Diagnosis Of Obesity Research Articles

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.

Cutoffs of different body measurement indexes of central obesity in patients with type 2 diabetes

Few research discuss whether the body measurement indexs of obesity in general populations is applicable to patients with type 2 diabetes. We explore the optimal cutoffs of visceral fat area (VFA) and subcutaneous fat area (SFA) in the diagnosis of central obesity and the cutoffs of corresponding waist circumference (WC) and body mass index (BMI) in patients with Type 2 Diabetes (T2D). Cross-sectional cohort study. 1057 patients with T2D (550 males and 507 females) aged 18 or above that satisfied the criteria were included. The definition and diagnostic criteria of Metabolic syndrome (Mets) were analyzed according to the 2020 Chinese Diabetes Society (CDS) Guideline. The VFA and SFA were measured by bioelectrical impedance analysis (BIA). The optimal VFA and SFA cutoffs and corresponding WC and BMI when two or more nonadipose components of MetS (without central obesity) were met were analyzed by ROC curve. Among all of the T2D patients, the optimal VFA cutoff for identifying two or more nonadipose components of MetS was 73.30 cm2 for females and 69.20 cm2 for males, while the optimal SFA cutoff was 186.70 cm2 for females and 123.30 cm2 for males. The ROC area under curve (AUC) of VFA for identifying two or more nonadipose components of MetS was higher than that of SFA (Female: 0.65 vs. 0.58, P = 0.01). The VFA cutoff of newly diagnosed T2D patients (females = 86.10 cm2, males = 69.00 cm2) was higher than that of non-newly diagnosed T2D patients (females = 73.30 cm2, males = 65.40 cm2). A stratification analysis of gender and whether newly diagnosed with T2D or not showed that the WCs corresponding to VFA were 85.00 cm and BMI was about 24.00 kg/m2. VFA measured by BIA can be a non-invasive method to detect central obesity in patients with T2D, the corresponding WC were 85.00 cm and BMI was 24.00 kg/m2.

Sex and age specificities of the dynamics of anthropometric indicators characterizing obesity (according to a prospective epidemiological research)

Background. Overweight and obesity significantly increase the risk of premature death and the development of chronic diseases. Many anthropometric indices have been developed to verify obesity, although the best among them still remains undetermined.The aim. To determine the sex and age specificities of the dynamics of anthropometric indicators characterizing obesity.Materials and methods. The program was implemented in the period from 2015 to 2020. It provided for the implementation of a sample research. The baseline research included 1,124 women and 476 men. The average age was 54.9 ± 9.75 years and 52.6 ± 10.0 years, respectively. To identify gender specificities, all participants were divided into three age groups: 35–49 years old, 50–59 years old, and 60–70 years old. The observation period was 3 years. To determine the level of visceral fat, the VS-532 fat mass analyzer (Tanita Health Equipment HK Ltd., Hong Kong) was used. Body mass index (BMI), waist-hip index (WV/HV), visceral obesity index (VOI) were also calculated. Statistical processing of the results was carried out using the program Statistica 6.0 (StatSoft Inc., USA).Results. New cases of obesity developed in 30.6 % of the surveyed. There was an increase in the prevalence of obesity according to the criteria of WV (by 8.9 %) and VFL (by 5.4 %) and a decrease in the number of people who are obese according to WV/HV – by 4.2 %. Of all the indicators, only VOI showed a statistically significant decrease in the mean values over the observed period, while BMI, WV and VFL showed an increase.Conclusions. It is necessary to apply various criteria for the diagnosis of obesity, since individual indices are not able to fully reflect the gender and age specificities of the distribution of fat in the body

Сравнительный анализ заболеваемости ожирением детей, проживающих в Московской области

Aim: to conduct a comparative analysis concerning the overall prevalence of obesity in children 0–17 years old living in the Moscow region (MO) for 2012 and 2022. Patients and Methods: a comparative descriptive epidemiological study was conducted based on the data from the annual reporting forms of the Federal Statistical Observation No. 12 "Information on the number of diseases registered in patients residing in the area served by the medical institution" for the child population (from 0 to 17 y.o.) for 2012 and 2022. Results: in 2012, the diagnosis of obesity (ICD-10 code E66 for Overweight and obesity) was established in 13,781 children, including 9,608 children under 14 years old and 4,173 adolescents aged 15–17. In 2022, the diagnosis was established in 19,329 children, including 13,386 children under 14 and 5,943 adolescents aged 15–17. The overall number of children with obesity in 2022 compared to 2012 increased by 4% (from 11.76 to 12.29 cases per 1000 children's population), with the most significant increase observed among adolescents aged 15–17 (23%, from 22.48 to 27.74 per 1000 population), primarily among female patients. An increase in the overall prevalence in 2022 versus 2012 was observed in 18 city districts (38%), and a decrease — in 14 city districts (30%). In 2012, the prevalence rate higher than the average regional level (45%) in the age group of 0–14 y.o. was reported in 21 city districts, in the age group of 15–17 y.o. – in 23 city districts (49%), whereas the lower rate was in 25 (53%) and 24 (51%) city districts, respectively. In 2022, prevalence rates higher than the regional average for children aged 0–14 and 15–17 were observed in 18 city districts (38%), and lower — in 28 (60%) and 29 (61%) city districts, respectively, with a morbidity increase in 2 or more times in some city districts. Comparative epidemiological data on childhood obesity prevalence in different city districts of the MR were characterized by heterogeneity and significant variation in indicators. Conclusion: the overall prevalence of childhood obesity in 2022 versus 2012 has increased on average by 4%. The number of regions with an increase in the overall prevalence of obesity exceeded the number of regions with a decrease in this indicator. KEYWORDS: obesity, children, adolescents, incidence, prevalence, Moscow region. FOR CITATION: Bokova Т.А., Shishulina E.E., Bevz А.S., Kartashova D.A. Comparative analysis concerning the prevalence of childhood obesity in the Moscow region. Russian Journal of Woman and Child Health. 2024;7(1):51–57 (in Russ.). DOI: 10.32364/2618-8430- 2024-7-1-8.

Prevention of obesity and carbohydrate metabolism disorders in the population at an industrial facility.

One of the urgent tasks of modern healthcare is the development of measures aimed at preventing obesity in the able-bodied population, including in the Republic of Kazakhstan, which would reduce economic losses and increase the coefficient of life expectancy in the population. To identify measures for the early prevention of excess weight, obesity, and carbohydrate metabolism disorders in the able-bodied population at an industrial facility in Kazakhstan. The study involved 662 people (574 men and 88 women) aged 19 to 64 years. The subjects were divided into 2 groups: the main group - persons with obesity (242 people) and the control group - relatively healthy persons (422 people). The diagnosis of obesity was made based on the medical history of a patient, external examination, and physical, laboratory, and instrumental assessment. Three main factors influencing the development of obesity have been identified: a significant level of inactivity; serum glucose; the presence of comorbidities. Other factors (gender and age, smoking) do not have a significant effect on the increase in the body mass index of persons working at an industrial facility. Accordingly, a priority in the prevention of obesity is a healthy lifestyle, involving regular physical activity and a healthy balanced diet.

Inflammatory profile of patients with different weight diagnoses and similar periodontal condition: A systematic review.

This study aimed to systematically review the literature regarding the inflammatory profiles, measured by cytokines and chemokines, of individuals with different diagnoses of weight, but with the similar periodontal condition. Searches were performed in five databases (Scopus, EMBASE, PubMed, Web of Science, and Cochrane-Central). Studies that compared the inflammatory profile of normal-weight individuals to those with obesity and evaluated the same cytokine, collection method, and periodontal diagnosis (periodontal health, gingivitis, or periodontitis) were included. Cross-sectional studies underwent evaluation by independent researchers using the Joanna Briggs Institute Critical Appraisal Checklist. The GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system assessed evidence certainty. Twelve studies were included. The diagnosis of obesity was done on the basis of body mass index, waist circumference, and waist-hip ratio. Pro-inflammatory cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF]-α, IL-1β, IL-31, and IL-34) were analyzed in serum, saliva, gingival crevicular fluid (GCF), and plasma. Periodontal diagnoses varied across studies. TNF-α expression was significantly higher in individuals with obesity and periodontal health or periodontitis. Serum IL-1β levels showed mixed results, but salivary IL-1β levels were elevated in obese individuals. IL-6 levels were higher in obese individuals, regardless of periodontal status. IL-34 and IL-10 showed no significant differences across groups. Monocyte chemoattractant protein-4 (MCP-4) levels were higher in obese individuals with periodontitis or periodontal health. IL-31 and IL-34 in GCF showed no significant differences between obese and nonobese individuals, without periodontitis. Heterogeneous results were noted for IL-6, IL-1β, IL-31, IL-34, TNF-α, and MCP-4, hindering conclusions on weight's impact on inflammatory profiles in periodontal patients.

Evaluation of mucin-1, nuclear factor κB, and hemoglobin A1c levels in obese and non-obese individuals.

Obesity is a chronic multisystem disease associated with increased morbidity and mortality. Obesity, which is a complex, multifactorial, and heterogeneous condition, is thought to result from the interaction of environmental, physiological, and genetic factors. In this study, the relationship between serum levels of hemoglobin A1c, mucin-1, and nuclear factor κB in obese and healthy cohorts was evaluated along with biochemical and gene expressions and with demographic and clinical covariates, and their effects on obesity were evaluated. This case-control study included a total of 80 individuals, 40 healthy controls and 40 obesity patients, consisting of female and male aged between 18 and 63 years. Hemoglobin A1c, mucin-1, and nuclear factor κB levels were determined by ELISA in serum samples obtained from patients. In addition, aspartate aminotransferase, alanine transaminase, low density lipoprotein, and glucose values were measured. The gene expressions of the same markers were analyzed by quantitative real-time polymerase chain reaction, and their regulation status was defined. Serum levels of hemoglobin A1c, mucin-1, and nuclear factor κB were found to be high in obese individuals (p<0.05). The gene expression of these serum markers was found to be upregulated. Of the anthropometric measurements, waist circumference and body mass index were correlated with both serum markers and gene expressions (p<0.05). In addition to the known association of hemoglobin A1c and nuclear factor κB with obesity, serum levels of mucin-1 as well as upregulation of genes point to its modifier effect on obesity. These parameters can be the powerful markers in the diagnosis of obesity.

Long term cost outcomes among commercially insured patients undergoing bariatric surgical procedures.

Bariatric procedures have become safer in recent years, warranting new data on long-term costs. This study examined the impact of bariatric procedures on a person's long-term healthcare costs up to 10years and if it differed by socio-economic status (SES). This retrospective observational study compared the downstream health care cost of patients with obesity who had undergone bariatric surgery (BS) between 2009 and 2018 to a 1:1 matched group of members with obesity but no surgery. 167,764 individuals from administrative claims data with an obesity diagnosis were included; 83,882 in the BS group and 83,882 in the non-surgical group. In follow-up years 2-10, the BS group was associated with lower total medical healthcare cost compared to the non-surgical group (cost ratios ranged 0.85-0.93, p values<0.05). When stratifying the BS group by SES quartiles, there were no significant cost differences by SES (cost ratios ranged from 0.96 to 1.05, most p values>0.05). BS was associated with lower long-term follow-up medical cost and cost savings appeared similar among the SES quartiles in the BS group. The study results may help policy makers and employers in designing benefits and extending coverage for bariatric surgical procedures.

Pubertal gynecomastia incidence among 530,000 boys: a cross sectional population based study.

Adolescent gynecomastia, a benign proliferation of male breast tissue, can lead to psychological issues during adolescence. The prevalence varies widely (4%-69%). The incidence peaks are during neonatal, pubertal, and senescent periods. Its affect on emotional well-being necessitates understanding and occasional intervention. This study aimed to determine the incidence of gynecomastia among male adolescents aged 12-15 years. A retrospective cross-sectional study utilized the Clalit Health Care Services database (2008-2021) with a population of approximately 4.5 million. Participants aged 12-15 years were included if diagnosed with gynecomastia (International classification of diseases-9 code 611.1) and having a body mass index (BMI) measurement and no obesity diagnosis (ICD9 code 278.0). Data analysis included incidence rates and associations with ethnicity, age, BMI, and socioeconomic status. 531,686 participants included with an incidence of 1.08%. Of all participants, 478,140 had a BMI ≤ 25 with an incidence of 0.7%, and 0.25%-0.35% yearly, and 70% of gynecomastia patients were aged 13-14 years. The prevalence of gynecomastia differed between Jews (1.28%) and Arabs (0.67%), but the disparity diminished when socioeconomic status was considered. This unprecedented Population study establishes a definitive rate of true pubertal gynecomastia, revealing a lower yearly incidence as compared to previous reports. The higher observed prevalence among Jewish adolescents, may be caused due to complex interactions between different influencing factors. Understanding these dynamics can aid in formulating more targeted interventions and policy strategies to address gynecomastia's affect on adolescent well-being.

Healthcare outcomes and dispositions in persons with obesity within emergency departments in Ontario, Canada: A cross-sectional analysis of the National Ambulatory Care Reporting System (NACRS), 2018-2022.

The experience of persons with obesity (PwO) in the Canadian healthcare setting has not been widely studied. The objective of this study was to assess care in PwO in emergency departments in Ontario, Canada. This secondary analysis made use of 2018-2022 Canadian Institute for Health Information's National Ambulatory Care Reporting System. The sample consisted of 4547 individuals with an obesity diagnosis, and 4547 controls who were matched for sex, age, and main diagnosis. Ordinal logistic and multiple linear regression analyses were used to assess triage scores, wait times, and length of stay. PwO had 4.8 minutes longer wait time for a physician initial assessment (p<0.01), 3.56 hours longer length of stay in the emergency department (p<0.0001), and 55% greater odds (OR = 1.55, 95% CI: 1.43-1.68) of having a less urgent triage score compared to controls matched for main diagnosis. When further matched for triage score, PwO experienced over three hours longer length of stay for triage level 2 (emergent, p<0.01), five hours longer for triage level 3 (urgent, p<0.01), and nearly two hours longer for triage level 4 (less urgent, p<0.05) cases. PwO were rated as less urgent and experienced longer wait times and length of stay, compared to controls matched by sex, age, and main diagnosis. Additional research is needed to confirm the consistency of these findings in other provinces/territories, and to examine clinical outcomes, and the underlying reasons for differences.

Efficacy of Triglyceride Glucose Index-Neck Circumference and Triglyceride Glucose Index-Neck-to-Height Ratio in the Diagnosis of Cardiovascular Diseases and Metabolic Syndrome.

A group of characteristics known as metabolic syndrome raises the chance of developing diabetes and cardiovascular disease. Insulin resistance (IR) and obesity are regarded as critical metabolic syndrome pathophysiology. The diagnostic accuracy of IR indicators, triglyceride (TG) glucose index-neck circumference (TyG-NC), and TG glucose index-neck-to-height ratio (TyG-NHtR) to be evaluated for the detection of cardiovascular diseases and metabolic syndrome in nondiabetic individuals. A cross-sectional study was conducted and passed by the Ethics Committee of the institute. The age should be 18 years or older, and subjects should not have diabetes. Each patient's clinical information was gathered, and lab tests were run. The study was done for a period of 1 year. The study has 100 participants. Around 74% of the group was women. Only 26.5% of the group had an obesity diagnosis. Poor fasting plasma glucose levels were found in 19.4% of the research team. Receiver operating characteristic (ROC)-area under the curve (AUC) testing revealed that all examined IR indices can differentiate individuals with metabolic syndrome from those who are healthy. Our analysis laid out the soaring high area under the ROC curve for TyG index and the low stunted area under the ROC curve for TyG-NC. For obesity, all indices showed appreciable diagnostic efficacy, indicating the maximum achieved area under the ROC curve for TyG index and the minimum recorded metabolic score for IR. The AUC in the case of the metabolic score for IR (METS-IR) male sample population was found to be not statistically compelling. The exploration of indirect indices, the proposed ones, namely TyG-NC and TyG-NHtR, emphasized an intricate link between cardiovascular diseases and metabolic syndrome.

Incidence of type 2 diabetes after gastric by-pass surgery in a Swedish controlled cohort study

AimsTo assess the long-term risk of developing type 2 diabetes in patients with obesity who have undergone gastric bypass surgery compared to non-operated patients with obesity and the general population. MethodsThis study included 71,495 patients aged 20–65 years with a principal diagnosis of obesity in the Swedish Patient Register in 2001–2013. Of these, 23,099 had undergone gastric bypass and 32,435 had not. Each patient was matched by age, sex and geographic region with two controls from the general population without obesity diagnosis, i.e., 44,735 controls for the gastric bypass cohort and 62,522 controls for the non-operated cohort with obesity. Operated and non-operated patients with obesity were also directly compared using Cox regression analysis, providing hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, education, and sex. ResultsDuring a median follow-up of 4.3 years (interquartile range [IQR] 2.4, 7.0 years), 3792 (11.7%) non-operated patients with obesity developed type 2 diabetes (incidence rate 22.8/1000 person-years, 95% CI 22.1–23.6) compared to 394 (1.7%) among gastric bypass patients (incidence rate 4.0/1000 person-years, 95% CI 3.6–4.5). The latter incidence was comparable to population controls (3.5/1000 person-years, 95% CI 3.2–3.8). Gastric bypass patients had 85% lower risk of diabetes compared to non-operated patients with obesity during the first six years of follow-up (HR 0.15; 95% CI 0.13–0.17). ConclusionGastric bypass surgery for obesity seems to reduce the risk of developing type 2 diabetes to levels similar to that of the general population during the first six years of follow-up but not thereafter.

Integration of Endogenous Opioid System Research in the Interprofessional Diagnosis and Treatment of Obesity and Eating Disorders.

This third and final chapter in our trilogy introduces the clinical distinctions and phenotypical similarities between obesity and eating disorders. Research elaborating on the shared neurobiological substrates for obesity and eating disorders is discussed. We present an interprofessional model of treatment for both disordered eating and for obesity. Additionally, this chapter establishes the translational importance of research connecting endogenous opioid activity with both obesity and eating disorders, with an emphasis on clinical interventions. We conclude with a discussion of future directions for research.

Саркопения и саркопеническое ожирение

Sarcopenia is a progressive generalised skeletal muscle disorder that is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. Sarcopenic obesity is a clinical and functional condition characterized by the coexistence of excess fat mass and sarcopenia. In 2018, the European Working Group on Sarcopenia in Older People presented updated data on sarcopenia (EWGSOP2). The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for sarcopenic obesity. This article contains the main provisions of the documents and a review of the literature on the mechanisms, diagnosis and clinical significance of sarcopenia and sarcopenic obesity.

A differentiated approach to the diagnosis of overweight and obesity in children based on bioimpedance analysis of body composition.

Aim: The current study introduces a novel diagnostic algorithm employing bioimpedance analysis to comprehensively evaluate body composition in children, assessing fat content, skeletal muscle content, and fat distribution. Materials and Methods: Bioelectrical impedance measurements were obtained using the TANITA MC-780 MA analyzer. Indicators such as body weight, BMI, total fat content, absolute limb muscle mass, skeletal muscle strength, and waist-to-hip ratio (WHR) were assessed. A sample of 101 children aged 9 to 14 were studied using the proposed algorithm, refining BMI-based classifications. Results: The algorithm comprises three steps, categorizing children based on fat content, presence of sarcopenia, and central fat distribution. It identified diverse somatotypes within the groups classified by BMI. Notably, it revealed prognostically unfavorable somatotypes, such as sarcopenic obesity with central fat distribution, highlighting potential health risks. Current BMI-centric diagnoses may misclassify cardiometabolic risks, making early detection challenging. The algorithm enables a detailed evaluation, unmasking metabolically unfavorable conditions like sarcopenic obesity. The incorporation of functional tests, such as a standardized hand-grip test, enhances diagnostic accuracy. The proposed WHR indicator for characterizing fat distribution provides a practical method for determining somatotypes in children. Conclusions: This comprehensive algorithm offers an alternative to BMI-based classifications, enabling early detection of obesity and associated risks. Further validation through large-scale epidemiological studies is essential to establish correlations between somatotypes and cardiometabolic risks, fostering a more nuanced and individualized approach to pediatric obesity management.

Sobrepeso y obesidad materna antes del embarazo como predictores de asma infantil en menores de cinco años: una cohorte retrospectiva en Perú

Abstract Objectives: to estimate the role of maternal overweight and obesity before pregnancy as predictors of childhood asthma in a population of Peruvian children under five years. Methods: we carried out a retrospective cohort study of children aged five years or less and their mothers from the Regional Hospital of Ayacucho and the María Auxiliadora Hospital in Lima, Peru. We included children who were born between 2013 and 2014 and follow them up until 2018 and 2019, respectively. The diagnosis of overweight and obesity of the mother before pregnancy and asthma in the child were registered in their clinical histories. Crude (cRR) and adjusted relative risks (aRR) and 95% confidence intervals (CI95%) were obtained using a generalized lineal model of the Poisson family with link log and robust variances. Results: we evaluated 431 medical records and found that 20.9% of the children had asthma, 26.7% of the mothers were overweight, and 20.2% were obese before pregnancy. In the adjusted regression model, overweight (aRR=2.94; CI95%= 1.54-5.60) and maternal obesity (aRR=5.10; CI95%= 2.73-9.51) were predictors of an increased risk of childhood asthma. Conclusions: maternal overweight and maternal obesity increased the risk of her children developing asthma threeand five-fold, respectively.

Исход COVID-19 тяжелого течения у ребенка с морбидным ожирением

Obesity is one of the most essential medical and social problems. When it was noted that obese children had higher risks of disease, complications and mortality, the overweight effect on the course and outcome of infectious respiratory diseases became particularly important during the flu pandemic. According to numerous studies, obesity has been considered as a predictor of the adverse and even fatal outcome of COVID-19, participating in the formation of multisystem inflammatory syndrome in children (MIS-C). This article demonstrates a case study of severe COVID-19 complicated by MIS-C, multiple thrombosis, and multiple organ dysfunction syndrome in a 9-year-old child with morbid obesity. The article describes the patient management and the complex of diagnostic and therapeutic measures conducted. The main pathogenetic mechanisms of the inflammatory process explaining the association between obesity and the SARS-CoV-2 coronavirus damaging effects are also considered. The need for timely diagnosis and treatment of both obesity itself and comorbid pathology is shown to prevent potentially life-threatening conditions. KEYWORDS: children, obesity, new coronavirus infection, COVID-19, SARS-CoV-2, multisystem inflammatory syndrome, premorbid history, thrombosis, multiple organ dysfunction syndrome. FOR CITATION: Kartashova D.A., Bokova T.A., Razheva I.V., Bevz A.S., Vorontsova S.V. Severe COVID-19 course outcome in a child with morbid obesity. Russian Journal of Woman and Child Health. 2024;7(1):79–85 (in Russ.). DOI: 10.32364/2618-8430-2024-7-1-12.

Effects of residential Yoga therapy on blood pressure and body mass index in women with hypothyroidism and obesity: A retrospective study

Abstract Background: Hypothyroidism is a highly prevalent endocrine disorder among women of reproductive age. Patients with hypothyroidism often develop obesity, which further increases the risk of hypertension and cardiovascular disease. Yoga has positive effects on hypothyroidism indices. Aim: This retrospective study evaluates the effects of a two-week residential Yoga intervention on blood pressure and body mass index (BMI) among women with hypothyroidism and obesity. Materials and methods: Data of 98 females with a clinical diagnosis of hypothyroidism and obesity, aged between 18 and 60 years, who received two weeks of residential Yoga intervention between 2013 and 2020 at Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India, was retrieved retrospectively. The residential Yoga intervention consisted of integrated Yoga sessions, breathing practices, devotional sessions, a simple and wholesome diet, and educational sessions every day. Data on systolic blood pressure, diastolic blood pressure, and body mass index (BMI) were analyzed. Records of patients with cardiac disease, cardiorespiratory compensatory disease, hypertension, or patients on antihypertensive drugs were excluded. Results: There was a significant decrease in systolic blood pressure, diastolic blood pressure, and BMI at two weeks compared to baseline. Conclusion: A two-week residential Yoga intervention has a positive impact on blood pressure and BMI in women with hypothyroidism and obesity. Future randomized controlled trials with larger samples and long-term follow-ups are warranted.

Agreement Between Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry to Estimate Fat Mass in Hispanic Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Adipose tissue excess is associated with adverse health outcomes, including type 2 diabetes. Body mass index (BMI) is used to evaluate obesity but is inaccurate as it does not account for muscle mass, bone density, and fat distribution. Accurate measurement of adipose tissue through dual-energy X-ray absorptiometry (DXA) and computed axial tomography (CT) is crucial for managing and monitoring adiposity-related diseases. Still, these are not easily accessible in most hospitals in Mexico. Bioelectrical impedance analysis (BIA) is non-invasive and low-cost but may not be reliable in conditions affecting the body's hydration status, like diabetes. To assess fat mass concordance between BIA and DXA in Hispanic-American adults with type 2 diabetes mellitus (T2DM). Cross-sectional study of a non-probabilistic sample of subjects over 18 years with type 2 diabetes. We used DXA as the reference method. We evaluated the accuracy of FM estimation through BIA and DXA in 309 subjects with type 2 diabetes. Results showed a trend of overestimating the diagnosis of obesity using BIA, especially in individuals with a higher fat mass index (FMI). At the group level, we found BIA accurate; however, at the individual level, it is not. The bias between the 2 methods showed a statistically significant overestimation of body fat by BIA (P ⩽ .01) in both sexes. BIA demonstrated high precision in estimating fat mass. We were able to provide a correction factor of 0.55 kg in men. BIA is inaccurate compared to DXA for body composition assessment in patients with diabetes. Inaccurate measurements can result in misclassification. However, BIA is precise for body composition assessment in patients with diabetes, so it is reliable for tracking patient progress over time.