Diagnosis Of Obesity Research Articles

Paediatric obesity diagnosis and intervention practices in Australian hospitals - Australia-wide survey.

Previous studies suggest a lack of a unified approach in identifying and addressing children with obesity while being inpatients in individual Australian hospitals. Our study aimed to describe current clinical practice across Australia and identify discrepancies that can aid in developing a more unified response to children identified with obesity as hospital inpatients. A cross-sectional exploratory online survey was distributed to major paediatric in-patient departments in Australia, with a response rate of 68%. Questions focused on education, identification, interventions and attitudes towards a national protocol. Twenty percent of respondents indicated that staff in their department regularly record body mass index, 66% address weight issues and only 8% consistently refer to appropriate outpatient services. Although 88% of respondents believe that a national protocol for addressing paediatric obesity would be beneficial, respondents emphasised concerns regarding their local resources. Our study can inform the development of a guideline for a unified response to opportunistically identify children with overweight and obesity as inpatients.

Standardized diagnosis and assessment of overweight or obesity in children

Standardized diagnosis and assessment of overweight or obesity in children

Obesity and metabolic syndrome in patients with heart failure with preserved ejection fraction: a cross-sectional analysis of the Veradigm Cardiology Registry.

The proportion of heart failure patients with preserved ejection fraction has been rising over the past decades and has coincided with increases in the prevalence of obesity and metabolic syndrome. The relationship between these interconnected comorbidities and heart failure with preserved ejection fraction (HFpEF) is still poorly understood. This study characterized obesity and metabolic syndrome among real-world patients with HFpEF. We identified adults with heart failure in the Veradigm Cardiology Registry, previously the PINNACLE Registry, with a left ventricular ejection fraction measurement ≥ 50% between 01/01/2016 and 12/31/2019. Patients were stratified by obesity diagnosis and presence of metabolic syndrome (≥ 3 of the following: diabetes, hypertension, hyperlipidemia, and obesity). We captured baseline demographic and clinical characteristics and used multivariable logistic regression to examine the odds of having cardiac (atrial fibrillation, coronary artery disease, coronary artery bypass surgery, myocardial infarction, and stroke/transient ischemic attack) and non-cardiac (chronic kidney disease, chronic liver disease, and peripheral artery disease) comorbidities of interest. The models adjusted for age and sex, and the main covariates of interest were obesity and metabolic burden score (0-3 based on the presence of diabetes, hypertension, and hyperlipidemia). The models were run with and without an obesity*metabolic burden score interaction term. This study included 264,571 patients with HFpEF, of whom 55.7% had obesity, 52.5% had metabolic syndrome, 42.5% had both, and 34.3% had neither. After adjusting for age, sex, and burden of other metabolic syndrome-associated diagnoses, patients with HFpEF with obesity had lower odds of a diagnosis of other evaluated comorbidities relative to patients without obesity. The presence of metabolic syndrome in HFpEF appears to increase comorbidity burden as each additional metabolic syndrome-associated diagnosis was associated with higher odds of assessed comorbidities except atrial fibrillation. Obesity was common among patients with HFpEF and not always co-occurring with metabolic syndrome. Multivariable analysis suggested that patients with obesity may develop HFpEF in the absence of other driving factors such as cardiovascular disease or metabolic syndrome.

Missed diagnosis—a major barrier to patient access to obesity healthcare in the primary care setting

ObjectiveTo investigate whether individuals with an elevated BMI measurement, for whom a diagnosis of overweight or obesity (OW/OB) is not recorded, are less likely to be offered clinical care for obesity compared to those with a recorded diagnosis.SubjectsA retrospective cohort study using the electronic medical record database of Maccabi Healthcare Services (MHS) in Israel. Included were 200,000 adults with BMI ≥ 25 kg/m2 measurement recorded during a primary care visit between 2014 and 2020, and no prior diagnosis of OW/OB or related co-morbidities.MethodsThe relationships between a recorded diagnosis of OW/OB and two composite outcomes: 1. A composite of referrals to screening tests for metabolic complications; 2. A composite of weight loss intervention and follow up, were analyzed using multivariate logistic regression models.ResultsIn only 18% of individuals, a diagnosis of OW/OB was recorded. After adjusting for multiple potential confounding factors, individuals who received a recorded diagnosis were 18% more likely to be offered an evaluation for obesity-related metabolic complication, (OR 1.18, 95% CI 1.15–1.21, p < 0.001), and almost twice as likely to be offered intervention and follow up for their excess body weight (OR 1.84, 95% CI 1.76–1.94, p < 0.001) compared to individuals with missed diagnosis. These results persisted after adjusting for inter-physician variability. In addition, male sex, older age, and Arab sector were all associated with lower rates of weight loss intervention and follow up, while young individuals were less likely to be screened for metabolic complications.ConclusionBeyond BMI measurement, a recorded diagnosis of OW/OB is associated with statistically and clinically significant higher rates of performance of obesity care and intervention. Undiagnosed OW/OB presents a significant clinical opportunity, as recording a diagnosis of OW/OB would predict improved patient access to obesity healthcare and improved clinical outcomes.

Epidemiology of Diabetes Mellitus in Adults and Seniors in Rio Branco, Acre, Western Brazilian Amazon

(1) Background: To analyze the prevalence and factors associated with diabetes mellitus in adults and the elderly in Rio Branco, Acre, Western Brazilian Amazon. (2) Methods: The R software version 4.0.5 was used for estimating the prevalence of diabetes mellitus, odds ratios, and 95% confidence intervals. Multiple analysis was conducted through hierarchical variable selection. (3) Results: 1.095 individuals aged 18 years and older participated in this study, with 6.4% of the respondents showing prevalence of diabetes mellitus. The prevalence of diabetes mellitus was positively associated with a prior medical diagnosis of obesity (OR: 3.2; 95% CI: 1.67–6.12), dyslipidemia (OR: 4.17; 95% CI: 2.08–8.36), and increasing age (OR: 1.07; 95% CI: 1.05–1.09). Conversely, an inverse association was observed with higher education (12 or more years of study; OR: 0.20; 95% CI: 0.07–0.61). (4) Conclusions: The prevalence of diabetes mellitus in the municipality of Rio Branco, Acre, Brazil, has significantly increased with advancing age. Education, obesity, and dyslipidemia were also identified as factors associated with diabetes mellitus in this population. Awareness campaigns regarding dietary patterns and lifestyle choices may serve as preventive and control measures.

Cohort study on incidence of new-onset type 2 diabetes in patients after bariatric surgery and matched controls.

Metabolic bariatric surgery the reduces risk of new-onset type 2 diabetes in individuals with obesity, but it is unclear whether the benefit varies by sex, age, or socioeconomic status. The aim was to assess the risk of new-onset type 2 diabetes after metabolic bariatric surgery in these subgroups. The Finnish Public Sector study, a follow-up study with matched controls nested in a large employee cohort, included patients without type 2 diabetes and with a diagnosis of obesity or self-reported BMI of at least 35 kg/m2. For each patient who had laparoscopic metabolic bariatric surgery (2008-2016), two propensity-score matched controls were selected. New-onset type 2 diabetes was ascertained from linked records from national health registries. The study included a total of 917 patients and 1811 matched controls with obesity. New-onset type 2 diabetes was diagnosed in 15 of the patients who had metabolic bariatric surgery (4.1 per 1000 person-years) and 164 controls (20.2 per 1000 person-years). The corresponding rate ratio (RR) was 0.20 (95% c.i. 0.12 to 0.35) and the rate difference (RD) was -16.1 (-19.8 to -12.3) per 1000 person-years. The risk reduction was more marked in individuals of low socioeconomic status (RR 0.10 (0.04 to 0.26) and RD -20.6 (-25.6 to -15.5) per 1000 person-years) than in those with higher socioeconomic status (RR 0.35 (0.18 to 0.66) and RD -11.5 (-16.9 to -6.0) per 1000 person-years) (Pinteraction = 0.017). No differences were observed between sexes or age groups. Metabolic bariatric surgery was associated with a reduced risk of new-onset type 2 diabetes in men and women and in all age groups. The greatest benefit was observed in individuals of low socioeconomic status.

Impact of the SARS-CoV-2 pandemic on the body mass index of children seen in the City of Buenos Aires.

Introduction. Childhood overweight and obesity are a public health problem. The onset of the COVID-19 pandemic may have contributed to this condition. The body mass index (BMI) Z-score has been accepted as an indicator for overweight and obesity diagnosis and follow-up. Objective. To assess whether the prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased during the pandemic. Population and methods. Retrospective, cohort study. Patients included were those seen at public health care facilities in the City of Buenos Aires (CABA), who were aged 2 to 5 years, had weight and height values recorded at 2 different visits, before and after the establishment of the preventive and mandatory social isolation policy. Patients' nutritional status (BMI Z-score) and the variation in this indicator between both visits were recorded. Results. A total of 3866 subjects were assessed; their average age was 3.4 ± 0.8 years; 48.1% were girls. The average interval between both visits was 14.3 ± 2.5 months. The prevalence of overweight/ obesity increased from 12.6% (95% CI: 11.6-13.6) to 20.9% (95% CI: 19.6-22.2), p < 0.001, and so did the BMI Z-score (0.4 ± 1.1 versus 0.8 ± 1.3, p < 0.001). Conclusion. The prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased significantly during the pandemic.

355 Risk Factors for Intrathecal Baclofen Pump Implantation Infections: A Retrospective Database Analysis

INTRODUCTION: Baclofen, a GABAB receptor agonist, can be delivered via intrathecal baclofen (ITB) pumps for patients with intractable spasticity. Prior literature has shown infection rates ranging between 10-30%. METHODS: A multi-institutional de-identified database TriNetX was queried to identify patients with: 1) implantation of ITB pump + infection within 6 months or 2) implantation of ITB pump without infection within 6 months. Two populations were analyzed: only pediatric patients, then patients of all ages. Characteristics were compared using log-rank tests and independent-sample t-tests. RESULTS: 1,880 patients were identified in the pediatric cohort, of which 236 (12.6%) developed infection. 13,936 patients of all ages were identified, of which 1955 (14.0%) developed infection. In pediatric patients who developed infection, there were higher rates of diagnoses of overweight and obesity, malnutrition, and hypokalemia; the prevalence of diabetes was also higher, but this analysis was limited by small sample size. In patients of all ages, all medical diagnoses assessed were significantly more prevalent in patients with infection. Erythrocyte sedimentation rates and platelets were significantly higher in all patients with an infection. Additionally, the number of emergency department visits within 6 months was significantly higher in the infection group for pediatric (t = 3.571, p = 0.0004) and all-age (t = 7.882, p &lt; 0.0001) patients. CONCLUSIONS: This study suggests that patients with certain comorbidities are at increased risk for infection post-ITB implantation. Since prevalence of diabetes, abnormal coagulation profile, tracheostomy, and B-vitamin deficiency remained significantly different between infection vs. no-infection cohorts as sample size increased with the addition of adults, these diagnoses should be considered when calculating the infection risk of ITB pump. Studies are underway to investigate the time of highest infection risk post-ITB implantation and the optimal time for ITB reimplantation after removal for infection.

Establishment of Obesity Diagnosis Criteria Using Body Volume Index of 3D BodyScanner

PURPOSE This study sought to establish obesity diagnosis criteria by using the Body Volume Index (BVI) by body part extracted through 3D BodyScanner.METHODS The body fat percentage was measured using Dual Energy X-ray Absorptiometer (DEXA) for 225 participants (male = 119, female = 106), and BVI for eight body parts was measured using 3D BodyScanner. Independent t-test and Receiver Operating Characteristic (ROC) analysis were conducted. ROC analysis calculated the Area Under the Curve (AUC), and the optimal cut-point by Youden's J index. Sensitivity, Specificity, Accuracy, Balanced Classification Rate (BCR), and F1-score (harmonic mean of recall and precision) values were calculated to verify the validity of the optimal cut-point.RESULTS A statistically significant difference was observed in BVI by body part according to whether obesity was present for both men and women, and the obese group higher than the normal group. The optimal cut-point for each body part to diagnose obesity was 7.96 for shoulder, 9.79 for chest, 7.15 for upper abdominal, 7.71 for lower abdominal, 14.89 for total abdominal, 9.79 for thigh, 5.70 for calf, and 74.96 for total body volume in men. In case of women, this was 6.04 for shoulder, 9.82 for chest, 4.96 for upper abdominal, 6.23 for lower abdominal, 11.63 for total abdominal, 8.88 for thigh, 4.05 for calf, and 58.15 for total body volume, and the accuracy was 0.6~0.9.CONCLUSIONS BVI is a useful indicator for diagnosing obesity. However, this can be applicable only to Asian adults since there may be differences depending on race or age.

From Sugar Spikes to Pressure Peaks: Navigating the World of Diabetes, Hypertension, Obesity, and Kidney Health.

Diabetes, hypertension, obesity, and chronic kidney disease (CKD) are major public health challenges globally, contributing significantly to morbidity and mortality. The co-occurrence and interplay among these conditions exacerbate health outcomes, highlighting the need for an integrated understanding and approach to management. This narrative review aims to explore the complex relationships between diabetes, hypertension, obesity, and CKD, elucidating their collective impact on health. It discusses the epidemiological trends, underlying pathophysiological mechanisms, genetic predispositions, current treatment strategies, and the future direction of research and therapy. An extensive review of current literature was conducted, focusing on the epidemiology, pathophysiology, risk factors, diagnosis, and treatment of diabetes, hypertension, obesity, and CKD. Additionally, the review delves into the genetic and molecular biology underlying these conditions, the potential for personalized medicine, and the importance of a multidisciplinary approach to care. The review identifies key areas where these conditions intersect, enhancing disease progression and complicating management. It highlights the role of genetic and environmental factors in disease etiology, the critical need for personalized treatment strategies, and the gaps in current management approaches. Innovations in pharmacotherapy, monitoring technologies, and the potential of pharmacogenomics are discussed as avenues for advancing patient care. Diabetes, hypertension, obesity, and CKD are intricately linked, necessitating an integrated, patient-centered approach to care that goes beyond traditional treatment modalities. Future research should focus on collaborative models and interdisciplinary strategies to address the multifaceted challenges posed by these conditions. Emphasizing personalized medicine and leveraging technological advancements offer promising pathways to improve outcomes and reduce the global health burden of these metabolic disorders.

Excess body weight, duration of insulin and antihypertensive therapy slow down the rate of progression of chronic kidney disease in type 2 diabetes

Objective: to study and clinically substantiate the relationship between overweight and the dynamics of CKD progression in patients with type 2 diabetes of different age groups using the diagnostic parameter Index of glomerular filtration rate reduction. Material and methods: a single-stage cross-sectional observational study of clinical indicators in a population sample of patients with type 2 diabetes of different age groups was performed, patterns of relationships, significance of differences in mean values and measures of influence (OR (95%CI)) were studied between the indicators of BMI, the stage of obesity and the presence of a diagnosis of obesity in the anamnesis and the original calculated diagnostic parameter, the Index of glomerular filtration rate reduction (RI_GFR), which allows to give an objective quantitative characteristic of the rate of progression of CKD. Results: significant correlations were established between RI_GFR and indicators of age, BMI, DM experience and duration of insulin therapy, a significant inverse relationship with BMI was noted only in the older group; when analyzing differences in the average values of clinical indicators in the groups of rapid and slow progression of CKD, divided by the threshold value of RI_GFR, significant factors affecting the rate of progression were determined CKD: DM experience, duration of insulin therapy, BMI; the logistic regression analysis determined the measure of the influence of the above factors on the dynamics of GFR reduction, confirmed its significance; when analyzing the factors of drug treatment in the elderly group, it was revealed that an integrated approach to the appointment of antihypertensive therapy (prescribing drugs of three or more groups) significantly reduces the risk of rapid progression of CKD. Conclusions: the most significant risk factors for the high rate of progression of CKD in patients with type 2 diabetes and overweight in the general sample and in patients of the older age group are the length of diabetes and duration of insulin therapy; the dynamics of GFR reduction in patients with type 2 diabetes of different age groups is interrelated with BMI, and in patients with overweight CKD progresses more slowly; an integrated approach to prescribing antihypertensive therapy (prescribing drugs of three or more groups) in elderly patients with type 2 diabetes significantly reduces the risk of rapid progression of CKD.

Combined polygenic scores for ischemic stroke risk factors aid risk assessment of ischemic stroke

BackgroundCurrent risk assessment for ischemic stroke (IS) is limited to clinical variables. We hypothesize that polygenic scores (PGS) of IS (PGSIS) and IS-associated diseases such as atrial fibrillation (AF), venous thromboembolism (VTE), coronary artery disease (CAD), hypertension (HTN), and Type 2 diabetes (T2D) may improve the performance of IS risk assessment. MethodsIncident IS was followed for 479,476 participants in the UK Biobank who did not have an IS diagnosis prior to the recruitment. Lifestyle variables (obesity, smoking and alcohol) at the time of study recruitment, clinical diagnoses of IS-associated diseases, PGSIS, and five PGSs for IS-associated diseases were tested using the Cox proportional-hazards model. Predictive performance was assessed using the C-statistic and net reclassification index (NRI). ResultsDuring a median average 12.5-year follow-up, 8374 subjects were diagnosed with IS. Known clinical variables (age, gender, clinical diagnoses of IS-associated diseases, obesity, and smoking) and PGSIS were all independently associated with IS (P < 0.001). In addition, PGSIS and each PGS for IS-associated diseases was also independently associated with IS (P < 0.001). Compared to the clinical model, a joint clinical/PGS model improved the C-statistic for predicting IS from 0.71 to 0.73 (P < 0.001) and significantly reclassified IS risk (NRI = 0.017, P < 0.001), and 6.48% of subjects were upgraded from low to high risk. ConclusionsAdding PGSs of IS and IS-associated diseases to known clinical risk factors statistically improved risk assessment for IS, demonstrating the supplementary value of inherited susceptibility measurement . However, its clinical utility is likely limited due to modest improvements in predictive values.

Abstract P410: Prevalence and Short Term Follow Up Rates Across the Childhood and Adolescent Obesity Population in a Community Hospital

Background: Obesity is a global pandemic, which is 20.7% prevalent among 6-11 yr old and 22.2% prevalent among 12-19 year old(CDC). Aim is to understand the prevalence across different age groups in a community hospital setting. Secondary aim is to assess the variance of follow up rates across childhood and adolescence as follow up is crucial for the success of any physician intervention. Methods: We considered pediatric patients between 5 to 20 years old visiting primary care clinics within a 3-month period with a diagnosis of obesity for our study. We determined the follow up rate for 3 month scheduled weight checks for obese patients relative to the age groups. Results: We identified a total of 264 patients with obesity diagnosis (&gt;95th percentile BMI) visiting outpatient clinics within a three month period. In our sample, the prevalence of obesity in childhood years (5-11) was 58.7%(155 of 264) and prevalence of obesity in the adolescent age group(12-20) was 41.2% (109 of 264). We recorded 30.3%(108 of 155) follow up in childhood years and 33.9%(72 of 109) follow up in the adolescent age group. The calculated p value was &gt;0.05, hence the follow up rates across different age groups are not statistically significant. Conclusions: Focused intervention on the childhood age group will decrease the prevalence rates of obesity in a community hospital setting. This study emphasizes the need to formulate a plan to increase the follow up rates in the pediatric obesity population given its high prevalence in community hospital settings. No statistical significance has been found with follow up rates across various age groups. Further research controlling the confounding factors like environmental and socioeconomic factors help us understand the factors hindering follow ups across various age groups.

Age-wise examination of the association of obesity based on body mass index and waist circumference with metabolic diseases in comprehensive health checkup participants.

Body mass index and waist circumference are used for obesity diagnosis and screening of visceral fat; however, their evidence in older adults is insufficient. This study investigated the age-specific association of body mass index and waist circumference with metabolic diseases, assessing their applicability as diagnostic criteria for individuals aged ≥65years. Analysis included 46,324 individuals aged ≥18years, categorized into five age groups: 18-44, 45-54, 55-64, 65-74, and ≥75years. Logistic regression analyses identified associations between obesity and metabolic diseases, stratified by age and sex. Men with obesity based on body mass index had a significantly high risk of hypertension, diabetes mellitus, and dyslipidemia across all age groups (all, p<0.05). Obesity based on waist circumference was significantly positively associated with all metabolic diseases (all, p<0.05). Women with obesity based on body mass index and waist circumference had a significantly high risk of all metabolic diseases across all age groups (all, p<0.05), except for diabetes mellitus in individuals aged ≥75years. Participants with obesity based on body mass index and waist circumference exhibited a high risk of hypertension, diabetes mellitus, and dyslipidemia among those aged 18-74years and men aged ≥75years. This study contributes to the early prevention and control of metabolic diseases.

Switching photocurrent polarity and mimicking enzyme functions of MIL-53(Fe)@hemin for homogeneous dual-modal ultrasensitive detection of PTP1B

Protein tyrosine phosphatase 1B (PTP1B) as a regulatory enzyme is an important target for the early diagnosis and drug discovery of diabetes, obesity, and cancer. Herein, a homogeneous dual-modal biosensor integrating photoelectrochemical and colorimetric (PEC-CL) strategies was developed in light of the switching photocurrent polarity and mimicking enzyme functions of MIL-53(Fe)@hemin for the sensitive detection of PTP1B activity. Magnetic Fe3O4@Au NPs were synthesized for more sufficient homogeneous biorecognition, and modified with the phosphorylated peptides (p-Peptide), and sequentially connected with MIL-53(Fe)@hemin by the specific coordination of phosphate groups with Fe(III). After PTP1B-mediated specific recognition and dephosphorylation, the separated MIL-53(Fe)@hemin were quickly collected via magnetic separation for further PEC and CL assay. MIL-53(Fe)@hemin not only switched the photocurrent polarity of SnS2 NFs from anode to cathode, but also exhibited excellent peroxidase-like activity for oxidizing 3,3′,5,5′-tetramethylbenzidine (TMB) in the presence of H2O2. As a signal amplifier, MIL-53(Fe) acted as a nanocarrier to load abundant PEC signal switching factor of hemin, and synergistically enhanced its enzyme-mimic property. Consequently, ultrasensitive PEC biosensing (with linear response range of 0.1 pg mL−1 to 3000 ng mL−1 and detection limit of 0.074 pg mL−1) assisted by visual CL strategy (with linear response range of 10 pg mL−1 to 3000 ng mL−1 and detection limit of 0.24 pg mL−1) for PTP1B activity assay were achieved, which not only provided high sensitivity, but also possessed portability, perceptual intuition and reliability.

Fat as a Friend or Foe of the Bone.

The objective of this review is to summarize the literature on the prevalence and diagnosis of obesity and its metabolic profile, including bone metabolism, focusing on the main inflammatory and turnover bone mediators that better characterize metabolically healthy obesity phenotype, and to summarize the therapeutic interventions for obesity with their effects on bone health. Osteoporosis and fracture risk not only increase with age and menopause but also with metabolic diseases, such as diabetes mellitus. Thus, patients with high BMI may have a higher bone fragility and fracture risk. However, some obese individuals with healthy metabolic profiles seem to be less at risk of bone fracture. Obesity has become an alarming disease with growing prevalence and multiple metabolic comorbidities, resulting in a significant burden on healthcare and increased mortality. The imbalance between increased food ingestion and decreased energy expenditure leads to pathological adipose tissue distribution and function, with increased secretion of proinflammatory markers and harmful consequences for body tissues, including bone tissue. However, some obese individuals seem to have a healthy metabolic profile and may not develop cardiometabolic disease during their lives. This healthy metabolic profile also benefits bone turnover and is associated with lower fracture risk.

Hedonic hunger, food addiction, and night eating syndrome triangle in adolescents and ıts relationship with body mass ındex

BackgroundThe relationship between adolescent obesity and eating disorders is an issue that needs urgent attention. Screening for eating disorders is as important as dietary interventions to treat obesity. This study aimed to determine the relationship between hedonic hunger, food addiction, and night eating syndrome, which are considered potential risk factors for obesity, and body mass index (BMI) in adolescents.MethodsThe data were collected through an online questionnaire. The “Power of Food Scale (PFS)” was used to assess hedonic hunger; the “Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0)” was used to assess food addiction; and the “Night Eating Questionnaire (NEQ)” was used to assess night eating syndrome (NES)”. BMI was calculated using self-reported height and weight values of adolescents. The mediated structural model analysis was performed to evaluate the effect of hedonic hunger on BMI z score via food addiction and NES.ResultsThe study was conducted with 614 voluntary adolescents aged between 11 and 18 years. The dYFAS-C 2.0 and NEQ scores were found to be higher in adolescents with overweight and obesity, and the BMI z-score of the adolescents had significant positive correlation with their PFS scores (p < .001). Hedonic hunger has no direct effect on BMI independent of food addiction and NES (β = − 0.051, p = .468), but when the total indirect effect is evaluated with the bootstrap analysis, it was found that one-unit increase in hedonic hunger score increases BMI z-score by approximately 0.22 units (β = 0.223, SE = 0.046, 95% CI 0.131–0.313). Hedonic hunger, food addiction, and NES together explained 5.2% of the total variance in BMI z score.ConclusionThis study showed that hedonic hunger significantly predicted BMI z-score in adolescents through food addiction and NES. This emphasizes the critical importance of evaluating adolescents in terms of hedonic hunger, food addiction, and NES in the prevention, diagnosis, and treatment of obesity.

Cutoff points of mid-upper arm circumference (MUAC) for diagnosis of adolescent obesity: A systematic review with metanalysis and MOSTA tape proposal: MUAC cutoff for diagnosis of adolescent obesity

Adolescents are particularly vulnerable to obesity. The initial step to implement preventive and therapeutic measures is the detection of patients affected. In some circumstances, it may be important that the diagnosis is made more quickly, and the mid-upper arm circumference (MUAC) has been used for this. The present study is a systematic review with meta-analysis seeking aiming to suggest cutoff points and propose a simple tool for screening or rapid diagnosis of adolescent obesity. Studies published between January 1990 and December 2022 on MUAC and obesity in adolescents from 10 to 18 years were researched. PRISMA statement and checklist were followed. Optimal cutoff values and the corresponding sensitivity and specificity were estimated using a meta-analysis of diagnostic accuracy studies, by maximizing the Youden index using the new “diagmeta” package of the R software. PROSPERO Submission number: 387,301. From 92 initially screened, a total of six papers fully met the inclusion criteria and were included in the meta-analysis, involving 39,149 adolescents from five countries. Using the proposed methodology, simplified cutoff points of MUAC (cm) were obtained for screening adolescents at risk for obesity: 23 for girls and 23.5 for boys (10–14 years); 28.14 for girls and 27.14 for boys (15–20 years). In conclusion, the present study proposes, through a systematic review with meta-analysis, simplified cutoff points of MUAC aiming for obesity screening for adolescents and the creation of a tool called MUAC Obesity Screening Tool for Adolescents (MOSTA tape) aimed at simple use and rapid diagnosis.

Abstract WP258: Younger Patients Have a Higher Likelihood of Recurrent Vessel Small Subcortical Infarct: A Post-Hoc Analysis of the SPS3 Trial

Introduction: Recurrent ischemic stroke due to intracranial large artery disease occurs in up to 20% of patients and is associated with uncontrolled cardiovascular risk factors. However less is known of recurrent vessel small subcortical infarcts (rvSSI), which may be related to branch atherosclerotic disease. The aim of this study was to describe the clinical risk factors associated with rvSSI. Methods: We performed a post-hoc analysis of the Secondary Prevention of Small Subcortical Strokes (SPS3) dataset which enrolled participants between 2003 and 2007. All participants were ≥ 30 years old and had a SSI index event within the preceding 6 months of randomization, confirmed by MRI with a maximal diameter on diffusion weighted imaging (DWI) of ≤ 20 mm, and were without competing stroke mechanism (e.g. ipsilateral carotid stenosis ≥ 50%). Participants were followed over a mean duration of 4 years post-enrollment during which stroke recurrence was noted and characterized. rvSSI was defined as recurrent SSI within the same vascular distribution as an index enrolling infarct confirmed by brain MRI. Chi-squared and student’s T test were used for categorical and continuous variables, respectively. Adjusted logistic regression models were formed to calculate odds ratio. Statistical significance was ≤ 0.05. Results: Of the 3020 participants enrolled in SPS3, 1245 participants met inclusion criteria with 15 having a rvSSI (mean time post-enrollment: 427 days). Participants with rvSSI were younger (54.5 ± 10.2 years vs 61.2 ± 10.6 years, p = 0.008) and had enrollment diagnoses of obesity [BMI ≥ 30 kg/m2; 80% (12/15) vs 49% (598/1230), p = 0.016] and hyperlipidemia [87% (13/15) vs 58% (713/1230), p = 0.025]. Sex, former/current tobacco use, and known diagnoses of hypertension and diabetes mellitus did not differ. For every advancing decade of life, the likelihood of developing a rvSSI was 0.46 (95%CI 0.26 - 0.82, p = 0.008). Conclusions: Participants of the SPS3 trial who were younger in age had rvSSI more frequently with the likelihood decreasing by roughly half with advancing decade of life.

A Comprehensive Review of Syndromic Forms of Obesity: Genetic Etiology, Clinical Features and Molecular Diagnosis.

Syndromic obesity refers to obesity occurring with additional clinical findings, such as intellectual disability/developmental delay, dysmorphic features, and congenital malformations. PURPOSE OF REVIEW: To present a narrative review regarding the genetic etiology, clinical description, and molecular diagnosis of syndromic obesity, which is a rare condition with high phenotypic variability and genetic heterogeneity. The following syndromes are presented in this review: Prader-Willi, Bardet-Biedl, Pseudohypoparathyroidism, Alström, Smith-Magenis, Cohen, Temple, 1p36 deletion, 16p11.2 microdeletion, Kleefstra, SIM1-related, Börjeson-Forssman-Lehmann, WAGRO, Carpenter, MORM, and MYT1L-related syndromes. RECENT FINDINGS: There are three main groups of mechanisms for syndromic obesity: imprinting, transcriptional activity regulation, and cellular cilia function. For molecular diagnostic, methods of genome-wide investigation should be prioritized over sequencing of panels of syndromic obesity genes. In addition, we present novel syndromic conditions that need further delineation, but evidences suggest they have a higher frequency of obesity. The etiology of syndromic obesity tends to be linked to disrupted neurodevelopment (central) and is associated with a diversity of genes and biological pathways. In the genetic investigation of individuals with syndromic obesity, the possibility that the etiology of the syndromic condition is independent of obesity should be considered. The accurate genetic diagnosis impacts medical management, treatment, and prognosis, and allows proper genetic counseling.