Borderline Obesity Research Articles

Abstract 15290: Hypertension in Black and White Breast Cancer Survivors: NCT02992730

Introduction: Hypertension (HTN) may increase the risk of cardiovascular (CV) events among breast cancer (BC) survivors, particularly in Black women. Limited information is available about factors associated with the presence of HTN at the time of BC diagnosis among Black versus White women. Methods: In a secondary analysis of data from a longitudinal cohort of Black and White women diagnosed with hormone receptor positive (HR+) BC, post initiation of adjuvant endocrine therapy (AET), medical records were used to determine HTN status and other clinical factors (stage, AET type, CV comorbidities). In the same cohort, psychosocial and quality of life data were collected via surveys. Logistic regression models evaluated factors associated with increased odds of HTN at baseline. Results: Women with BC (n=243) were mostly White (66.7%), mean (SD) aged 61.6 (10.9) years, with borderline obesity (BMI: 29.9 (6.6)). Comorbidities and tamoxifen use were reported by 40.7% and 28.4% of women, respectively. HTN was present in 140 (57.6%) women (38% Black, 62% White). Relative to their White counterparts, Black women with HTN were significantly younger, (61.5 vs. 67.5 years of age, p< 0.01) more overweight (BMI, 32.8 vs 29.3, p =<.01), received chemotherapy more frequently (44.4% vs 22.1%, p <0.01), were more likely to have experienced discrimination (35.2% vs 7%, p <0.01) and more often to possess CV comorbidities (61.1% vs 37.2%, p <0.01). Multivariable logistic regression showed that the odds of having HTN increased significantly with age by 10% per year (OR: 1.10, 95% CI: 1.06-1.14; p<.0001), with Black women having a 2-fold greater risk of having HTN (OR: 2.02, 1.02-4.03; p=.044) than White women. Additionally, a 1-unit increase in BMI was associated with 6% higher odds of having HTN (OR: 1.06, 95% CI: 1.03-1.11; p=0.0390) while Tamoxifen use, presence of CV comorbidities and worse social well-being were not associated with more frequent HTN in women with BC. Conclusions: A high proportion of women diagnosed with HR+ BC have HTN with Black vs White women experiencing more HTN. These results raise the possibility that Black women with BC may benefit from focused HTN management strategies to reduce potential CV events.

순환식 탄력밴드 운동이 경계성 비만중년여성들의 심혈관질환 유발인자와 간 기능 요인에 미치는 영향

The purpose of this study was to investigate the effects of circulatory band exercise on cardiovascular disease-inducing factors and liver function improvement in middle-aged women with borderline obesity. and the following conclusions were drawn. In the cardiovascular disease inducing factors, there was no significant difference the measurement period and the groups in all factors of blood lipid, and it was found that there was an interaction effect only the measurement period × the groups. In liver function, there was no significant difference in the measurement period, groups, measurement period×groups in all factors in AST and ALT, and there was no interaction effect, and only γ-GTP showed an interaction effect.<BR>Summarizing the above, it was found that circulatory band exercise had a positive effect on cardiovascular disease-causing factors and liver function in borderline obese middle-aged women. An improved form was shown in the exercise group. Therefore, it is thought that better results can be derived if these exercises are carried out with a more detailed and prolonged exercise prescription.

0819 Restless Sleep, Snoring, Excessive Daytime Sleepiness, And Ataxia: A Pediatric Quandary

Abstract Introduction Central sleep apnea in pediatrics is inherently complex, often going undiagnosed and untreated. Signs and symptoms of central nervous system dysfunction may be attributed to more common childhood conditions. We aim to educate on the diagnosis and treatment of central sleep apnea in this vulnerable patient population. Report of Cases: A 12-year-old girl presents for initial sleep visit with global developmental delay, borderline obesity, chronic headaches, early morning tremors, and insulin resistance. She has history of snoring and restless sleep for years with severe daytime sleepiness for the past three months with worsening over two to four weeks. She is unable to stay awake in school. Epworth sleepiness scale (ESS) score is twenty-one. There is history of recurrent Strep but no history of infectious mononucleosis or influenza infection. Primary sleep disorders or CNS hypersomnia are suspected, and polysomnogram with MSLT is ordered. MRI of the brain is pending. The patient presents to the emergency department ten days later with frontal headaches, ataxia, altered speech, and oral aversion. CT head is normal. Hematology, neurology, and neurosurgery are consulted. MRI of the brain shows thrombosis of the superior sagittal sinus, the right transverse sinus, the right sigmoid sinus, the right jugular bulb, as well as cortical veins overlying both cerebral hemispheres, and she is started on anticoagulation for suspected stroke. A polysomnogram shows a severe degree of central sleep apnea with a central apnea index of 49.9 events per hour. There is significant periodic breathing present. There is no nonapneic hypoxemia or sleep hypoventilation present, and the patient is scheduled for an oxygen titration study. Conclusion Central sleep apnea is more prevalent in older male individuals and may affect patients with heart failure1.Pediatricians and subspecialists must remain vigilant as children are also susceptible to medical conditions which result in central nervous system dysfunction. Support (If Any) 1.) Donovan LM, Kapur VK. Prevalence and Characteristics of Central Compared to Obstructive Sleep Apnea: Analyses from the Sleep Heart Health Study Cohort. Sleep. 2016;39(7):1353-1359. Published 2016 Jul 1.doi:10.5665/sleep.5962

Trajectories of body mass index in adulthood and all-cause and cause-specific mortality in the Melbourne Collaborative Cohort Study

ObjectiveLimited research has assessed the association between patterns of body mass index (BMI) change across adulthood and mortality. We aimed to identify groups of individuals who followed specific group-based BMI...

규칙적인 복합운동이 경계성 비만 중년여성들의 혈압과 건강관련체력에 미치는 영향

In this study, we classified middle-aged women with borderline obesity into the exercise group(n=20) and a total of 8 weeks of combined(band+circulation) exercise program was performed. The results were compared with those of 0 week and 8 week. First, blood pressure of middle-aged women with borderline obesity increased in the second measurement rather than the first measurement, and maintained the normal level. Second, there was no statistically significant difference in the waist circumference, body weight, and body fat percentage in the health-related physical fitness of the borderline obese middle-aged women. There was also a statistically significant difference in muscle strength, muscle endurance, cardiovascular endurance, and flexibility. In conclusion, we conclude that combined exercise for middle-aged women with borderline obesity is one of the exercise programs that can improve the physical fitness level with positive blood pressure maintenance and improvement of health-related physical fitness. In later studies, exercise intensity and frequency were found to be better for women with borderline obesity, and it would be expected to prevent diseases such as lifestyle-related diseases.

TABATA 운동이 경계성 비만 중년여성들의 간기능 개선과 대사증후군 위험인자에 미치는 영향

TABATA 운동이 경계성 비만 중년여성들의 간기능 개선과 대사증후군 위험인자에 미치는 영향

The impact of BMI extremes on disease-free survival and overall survival following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are increasingly being offered to patients with peritoneal carcinomatosis (PC). On the other hand, the prevalence of obesity is also increasing and expected to reach unprecedented rates in the upcoming decades. Therefore, managing patients on either extreme of the body mass index (BMI) range is anticipated to become a routine challenge and it becomes imperative to understand the impact of BMI, as a spectrum, on the long-term outcomes of CRS and HIPEC. We aim to study the short and long-term outcomes of CRS and HIPEC in patients on both extremes of the BMI spectrum. Patients with PC who underwent CRS and HIPEC over 10 years for ovarian, colorectal, and pseudomyxoma peritonei (PMP), and whose BMI was recorded were retrospectively included. Patients were divided based on their weight strata. The primary outcomes were disease-free survival (DFS) and overall survival (OS). A total of 126 patients were included. Fifty-seven point one percent were females and mean age was 59.31±1.57 years. No difference was noted between the groups in regards to demographics, perioperative characteristics, and immediate postoperative outcomes. Underweight group had a trend toward a higher peritoneal cancer index and lower rates of complete cytoreduction. Optimum BMI for OS and DFS was in the obesity range in colorectal PC, in the overweight range in ovarian PC, and in borderline obesity in PMP. Regression analysis identified underweight as an independent risk factor for shorter DFS, whereas underweight and morbid obesity were risk factors for shorter OS, after adjustment for other factors such as incomplete cytoreduction, tumor histology, and grade. OS and DFS vary across the BMI strata. Ovarian PC demonstrates earlier recurrence and shorter survival, whereas colorectal PC demonstrates the "obesity paradox" as patients move into the realm of obesity. BMI extremes, low or high, generally carry a poor prognosis for OS.

Sa1589 Gastric Balloon Treatment of 539 Overweight Patients. Research, Statistics, Problems, Complications, Successes, Failures and Long-Term Effects. Uyak, Medical One Hamburg/Germany

We have had10 years of experience from 2003 to 2013 with gastric balloon treatment. Of 539 overweight patients BMI more than 27 were at Medical One in Germany. We have studied statistics and long-term effects, successes and failures, problems, complications and research. We conducted a hormone study between 2010-2011 at Medical One HAMBURG. Our question was: Is insulin resistance the preliminary stage of the metabolic syndrome and obesity?We looked at the results of treatment of borderline obesity, (87patients), obesity1st (168 Patients), obesity 2nd (187 Patients), obesity 3rd (97 Patients) degree and the difference between females and males.

The relationship between morphometric parameters and Trendelenburg sign following the Hardinge incision

We evaluated the relationship between morphometric parameters such as height, weight, and body mass index with the development of the Trendelenburg gait following the Hardinge approach, which is one of the most commonly used approaches in total hip arthroplasty. The study included 59 patients (43 women, 16 men; mean age 55 years; range 37 to 74 years) who underwent total hip arthroplasty via the Hardinge approach for primary coxarthrosis. The patients were examined postoperatively at 15 days, and at the end of the first and third months. The mean follow-up period was 24.3 months (range 12 to 37 months). The height, weight, and body mass index values of the patients with and without a positive Trendelenburg sign were compared. The Trendelenburg sign was positive in 19 patients (32.2%) following total hip arthroplasty with the Hardinge approach and persisted for a mean of 8.3 months (range 4-14 months). Patients with a positive Trendelenburg sign had a mean height of 157.4 cm (range 151 to 173 cm), mean weight of 82.5 kg (range 70 to 108 kg), and mean body mass index of 33.2 kg/m(2) (range 25.4 to 30.5 kg/m(2)). The corresponding figures in patients without a Trendelenburg sign were as follows: 166.3 cm (range 158 to 180 cm), 79.4 kg (range 72 to 94 kg), and 28.7 kg/m(2) (range 21.6 to 30.5 kg/m(2)). There was no significant difference between the two patient groups with respect to weight, but height and body mass index showed highly significant differences (p<0.0001). Based on our finding that patients having a significantly shorter height and greater body mass index sustained Trendelenburg positivity for quite a long time, we recommend that these two factors be taken into consideration in the preoperative evaluation of patients for total hip arthroplasty with the Hardinge approach. Thus, the use of the Hardinge approach in total hip arthroplasty may not be convenient in short subjects having borderline obesity.

Persistent Heartburn in a Patient on Proton-Pump Inhibitor

r H a d a Clinical Scenario A 36-year-old woman with 6-year history of heartburn as referred for further evaluation and management. Her sympoms occurred up to 3 times daily during “bad” months and bout 3 times a week during the rest of the year. The patient escribes a burning sensation behind the chest bone that travels o her neck. Symptoms occasionally awaken her from sleep uring the night, primarily after having heavy meals in the vening. She has rarely experienced sour or bitter taste in the outh. She denies dysphagia, odynophagia, chest pain, early atiety, epigastric pain or discomfort, bloating, nausea, or vomting. Her appetite is good, and she has not lost any weight. She s a social worker, married, and has 2 toddlers at home. Both of er pregnancies were unremarkable. She considers her work nd the need to juggle her family life at the same time to be very tressful. She denies smoking or drinking alcohol. However, she dmits to occasional late-night business meals and a passion for exican food. Her physical examination is unremarkable exept for borderline obesity. The patient was initially seen by her rimary care physician, who suggested that she adopt lifestyle odifications, attempt to lose weight, and consider a less busy ork schedule. She was also started on an H2-receptor antagoist (H2RA) twice daily. The patient stated that she felt no mprovement in her symptoms despite 2 months of therapy ith H2RA. In addition, she was unable to lose weight or change er work schedule. Three months ago, she was initiated on roton-pump inhibitor (PPI) once daily half an hour before reakfast. She stated that the PPI appeared to help her during he first 2 weeks, but symptoms recurred, although with some essened severity and frequency than before. She has been suplementing her PPI once daily with antacids, over-the-counter 2RA, and occasionally by adding another PPI before bed time. How should the patient’s refractory heartburn be treated?

Body Mass Index of 23 or More is a Risk Factor for Hypertension and Hyperlipidemia in Japanese Workers

In comparison with western populations, body mass index (BMI) of the Japanese population is typically lower. In this study, the relationship between BMI and other metabolic risk factors was examined in 1,130 male manufacturing workers surveyed from 2000 to 2003. The association between the BMI and the relative risk of hypertension was evaluated in a cross-sectional design using logistic regression analysis. The mean BMI in the subjects was 23.6 (SD=3.2). Of the total number of subjects, 26.6% and 3.3% were classified as pre-obese and obese, respectively. Multivariate analysis indicated that BMI of 23 or greater was significantly associated with an increased risk of hypertension and/or hyperlipidemia. Health education of weight control of borderline obesity of workers is important for the primary prevention of hypertension and hyperlipidemia in Japan.

Multilevel radiofrequency for OSAS: Long-term follow-up

Objectives: To determine long-term effectiveness of multilevel (tongue and palate) temperature controlled radiofrequency tissue ablation (TCRFTA) for patients with obstructive sleep apnea syndrome (OSAS) Methods: Prospective series of 20 subjects with mild to moderate OSAS (AHI 10 to 30) and at least 1 year from completion of multilevel TCRFTA were included, representing a subset of 90 subjects enrolled in a previously published controlled trial. Exclusion criteria for this long-term follow-up study included any additional treatment for OSAS following completion of TCRFTA. Outcomes were compared to pretreatment baseline and included reaction time testing, daytime somnolence, OSA related quality-of-life, and polysomnographic respiratory parameters using validated measures. Results: At pretreatment baseline, subjects had moderate OSA (mean + standard deviation AHI, 22.6 + 8.1) with excessive daytime sleepiness (Epworth, 12.9 + 4.1) and borderline obesity (BMI, 28.9 + 3.5). Median follow-up after completion of treatment was 25 months (range, 13–34). Daytime sleepiness was significantly improved at long-term follow-up (Epworth, 12.6 to 8.7; P = 0.0003). OSAS-related quality-of-life was also significantly improved (FOSQ 15.9 to 17.6, P = 0.0003; SNORE25 1.4 to 0.8; P < 0.0001). Median reaction time testing was nonsignificantly improved at long-term follow-up (229.4 to 222.8 msec, P = 0.07). Fastest and slowest reaction times were also nonsignificantly improved ( P = 0.15 and 0.13). AHI and AI were nonsignificantly improved at long-term follow-up (22.6 to 18.3, P = 0.14; 9.1 to 7.1; P = 0.33), while HI progressed nonsignificantly (15.0 to 18.8, P = 0.76). Body mass index was unchanged (BMI 29). Conclusions: Multilevel TCRFTA treatment of mild to moderate OSAS resulted in prolonged improvement in daytime somnolence and OSAS related quality-of-life in this group of subjects.