved ≥25% total body weight loss (TBWL) status-post-RYGB and regained ≥10% TBWL after reaching nadir weight (NW). Subjects 18–120 months post-RYGB were randomized to receive liraglutide 3.0 mg/d (n = 89) or placebo (n = 43) with lifestyle counseling regularly for 56 weeks. The co-primary endpoints were the proportion of subjects losing at least 5%, 10%, and 15% TBWL and achieving weight lower than their NW. Results53.4% of the placebo group and 65% of the liraglutide group completed the trial due to Severe acute respiratory syndrome coronavirus 2 pandemic. The change in %TBWL from baseline to 56-weeks was −8.8 (8.5, −29.2 to 9.7) and 1.1 (3.5, −7.9 to 5.99) in the liraglutide and placebo groups, respectively. 76% and 17% of subjects achieved ≥5% TBWL at 56 weeks in the liraglutide and placebo groups, respectively; 51% and 26.0% of the liraglutide group achieved ≥10% and ≥15% TBWL, respectively. None of the placebo group lost ≥10% TBWL. Twenty-one percent of subjects receiving liraglutide surpassed postoperative NW. No subjects on placebo met this goal. Nonserious adverse events occurred in 41.6% of subjects on liraglutide. Serious adverse events (SAE) occurred less often on liraglutide. ConclusionsLiraglutide was significantly more effective than placebo in treating weight regain that occurs post-RYGB without increased SAE.