Degree Of Weight Loss Research Articles

Calorie restriction causes multiple beneficial metabolic adaptations linearly related with the degree of weight loss in non-obese individuals: Results of CALERIE, a multicenter randomised controlled trial

BACKGROUND & AIMS: Understanding the temporal association and relative power of anthropometric, body composition and energy metabolism measurements of calorie restriction (CR) in predicting metabolic and hormonal adaptations is important, given the clinical and public health implications of excess weight and adiposity. METHODS: Anthropometric (body weight, BMI, waist circumference), body composition (body fat and lean mass by DXA), energy metabolism (leptin and total daily energy intake by doubly labelled water [DLW]) markers and an extensive assessment of cardiometabolic, inflammatory and hormonal risk factors were obtained in 191, 21–50 year old non-obese (BMI 22·0–27·9 kg/m2) women and men, who participated in the 2-yr CALERIE randomized clinical trial. Pairwise correlations for each adiposity and energy metabolism measure were calculated against each other and against each metabolic parameter. In addition, spline and linear regression models were developed to determine a threshold effect of adiposity and energy metabolism measures to trigger changes in metabolic parameters. RESULTS: Among the progressively more sophisticated measures of adiposity, body weight is the variable that is most strongly correlated with cardiometabolic and inflammatory outcomes during CR-induced weight loss in young and middle-aged non-obese men and women. Waist circumference and DXA body fat are not superior to body weight or BMI in detecting these biological modifications. We did not find a specific threshold in weight loss to be exceeded for changes in metabolic and inflammatory adaptations to occur. Even small reductions in body weight cause a significant decline in serum T3 levels, a predictor of post-CR weight regain. CONCLUSIONS: Calorie restriction with adequate nutrition causes multiple beneficial cardiometabolic and hormonal adaptations that are linearly related with the degree of weight loss in non-obese individuals. Once a baseline has been established, tracking changes in body weight is sufficient to monitor improvements in metabolic health.

파프리카 저장 온도 변화와 폴리아미드 필름 포장 적용에 따른 품질 변화

The purpose of this study was to examine the effect of packaging on quality maintenance of paprika (Capsicum annuum L. cv. Nagano RZ) stored at three different temperatures. In Korea, paprika is stored and distributed under ambient conditions. To ensure the freshness maintenance, determining optimal storage temperature is necessary. Paprika were unpacked (control) or packed with polyamide film and stored at 5oC, 10oC and 20oC for 35 days. Quality characteristics such as weight loss and appearance were examined. Paprika packed with polyamide film showed less quality changes compared to unpacked paprika under all the storage temperatures. The commercial properties tended to decrease rapidly during storage at 20oC regardless of packing. The degree of weight loss was significantly lower in packed paprika compared to unpacked paprika. It was found that soluble solids, pigments, hardness, etc. were complexly affected by storage temperature and film packaging. For paprika, the storage temperature of 5oC or 10oC was effective in maintaining freshness; paprika packed in polyamide film packing maintained greater freshness than unpacked paprika. Our results showed that, packaging is required to preserve the freshness and to improve the marketability of paprika in the domestic market. It seems that it is necessary to continuously search for an effective packaging method.

Trajectories of body weight change and survival among patients with mCRC treated with systemic therapy: Pooled analysis from the ARCAD database

BackgroundHigher body mass index is associated with a higher incidence of colorectal cancer (CRC) but also with improved survival in metastatic CRC (mCRC). Whether weight change after mCRC diagnosis is associated with survival remains largely unknown. MethodsWe analysed individual patient data for previously untreated patients enrolled in five phase 3 randomised trials conducted between 1998 and 2006. Weight measurements were prospectively collected at baseline and up to 59.4 months after diagnosis. We used stratified multivariable Cox models to assess the prognostic associations of weight loss with overall and progression-free survival, adjusting for other factors. The primary end-point was a difference in overall survival (OS) between populations with weight loss and stable or increasing weight. FindingsData were available for 3504 patients. The median weight change at 3 months was −0.54% (IQR −3.9 … +1.5%). We identified a linear trend of increasing risk of death associated with progressive weight loss. Unstratified median OS was 20.5, 18.0, and 11.9 months (p < 0.001) for stable weight or gain, <5% weight loss, and ≥5% weight loss at 3 months, respectively. Weight loss was associated with a higher risk of death (<5% loss: aHR 1.18 [1.06–1.30], p < 0.002; ≥5% loss: aHR 1.87 [1.67–2.1], p < 0.001) as compared to stable or increasing weight at 3 months post-baseline (reference), while adjusting for age, sex, performance, and a number of metastatic sites. InterpretationPatients losing weight during systemic therapy for metastatic colorectal cancer have significantly shorter OS. The degree of weight loss is proportional to the observed increased risk of death and remains evident among underweight, normal weight, and obese individuals. On-treatment weight change could be used as an intermediate end-point. FundingThe creation and management of the database containing the individual patient data from the original randomised trials is supported by the Aide et Recherche en Cancérologie Digestive Foundation.

Impact of Weight Loss on the Severity of Albuminuria in Obese Diabetic Patients Undergoing Laparoscopic Sleeve Gastrectomy and One-Anastomosis Gastric Bypass.

AimTo examine the effect of weight-loss induced bariatric procedures on albuminuria levels among diabetic patients suffering from obesity.MethodsAdults patients who suffer from morbid obesity and type 2 diabetes mellitus (T2DM) were included in a prospective cohort study. Subjects were scheduled to undergo laparoscopic sleeve gastrectomy (LSG) or one-anastomosis gastric bypass (OAGB). The albumin-to-creatinine ratio (ACR) was adopted to assess the degree of albuminuria. Microalbuminuria was determined as a ratio of >2.5–30 mg/mmol and >3.5–30 mg/mmol for males and females, respectively, while macroalbuminuria was diagnosed when the ACR exceeded >30 mg/mmol.ResultsThe mean uACR decreased significantly from 20.95±16.89 to 9.92±12.69mg/mmol in LSG cohort (p <0.001), and from 19.52±16.65 to 9.34±11.77mg/mmol in the OAGB cohort, with no statistically considerable differences between both cohorts at the end of follow-up (p = 0.78). Twelve months after the procedures, the percentages of cases with microalbuminuria decreased significantly to 23.8% and 23.9%, respectively (p < 0.001); likewise, the percentages of cases with macroalbuminuria significantly decreased to 7.9% and 7.5% in the LSG and OAGB groups, respectively (p < 0.001). There were no statistically considerable differences between LSG and OAGB regarding the percentages of patients with micro or macroalbuminuria at the end of follow-up. Besides, there were no significant associations between the degree of weight loss and improvement (p = 0.959) or remission (p = 0.73) of microalbuminuria.ConclusionBariatric surgery significantly reduced the severity of albuminuria 1-year after the procedure, with no preference for one procedure over the other.

The Extent of Lifestyle-Induced Weight Loss Determines the Risk of Prediabetes and Metabolic Syndrome Recurrence during a 5-Year Follow-Up.

It is controversial whether lifestyle-induced weight loss (LIWL) intervention provides long-term benefit. Here, we investigated whether the degree of weight loss (WL) in a controlled LIWL intervention study determined the risk of prediabetes and recurrence of metabolic syndrome (MetS) during a 5-year follow-up. Following LIWL, 58 male participants (age 45–55 years) were divided into four quartiles based on initial WL: Q1 (WL 0–8.1%, n = 15), Q2 (WL 8.1–12.8%, n = 14), Q3 (WL 12.8–16.0%, n = 14), and Q4 (WL 16.0–27.5%, n = 15). We analyzed changes in BMI, HDL cholesterol, triglycerides (TGs), blood pressure, and fasting plasma glucose (FPG) at annual follow-up visits. With a weight gain after LIWL between 1.2 (Q2) and 2.5 kg/year (Q4), the reduction in BMI was maintained for 4 (Q2, p = 0.03) or 5 (Q3, p = 0.03; Q4, p < 0.01) years, respectively, and an increase in FPG levels above baseline values was prevented in Q2–Q4. Accordingly, there was no increase in prediabetes incidence after LIWL in participants in Q2 (up to 2 years), Q3 and Q4 (up to 5 years). A sustained reduction in MetS was maintained in Q4 during the 5-year follow-up. The present data indicate that a greater initial LIWL reduces the risk of prediabetes and recurrence of MetS for up to 5 years.

Jatrorrhizine from Rhizoma Coptidis exerts an anti-obesity effect in db/db mice

Ethnopharmacological relevanceObesity is closely related to diabetes. Jatrorrhizine (JAT) from Rhizoma Coptidis (RC) can reduce blood glucose and lipid levels. However, the molecular mechanisms for JAT's anti-obesity effect are still not clear. Aim of the studyTo explore the effect of JAT in the treatment of obesity and the underlying molecular mechanisms. Materials and methodsdb/db mice were used as a typical obese animal model in current study. The anti-obesity effects of five alkaloids from RC were compared by feeding the mice for 8 weeks with a dosage of 105 mg/kg while the dose-dependent study (35 mg/kg and 105 mg/kg) of JAT on obese mice was conducted in another 8-week-long animal experiment. Meanwhile, RNA-seq analysis, in vitro experiments, and western blotting were utilized to predict and confirm the potential pathway that JAT participated in improving obesity. ResultsThe experimental results demonstrated that five RC alkaloids caused different degrees of weight loss in db/db obese mice. Among them, JAT showed the best effect. It could significantly reduce the body weight, blood lipid levels, and epididymal fat weight of db/db mice. H&E and Oil red O staining results showed that it could also dramatically improve liver lipid metabolism. The results from RNA-seq suggested that JAT had significantly altered 207 DEGs for the treatment of obesity, among which IRS1 changed the most. Next, GO and KEGG analysis enriched four major lipid metabolism-related pathways: biosynthesis of unsaturated fatty acids, PI3K-AKT signaling pathway, metabolic pathways, and fatty acid elongation. Finally, in vitro experiments and western blotting proved that JAT regulated the expression of IRS1/PI3K/AKT pathway-related proteins in a dose-dependent manner to address obesity. ConclusionsIn conclusion, JAT from RC has an effect on treating obesity, and its anti-obesity effect may be exerted via the IRS1/PI3K/AKT signaling pathway.

Longitudinal relationship of baseline functional brain networks with intentional weight loss in older adults.

ObjectiveThe goal of this study was to determine whether the degree of weight loss after 6 months of a behavior‐based intervention is related to baseline connectivity within two functional networks (FNs) of interest, FN1 and FN2, in a group of older adults with obesity.MethodsBaseline functional magnetic resonance imaging data were collected following an overnight fast in 71 older adults with obesity involved in a weight‐loss intervention. Functional brain networks in a resting state and during a food‐cue task were analyzed using a mixed‐regression framework to examine the relationships between baseline networks and 6‐month change in weight.ResultsDuring the resting condition, the relationship of baseline brain functional connectivity and network clustering in FN1, which includes the visual cortex and sensorimotor areas, was significantly associated with 6‐month weight loss. During the food‐cue condition, 6‐month weight loss was significantly associated with the relationship between baseline brain connectivity and network global efficiency in FN2, which includes executive control, attention, and limbic regions.ConclusionThese findings provide further insight into complex functional circuits in the brain related to successful weight loss and may ultimately aid in developing tailored behavior‐based treatment regimens that target specific brain circuitry.

Body weight, diabetes incidence vascular events and survival 15 years after very low calorie diet in community medical clinics in the UK

ObjectiveTo assess weight loss maintenance, diabetes status, mortality and morbidity 15 years after a very low calorie diet programme (VLCD) in patients with obesity.DesignGeneral practice data bases were interrogated for...

Korean Medicine with Self-monitoring for Weight Control and Factors Associated with Weight Loss: a Retrospective Observational Study

Objectives: The purpose of this study was to investigate the effect of weight loss in Korean Medicine (KM) obesity treatment combined with self-monitoring and to identify the relevant factors which are related to successful weight loss. In addition to this, adverse events reported by the patients were analyzed to assess the safety of KM treatments for obesityMethods: This was a retrospective observational study that analyzed the medical records of the patients that participated in the 10-week of KM treatment. All patients took herbal medicine for weight loss and were instructed to reduce calorie intake and adhere to self-monitoring. Clinical data including body weight were collected for evaluating the effect of the treatments. Behavior factors affecting weight loss were collected. The correlation between each factor and weight loss was analyzed. Adverse events (AEs) were collected at each time to evaluate the safety of the intervention.Results: One hundred eighteen patients’ records were included in this study. The average weight loss was 7.64kg(74.59kg to 66.95kg). 94.9% of patients lost 5% or more of their initial weight. The degree of weight loss was identified to be related to self-assessment of diet control and self-assessment of appetite control. The average self-weighing frequency significantly increased(2.45 times/week before treatment and 4.70 times/weeks during treatment). Constipation, insomnia, and dizziness were found to be the most frequent AEs, and except for one case, most AEs were mild cases.Conclusion: From this study, we found that KM obesity treatment combined with self-monitoring showed significant weight loss without serious AE.

Diabetes duration and weight loss are associated with onset age and remote metastasis of pancreatic cancer in patients with diabetes mellitus.

ObjectiveTo analyze the clinical characteristics of patients with pancreatic cancer (PC) and diabetes and to explore the impact of diabetes duration, weight loss, and hypoglycemic drugs on the tumor biological behavior of PC.MethodsThis is a retrospective study on patients with PC and diabetes. Subjects were grouped according to the onset age of PC, distant metastasis, duration of diabetes, degree of weight loss (∆Wt), and type of hypoglycemic drugs. Logistic regression analysis was used to evaluate the association between diabetes duration, weight loss, hypoglycemic drugs, and early‐onset PC, distant metastasis.ResultsCompared with late‐onset PC, patients with early‐onset PC had a higher proportion of new‐onset DM (35 [79.5%] vs. 217 [46.9%], p < 0.001), smoker, drinker, and more obvious weight loss (8.5 [3.8, 15] kg vs. 5 [0, 10] kg, p < 0.001). Patients with remote metastasis had an earlier diagnosis age, heavier weight loss, lower body mass index, and were more likely to be smokers but had cancer less likely to be localized in the head of pancreas. Regression analysis showed that new‐onset diabetes and weight loss were independently correlated to early‐onset PC: odds ratio (OR) = 3.38 (95% CI 1.36‐8.4, p = 0.09; OR = 1.56 (95% CI 1.16‐2.1), p = 0.003, respectively. In contrast, long‐term diabetes, and heavy weight loss were independently associated with remote metastasis: OR = 3.38 (95% CI 1.36‐8.4, p = 0.09; OR = 1.56 (95% CI 1.16‐2.1), p = 0.003, respectively.ConclusionNew‐onset diabetes and weight loss were common presentation and risk factors of early‐onset PC, which required more attention. Long‐term diabetes and heavy weight loss were risk factors contributing to distant metastases, indicating potential risk factors contributing to the adverse prognosis of patients with PC.

Trajectories of body weight change and survival among mCRC patients treated with systemic therapy: Pooled analysis from the ARCAD database.

80 Background: Higher baseline body mass index is associated with improved survival in metastatic CRC (mCRC). Whether weight gain or loss after mCRC diagnosis is associated with survival remains largely unknown. Methods: We analyzed individual patient data from 3504 patients with previously untreated mCRC enrolled in five phase III randomized trials (AVF2017g, AVF2192g, CRYSTAL, N9741, OPUS) conducted between 2000 and 2006. Weight measurements were prospectively collected at 3 months after diagnosis and then up to 5 years. Patients were categorized into three groups based on the percent weight change at 3 months: stable weight or gain, weight loss up to 5% of baseline weight, and ≥5% weight loss of baseline weight. Cox models were used to assess the prognostic associations of weight change at 3 months with overall survival (OS) and progression-free survival (PFS), adjusting for baseline BMI, age, sex, performance score, chemotherapy backbone (oxaliplatin vs. irinotecan), and biologics type (cetuximab vs. bevacizumab). Sub-analyses included Cox models adjusted for additional clinical-pathological factors (primary tumor sidedness [right colon vs. left colon-rectum], and BRAF status; N=1,511). Results: Median percent weight change at 3 months was -0.5% (IQR -4.0 to+1.6%). OS was better in patients with weight stability or gain than in those with weight loss (up to 5% or ≥5%; (Table). Results were consistent for PFS for patients with ≥5% weight loss of baseline weight, as well as for sub-analyses. Conclusions: Patients losing weight during the first 3 months of systemic therapy for metastatic colorectal cancer have significantly shorter overall survival than those with stable or increasing weight. Degree of weight loss is proportional to the observed increased risk of death and remains evident among underweight, normal weight and obese individuals. Further studies examining possible usefulness of on-treatment early weight loss as a novel intermediary end-point are needed.[Table: see text]

Intestinal Claudin-7 deficiency impacts the intestinal microbiota in mice with colitis

BackgroundIntestinal epithelial cells form a physical barrier that protects the intestine against the intestinal microbiota through tight junctions (TJs) and adhesive junctions, while barrier disruption may lead to inflammatory bowel disease (IBD). Claudin-7 (Cldn7) has been implicated in this protection as an important member of TJs. Here, we experimentally study the effect of Cldn7 deletion on intestinal microbiota in colitis.MethodsColitis model was established based on inducible intestinal conditional Cldn7 gene knockout mice (Cldn7fl/fl; villin-CreERT2), by feeding with dextran sodium sulfate (DSS). AB-PAS staining and immunohistochemical staining of Muc2 mucin were used to detect the effect of Cldn7 deficiency on the mucus layer of mice with colitis, and fluorescence in situ hybridization was used to detect how Cldn7 promotes spatial separation of the gut microbiota from the host. The microbiota population was characterized by high-throughput 16S rRNA gene sequencing of DNA extracted from fecal samples.ResultsCompared with the controls, Cldn7 knockout increased susceptibility to colitis, including greater degree of weight loss, colon shortening, and a significantly higher disease activity index score. DSS-treated Cldn7 knockout mice promoted the migration of bacteria to the intestinal epithelium to some extent by damaging the intestinal mucus layer. Sequencing of 16S rRNA showed that DSS-treated Cldn7 knockout mice reduced the gut microbiota diversity and had greater relative abundance of Escherichia coli. LEfSe analysis indicated that Escherichia coli may be the key bacteria in Cldn7 knockout mice during DSS-induced colitis. Furthermore, the Tax4Fun analysis predicted that DSS-treated Cldn7 knockout mice enriched for microbiota impacting infectious diseases, immune system and metabolic functions.ConclusionsOur data suggests an association between intestinal Cldn7 knockout and microbiota dysbiosis during inflammatory events.

Prognosis and survival analysis of patients with pancreatic cancer: retrospective experience of a single institution

BackgroundThe overall survival of patients with pancreatic cancer is extremely low. Despite multiple large-scale studies, identification of predictors of patient survival remains challenging. This study aimed to investigate the prognostic factors for pancreatic cancer.MethodsThe clinical data of 625 patients with pancreatic cancer treated at Shengjing Hospital of China Medical University from January 2013 to December 2017 were collected.ResultsOf 625 patients, 569 were followed from 1 to 75 months. The median overall survival was 9.3 months. The overall 1-, 3-, and 5-year survival rates were 37.8%, 15.1%, and 10.5%, respectively. Cox proportional hazards model indicated that baseline carbohydrate antigen 199 level, neutrophil-lymphocyte ratio, operative procedure, lymph node metastasis, number of distant organ metastasis, and postoperative adjuvant chemotherapy were independent prognostic factors of patients with pancreatic cancer. Baseline carbohydrate antigen 199 level, degree of weight loss, operative procedure, lymph node metastasis, number of distant organ metastasis, and postoperative adjuvant chemotherapy were independent prognostic factors of pancreatic head cancer subgroup. Baseline carbohydrate antigen 199 level, carcinoembryonic antigen level, total bilirubin level, neutrophil-lymphocyte ratio, peripancreatic invasion, number of distant organ metastasis, and postoperative adjuvant chemotherapy were independent prognostic factors of the pancreatic body/tail cancer subgroup.ConclusionsHigher carbohydrate antigen 199 levels, neutrophil-lymphocyte ratio, lymph node metastasis and distant organ metastasis predict a poor prognosis in patients with pancreatic cancer. Early detection, early radical surgery and adjuvant chemotherapy are needed to improve prognosis for this deadly disease.

Efficacy and safety of thalidomide in preventing oral mucositis in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy: A multicenter, open-label, randomized controlled trial.

This multicenter clinical trial was designed to evaluate the efficacy and safety of thalidomide (THD) in preventing oral mucositis (OM) in patients with nasopharyngeal carcinoma (NPC) undergoing concurrent chemoradiotherapy (CCRT). Patients with locally advanced NPC were randomly assigned to either a THD group or a control group. All 160 patients received radical intensity-modulated radiotherapy plus cisplatin-based concurrent chemotherapy and basic oral hygiene guidance. Patients in the THD group received additional THD at the beginning of CCRT. The primary end points were the latency period and the incidence of OM. The secondary end points were mouth and throat soreness (MTS), weight loss, short-term efficacy, and adverse events. The median latency period of OM was 30 and 14 days in the THD and control groups, respectively (hazard ratio, 0.32; 95% confidence interval, 0.23-0.35; P < .0001). The incidence of OM and severe OM (World Health Organization grade 3 or higher) was significantly lower in the THD group than the control group (87.5% vs 97.5% [P = .016] and 27.5% vs 46.3% [P = .014], respectively). THD treatment also remarkably reduced the intensity of MTS and the degree of weight loss. In comparison with the control group, the incidence of nausea, vomiting, and insomnia was significantly decreased, whereas the incidence of dizziness and constipation was obviously increased in the THD group. The objective response rates 3 months after CCRT were similar between the groups. THD prolonged the latency period, reduced the incidence of OM, and did not affect the short-term efficacy of CCRT in patients with NPC. Oral mucositis is the most common complication of nasopharyngeal carcinoma during chemoradiotherapy; it decreases the patient's quality of life, and ideal mucosal protective agents are lacking. A few basic research and preclinical studies have shown that thalidomide may be an approach to ameliorating oral mucositis. The results of the current study confirm that thalidomide has a protective effect against oral mucositis in patients who have received chemoradiotherapy for nasopharyngeal carcinoma.

The Association Between Weight Loss and Platelet Markers in Morbidly Obese Patients

Objective: To examine the association of weight loss achieved through obesity treatment with platelet number and markers (mean platelet volume, MPV; plateletcrit, PCT; platelet/lymphocyte ratio, PLR; and platelet distribution width, PDW) in morbidly obese patients.&#x0D; Methods: A total of 300 patients diagnosed with morbid obesity between 2017 and 2019 were included in this retrospective study. Weight at baseline and 6 months, body mass index (BMI), complete blood count (platelet, lymphocyte, plateletcrit, platelet/lymphocyte ratio, and platelet distribution width), and demographic data were evaluated.&#x0D; Results: A total of 300 morbidly obese patients with a BMI ≥ 40 kg/m2 were included. A weight loss of ≥ 10% was considered “significant”, and a weight loss of &lt; 10% was considered insignificant. A significant decrease in platelet number was found in association with weight loss (p &lt; 0.05), as were the changes in PCT and PLR. These findings suggest that platelet markers PCT and PLR may be associated with the degree of weight loss.&#x0D; Conclusion: Our results suggest that platelet markers simply obtained through a complete blood count may be utilized in the treatment and follow-up of obesity, which may lead to a number of different conditions such as coronary artery disease, cerebrovascular events, and myocardial infarction through predisposition to thrombosis.

P.0356 Bariatric surgery leads to potentially favourable changes in proteins associated with neurocognitive function related to the degree of weight loss

P.0356 Bariatric surgery leads to potentially favourable changes in proteins associated with neurocognitive function related to the degree of weight loss

Effect of zinc oxide on wollastonite: Structural, optical, and mechanical properties

Partial substitution of ZnO for CaO in the wollastonite formula was performed via wet precipitation. The effects of ZnO/CaO replacement on the structure, porosity, morphology, optical, and mechanical properties of the CaO–SiO2 ceramic were examined. Structural results and Fourier transform infrared (FTIR) spectra indicated the existence of mixed phases of wollastonite with hardystonite and willemite with hadystonite composites, depending on the ZnO content. The calculated crystallite size confirmed that the formed composites were in the nanoscale range. The FTIR results verified the mixed phases of the prepared samples. The optical band gap energy (Eg) values of 3.3 and 4.56 eV referred to the willemite phase in samples with high ZnO content. Addition of ZnO increased the bulk density and decreased the porosity of the wollastonite. The reduced porosity controlled the mechanical behavior of the prepared composites. The maximum stress (σu) increased from ∼4.10 to ∼26.68 N/mm2 as the porosity decreased from 52.20% to 40.17% for a ZnO content increased from 0% to 50%. The fracture load increased with the ZnO content. The degradability of samples revealed that the higher the ratio of ZnO to the nominal wollastonite, the more influential it was on the degree of weight loss % and the variation in the pH value. The bioactivity test estimated that all samples surface exposed development of a newly formed apatite layer, consequently evidencing the bioactivity of the prepared ceramic composites. Therefore, such substitution can be used in vital applications.

Does the Presence of Type 2 Diabetes or Metabolic Syndrome Impact Reduction in Waist Circumference During Weight Loss?

ObjectivesOur aim in this study was to compare the change in waist circumference given the same degree of weight loss in patients who meet the criteria for metabolic syndrome or type 2 diabetes and those who do not meet these criteria. Because visceral adiposity is a key feature of both conditions and intra-abdominal adipocytes show higher lipolytic activity, we sought to determine whether changes in waist circumference differed in individuals with and without these conditions. MethodsThe Ottawa Hospital Weight Management Clinic offers a course in lifestyle modification and uses 12 weeks of total meal replacement. We compared the decrease in waist circumference between patients with metabolic syndrome or diabetes and those without these conditions who had lost a similar amount of weight using measurements from the first 6 weeks of meal replacement. ResultsWe evaluated 3,559 patients who attended the program between September 1992 and April 2015. The patient population was largely Caucasian and of European descent and all meetings were face to face. The mean weight loss for men was 15.1±20.2 kg, and the mean weight loss for women was 9.7±2.4 kg. There were no significant differences in decrease in waist circumference between those with and without metabolic syndrome in both men (11.7±3.9 cm vs 11.4±3.8 cm, p=0.48) and women (9.0±3.6 cm vs 9.1±3.7 cm, p=0.26). ConclusionsOur results show that, given the same degree of weight loss, patients with and without diabetes or metabolic syndrome experience a similar change in waist circumference.

Weight loss and its impact on outcome in head and cancer patients during chemo-radiation

BackgroundWeight loss during chemotherapy and its impact on the cancer outcomes have been invariably reported in the literature. We also did a post-hoc analysis of a randomized phase III trial to see the same. Materials and methodsThe database of a recently published randomized study comparing cisplatin-radiation with nimotuzumab cisplatin-radiation was used for this analysis. Week-wise weight loss during the course of treatment was noted. The impact of severe weight loss (grade 2–3) on progression-free survival (PFS), locoregional control (LRC) and overall survival (OS) was studied using the Kaplan Meier method. Binary logistic regression analysis was used to see the effect of various factors. ResultsOut of a total of 536 patients, weight loss was captured in 524. Out of these 524 patients, any degree of weight loss was seen in 293 (55.91%) patients. Grade 1 weight loss was noted in 192 (36.6%) patients, grade 2 in 96 (18.3%) and grade 3 in 5 (1%) patients. The 2-year PFS was 53% and 57.1% in severe and non-severe weight loss groups respectively (p-value = 0.36). The 2-year LRC was 60% in patients with severe weight loss, while it was 63.5% in those with non-severe weight loss (p-value = 0.47). The 2-year OS was 59.3% versus 62.2% in severe and non-severe weight loss cohorts respectively (p-value = 0.21). None of the factors was found to be associated with severe weight loss. ConclusionSevere weight loss was uncommon in our patients. Weight loss during treatment was not associated with poor survival outcomes.

Is CT thorax, abdomen and pelvis a useful test in patients with weight loss?

Unintentional weight loss is an important clinical problem. The role of CT is not firmly established in the workup of these patients. The aim of this study is to determine the diagnostic yield of CT Thorax, Abdomen and Pelvis (CT TAP) in patients with unexplained weight loss and to determine whether clinical or laboratory variables are associated with positive CT findings. A retrospective review was performed of CT TAP examinations over 12 months with weight loss as an indication. Patients' electronic records and radiology reports were reviewed. Clinical and laboratory variables were assessed for correlation with positive findings on CT. 461 CT TAP studies with weight loss as the primary indication were identified. 124 were excluded; 82 due to a recent history of malignancy, 41 because CT TAP was used for staging of a new malignancy and one study was incomplete. This left 337 eligible examinations. 217 studies had findings of no clinical relevance, 50 studies were normal, 40 studies identified a possible cause of weight loss and 30 studies identified a definite cause. Of the 40 where a possible cause was identified, further work up led to a diagnosis which explained the weight loss in 13 patients. The diagnostic yield of CT TAP was 12.8%. Age, abdominal symptoms, degree of weight loss, anaemia, tumour markers and LDH did not significantly correlate with positive findings on CT. CT TAP is a helpful investigation in patients with unexplained weight loss with a diagnostic yield of 12.8%.