Difference In Mean BMI Research Articles

Morphologic Features of the Contralateral Femur in Patients With Unilateral Slipped Capital Femoral Epiphysis Resembles Mild Slip Deformity: A Matched Cohort Study

AbstractBackgroundHip osteoarthritis has been reported in the contralateral hip in patients who had been treated for unilateral slipped capital femoral epiphysis (SCFE) during adolescence. Although this might be related to the presence of a mild deformity, the morphologic features of the contralater

Nutritional Status, Dietary Practices and Physical Activities among Female Adolescents: A Cross Sectional Study in District Okara, Pakistan

Adolescence is a period between childhood and adulthood and is important period of human growth cycle. During this significant period dietary pattern have important impact on lifetime nutritional status and health. The prevalence of overweight and obesity among children and adolescents has increased at an alarming rate in many parts of the world. The present study was designed to assess the nutritional status, physical activity pattern and dietary Practices among female adolescents in district Okara, Pakistan. A cross sectional study was designed among female adolescents of secondary school. There were 449 students from government schools and 401 were from private schools. Overall private school girls were significantly (p<0.005) taller and heavier than government school girls. Most of the private school students have sedentary lifestyle. Most of the students spend more time on screen than recommended. There was no significant difference in mean BMI of both the schools. There was significant result (p<0.005) of the dietary pattern of both the schools private school adolescents were having greater consumption of fast food than government school due to urbanization and due to socioeconomic differences. Most of the Pakistani adolescent girls do not perform physical activities adequately and have sedentary lifestyle. They spend most of their time on watching TV, using internet and other computer based activities. They also have unhealthy eating pattern. So there is need of implementing some interventions to promote physical activities and healthy eating pattern.

Reassessing Ethnic Differences in Mean BMI and Changes Between 2007 and 2013 in English Children.

ObjectiveNational body fatness (BF) data for English South Asian and Black children use BMI, which provides inaccurate ethnic comparisons. BF levels and time trends in the English National Child Measurement Programme (NCMP) between 2007 and 2013 were assessed by using ethnic‐specific adjusted BMI (aBMI) for South Asian and Black children.MethodsAnalyses were based on 3,195,323 children aged 4 to 5 years and 2,962,673 children aged 10 to 11 years. aBMI values for South Asian and Black children (relating to BF as in White children) were derived independently. Mean aBMI levels and 5‐year aBMI changes were obtained by using linear regression.ResultsIn the 2007‐2008 NCMP, mean aBMIs in 10‐ to 11‐year‐old children (boys, girls) were higher in South Asian children (20.1, 19.9 kg/m2) and Black girls, but not in Black boys (18.4, 19.2 kg/m2) when compared with White children (18.6, 19.0 kg/m2; all P < 0.001). Mean 5‐year changes (boys, girls) were higher in South Asian children (0.16, 0.32 kg/m2 per 5 y; both P < 0.001) and Black boys but not girls (0.13, 0.15 kg/m2 per 5 y; P = 0.01, P = 0.41) compared with White children (0.02, 0.11 kg/m2 per 5 y). Ethnic differences at 4 to 5 years were similar. Unadjusted BMI showed similar 5‐year changes but different mean BMI patterns.ConclusionsBF levels were higher in South Asian children than in other groups in 2007 and diverged from those in White children until 2013, a pattern not apparent from unadjusted BMI data.

A Study of the Diurnal Height Changes among sample of Adults aged Thirty years and above in Ghana

Introduction: The diurnal variations in stature significantly affect the reliability of height data. Diurnal variation in stature affects the reliability of any data that involves height measurement without a correction factor at different times of the day. The aim of the study was to determine the diurnal height loss of adults aged ≥ thirty years in the Greater Accra Region of Ghana.Materials and Methods: A total of 90 subjects were randomly sampled. Weight and Height measurements were taken twice a day between 5.30 - 7.30 am and 5 - 7 pm. WHO-Step wise questionnaires were used to gather all information on subjects. Results: The maximum height loss between 7 am and 7 pm from the study was 2.7 cm whiles mean was 1.61 cm. There was a greater mean height loss in males (1.63 cm) than in females (1.59 cm), greater mean BMI difference between morning and evening BMI was observed for females (1.21 kg/m2) than in males (1.02 kg/m2). There was significant association between height loss and occupational activities (p-value < 0.001).Conclusion: The height of the subjects significantly reduced from 7 am to 7 pm and increased from 7 pm to 7 am. The major factor that contributes to diurnal height variations is the level of occupational activity performed in a day. No significant relationships were established between age, sex, total caloric intake and diurnal height loss.

Influence of School Location within Districts of Terengganu on Body Weight Status among School Adolescents

Rapid development in the urbanisation process is linked to a shift in dietary intake and lifestyle. The locality may also determine the differences in socio-demographic and environmental factors related to nutrition between the rural and urban populations. The present study aimed to determine prevalence of obesity and to compare the body weight status on body weight status among school adolescents aged 10 to 17 years within districts of Terengganu. A cross sectional survey involving school adolescents aged 10 to 17 years from all government school in seven districts in Terengganu were carried out. Anthropometrics data were obtained from National Fitness Standard (SEGAK) assessment which was uploaded into specific developed database Health Monitoring System (HEMS) and BMI were classified using WHO BMI-for-age z-score. A total of 62,567 school adolescents were involved in this study. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. There were significant differences in mean BMI between rural and urban school locations school adolescents in all age groups (P <0.001) among boys and girls. Significant differences were also found between rural and urban school location in 10 to 12 years old in Dungun and Marang, whilst Kemaman and Kuala Terengganu districts had significant difference between rural and urban in 16 to 17 years old age group. Marang had the highest obesity prevalence within urban 15.3% school location whilst rural school location within Kuala Terengganu had the highest prevalence of obesity (14.1%). The obesity prevalence increased substantially regardless of school locations compared to previous years. School adolescents in both rural and urban have an equal prevalence of obesity suggesting that intervention and prevention programme should be targeting in both locations. Future studies should look at the association between the potential risk factors to tackle this problem from the origin.

Discordant ovarian reserve testing is a predictor of lower clinical pregnancy during COH-IUI fertility treatment

Patients with poor ovarian reserve often have a diminished response to controlled ovarian hyperstimulation (COH). Both Anti-Mullerian hormone (AMH) and Day-3 FSH levels have been shown to independently reflect ovarian reserve and are predictive of pregnancy success rates. However, when the levels are discordant, it is unclear how to counsel patients. At present no studies have evaluated COH-IUI outcomes in women with discordant FSH and AMH levels. This study was designed to evaluate pregnancy outcomes in women with discordant FSH and AMH levels after COH fertility treatment. Retrospective Cohort of 745 women. Excluding only women with polycystic ovarian syndrome, data from all fertility patients undergoing COH cycles during the period June, 2013 through March 2017 were studied. Women were considered to have normal Day-3 FSH with value <10 (mIU/mL), and normal AMH if values fell within age specific reference value. Clinical pregnancy rate is the cumulative pregnancy achieved after maximum of three cycles of COH with or without IUI. Chi- Square were used for statistical analysis using SPSS. Table below show as expected, concordant abnormal AMH/FSH values (Grp D) have significantly lower pregnancy rate than concordant normal (Grp A) patients. Abnormal FSH discordance (Grp C) have an intermediate pregnancy rate, statistically lower than normal concordance but significantly higher than abnormal concordant group. Patients with discordant abnormal AMH/normal FSH (Grp B) were not statistically different from abnormal concordance group but significantly lower than normal concordant group. There was no statistical difference in mean age or BMI among the four groups.Tabled 1GroupsABCD%Pregnant (n/N)64.2%(300/467)7.9%(9/114)32.2%(30/93)14.1%(10/71)Statistical comparisons: A vs. D p<0.0001; A vs B p<0.0001; A vs. C p<0.001; C vs. D p<0.04; B vs. D p>0.05(NS). Open table in a new tab Statistical comparisons: A vs. D p<0.0001; A vs B p<0.0001; A vs. C p<0.001; C vs. D p<0.04; B vs. D p>0.05(NS). To the best of our knowledge, this is the first study to investigate pregnancy outcomes in women with discordant Day-3 FSH and AMH levels after non-IVF COH fertility treatment. The data clearly indicate that women with discordant FSH and AMH levels will frequently have lower clinical pregnancy rates after fertility treatment.This investigation also showed that, irrespective of age, low AMH, whether combined with a normal or high FSH level, is predictive of poor fertility treatment outcome. Abnormal Day-3 FSH in the presence of a normal AMH is also a predictor of decreased pregnancy success but the prognosis is not as poor as when the AMH is abnormal. Our data support obtaining a Day-3 FSH value in patient with normal AMH to be able to more accurately counsel them about their prognosis for pregnancy success.

Differences in genetic and environmental variation in adult BMI by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts

Background: Genes and the environment contribute to variation in adult body mass index [BMI (in kg/m2)], but factors modifying these variance components are poorly understood.Objective: We analyzed genetic and environmental variation in BMI between men and women from young adulthood to old age from the 1940s to the 2000s and between cultural-geographic regions representing high (North America and Australia), moderate (Europe), and low (East Asia) prevalence of obesity.Design: We used genetic structural equation modeling to analyze BMI in twins ≥20 y of age from 40 cohorts representing 20 countries (140,379 complete twin pairs).Results: The heritability of BMI decreased from 0.77 (95% CI: 0.77, 0.78) and 0.75 (95% CI: 0.74, 0.75) in men and women 20-29 y of age to 0.57 (95% CI: 0.54, 0.60) and 0.59 (95% CI: 0.53, 0.65) in men 70-79 y of age and women 80 y of age, respectively. The relative influence of unique environmental factors correspondingly increased. Differences in the sets of genes affecting BMI in men and women increased from 20-29 to 60-69 y of age. Mean BMI and variances in BMI increased from the 1940s to the 2000s and were greatest in North America and Australia, followed by Europe and East Asia. However, heritability estimates were largely similar over measurement years and between regions. There was no evidence of environmental factors shared by co-twins affecting BMI.Conclusions: The heritability of BMI decreased and differences in the sets of genes affecting BMI in men and women increased from young adulthood to old age. The heritability of BMI was largely similar between cultural-geographic regions and measurement years, despite large differences in mean BMI and variances in BMI. Our results show a strong influence of genetic factors on BMI, especially in early adulthood, regardless of the obesity level in the population.

Socio-economic status over the life course and obesity: Systematic review and meta-analysis.

BackgroundThe purpose of this review was to summarize the published literature on the association of childhood, adulthood and life course socio-economic status (SES) with obesity between January 1990 and June 2015.MethodsThe major medical electronic databases were searched to identify studies that examined SES over the life-course in relation to obesity. A total of 219 studies were identified through the initial search, and 35 qualified for full review. Of these, 14 publications met our inclusion criteria for the meta-analysis, all from developed or upper-middle income countries.ResultsThere was a consistent association between lower life course SES and obesity among women (summary OR: 1.35, 95% CI: 1.04, 1.76), but not among men (summary OR: 0.92, 95% CI: 0.60, 1.40). Overall, mean BMI was higher among individuals with lower life course SES compared with those with higher life course SES (summary mean BMI difference: 0.65, 95% CI: 0.59, 0.71). Mean waist circumference (WC) was higher among women with lower life course SES compared with those with higher life course SES (summary mean WC: 4.67, 95% CI: 4.15, 5.20), but lower among men (summary mean WC difference: -0.10, 95% CI: -0.11, -0.08).ConclusionThe inverse relationship between life course SES and obesity among women was consistent, based mostly on studies in developed countries. Nevertheless, critical information gaps remain in relation to the impact of childhood and life course SES on obesity in developing countries.

Advanced glycation end products as a biomarker for incisional hernia

BackgroundIncisional hernia is one of the most frequent complications after abdominal surgery, with incidences up to 30%. A reliable biomarker for the prediction of this complication is lacking. Advanced glycosylation end products (AGEs), also known as non-enzymatic collagen crosslinks, are correlated with aging, smoking, hyperglycemia, hyperlipidemia and oxidative stress. In this study the accumulation of AGEs and the relation between AGEs and incisional hernia were investigated.Materials and methodsIn an exploratory case–control study, 23 patients with incisional hernia after midline incision were compared with 17 patients without clinical or radiological signs of incisional hernia after midline incision, AGEs were measured using a Skin Auto Fluorescence (SAF)-reader.ResultsTwenty-three patients with a clinically significant incisional hernia and 17 control patients were included. The study groups had significant differences in mean BMI. There was a significant difference between mean AGEs in patients with and without incisional hernia after midline incision (3.00 ± 0.15 vs. 2.56 ± 0.11, T test p = 0.03).ConclusionAGE accumulation measured in the skin indirectly with autofluorescence might be associated with incisional hernia. Prospective larger trials should confirm this finding.

BODY MASS INDEX VALUES IN THE GENTRY AND PEASANTRY IN NINETEENTH AND EARLY TWENTIETH CENTURY POLAND.

The aim of this study was to assess the impact of social and occupational status on the BMI of the gentry and peasantry in the Kingdom of Poland at the turn of 19th and early 20th centuries. Use was made of data on the height and weight of 304 men, including 200 peasants and 104 gentlemen, and 275 women, including 200 from the peasantry and 75 from the gentry. Gentlemen were characterized by a greater body height than peasants (169.40 cm and 166.96 cm, respectively), a greater body weight (67.09 kg and 60.99 kg, respectively) and a higher BMI (23.33 kg/m2 and 21.83 kg/m2, respectively). Landowners and intelligentsia had a greater BMI than peasants (23.12 kg/m2 and 24.20 kg/m2 vs 21.83 kg/m2, respectively). In the case of women, there were no statistically significant differences in mean height, weight and BMI by their social position, and in BMI by occupational status. Underweight occurred less frequently in the gentry and more frequently in the peasantry (0.97% and 2.04%, respectively). Overweight was five times more common in gentlemen than in peasants (26.21% and 5.10%, respectively). Differences in the BMI of gentlefolk and peasants resulted from differences in diet and lifestyle related to socioeconomic status.

Obesity Is Protective Factor in Hepatocellular Carcinoma

Introduction: The incidence of hepatocellular carcinoma (HCC) has been increasing significantly with the nationwide epidemic of obesity. The relationship between obesity, metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) is well established. However, as HCC is heterogeneous regarding etiology and severity of concurrent cirrhosis, the overall role of obesity in HCC warrants more investigation. This study aims to characterize prevalence of obesity in HCC patients, assess association of obesity with tumor characterstics and prognosis. Methods: We retrospectively analyzed patients with diagnosis of hepatocellular carcinoma (by ICD-9 code) at a large public hospital during 10 years (05/2006 through 05/2015). HCC was confirmed with characteristic radiologic features and/or histology from liver biopsy. Patients are categorized according to body weight index (BMI) at diagnosis of HCC as underweight (2), normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), Class I Obesity (30-34.9 kg/m2), Class II Obesity (35-39.9 kg/m2), Class III Obesity (≥ 40 kg/m2). HCC is categorized according to etiology into viral, alcoholic, viral-alcoholic, nonviral-nonalcoholic. We constructed multivariable regression model of mortality with STATA 13. Results: 270 patients were included of which 13(4.81%) were underweight, 99(36.7%) normal weight, 78(28.9%) overweight, 50 (18.5%) Class I obese, 15(5.6%) Class II obese, 15(5.6%) Class III obese. There was no difference in mean BMI by severity of cirrhosis. However there was significant difference of mean BMI by etiology (p < 0.0001): nonviral-nonalcoholic HCC showed significant higher BMI. Higher BMI is associated with extra-hepatic metastasis (p=0.026), however there's no difference in tumor number and size. BMI is independent risk factor for venous thromboembolic event (VTE) (OR 1.15, p=0.020; CI 1.02-1.29), and independent protective factor for mortality (OR=0.92 p=0.038; CI: 0.84-0.99). After exclusion of patients with prior paracentesis (70/270), protective effect of BMI persists (OR 0.86, p=0.007; CI 0.77-0.96). Conclusion: Patients with HCC of different etiologies have significantly different BMI: nonviral-nonalcoholic-HCC which mostly represent (NAFLD) is associated with higher BMI. Higher BMI is associated with extra-hepatic metastasis and risk of VTE. BMI is not risk factor for hospice or preclusion from curative treatment. However interestingly higher BMI showed protective effect against mortality.

70 Anthropometric measurements differs among preeclampsia patients with and without comorbidities

Introduction The onset of preeclampsia is related to nutritional status. Anthropometric measurements can indicate prognosis and underlie different directions. Objectives To assess the anthropometry of preeclampsia patients with and without comorbidities. Methods A transversal study, developed at the Guilherme Alvaro Hospital, located at Santos/Brazil. The anthropometric data from 72 women in the mediate postpartum was collected from January 2015 to May 2016. Inclusion criteria: mothers with PE according to the criteria of NHBPEP (2000). After recruitment and acceptance to participate in the study, the patients signed an informed consent. Data analyzed: body mass index (BMI-kg/m2), waist circumference (WC, cm) – with reference to the distance from the last rib to the iliac crest, divided by two, and comorbidities associated: diabetes mellitus (DM) and systemic arterial hypertension (SAH). The frequency was calculated by Fisher’s exact test and comparisons between groups, by the Mann-Whitney test (significance value of p Results In the table are expressed the mean values of BMI and WC after patients have been separated into groups: PE (total), PE + DM, PE + SAH, PE + DM + SAH and PE without comorbidities (pure). There was a significant difference in mean BMI when the groups were compared (PE + DM vs PE without comorbidities, p = 0.038; PE + SH vs PE without comorbidities, p = 0.027, and PE + DM + SAH vs PE without comorbidities, p = 0.012). Regarding the waist circumference values, it was only significant difference when the PE group + DM + SAH was compared with PE group without comorbidity (p = 0.007). Download : Download high-res image (116KB) Download : Download full-size image Conclusions It can be concluded that the more comorbidities are associated with PE, more changes are observed in anthropometric parameters. It means that a multidisciplinary team monitoring the anthropometric data of these patients is essential to an early observation of comorbidities development that compromises the health status of patients with PE.

Prevalence of Overweight and Obesity among Primary School Children Aged 8-13 Years in Dar es Salaam City, Tanzania.

Background. The understanding of obesity as a growing health problem in Africa and Tanzania in particular is hampered by lack of data as well as sociocultural beliefs in which overweight and obesity are revered. This study sought to determine the prevalence of overweight and obesity among primary school children aged 8–13 years in Dar es Salaam, Tanzania. Method. A cross-sectional analytical research design was used to study overweight and obesity in primary schools in Dar es Salaam, Tanzania. The target population was 150,000 children aged 8–13 years. Stratified random sampling was used to select 1781 children. Weight and height were taken and WHO standards for children were used to determine weight status. Results. Findings showed that the prevalence of overweight and obesity was 15.9% and 6.7%, respectively (N = 1781). However, 6.2% of the children were underweight. There were significant differences in mean BMI between children in private and public schools (p = 0.021), between male and female (p < 0.001), and across age groups of 8–10 and 11–13 years (p < 0.001). Conclusion. The prevalence of overweight and obesity among primary school children is significant and requires management and prevention strategies.

Positive Airway Pressure Therapy for Sleep Disordered Breathing in Congestive Heart Failure is Associated with Reduction in Pulmonary Artery Systolic Pressure

Background: Sleep disordered breathing and pulmonary hypertension are both highly prevalent in patients with congestive heart failure (CHF). Since (SDB) has been shown to increase pulmonary pressures, we hypothesized that initiation of positive airway pressure (PAP) may reduce pulmonary artery systolic pressure (PASP) in compliant patients. Methods: A total of 125 consecutive CHF patients admitted for decompensation were screened. Of these patients, 18 met inclusion criteria for the study which included a PASP ≥ 36 and polysomnogram-proven SDB. A repeat echocardiogram performed at mean 8 weeks post intervention was reviewed to compare PASP. Results: There was no statistically significant difference in mean age, BMI, AHI, baseline PASP, and ejection fraction between the PAP-compliant group and PAP non-compliant group. A statistically significant mean reduction in PASP of 13.8 ± 7.0 mmHg (range: -25, -1) was observed in CHF patients with SDB who were compliant with PAP therapy, versus a mean increase of 0.9 ± 8.7 mmHg (range: -8, 15) in heart failure patients with SDB who were noncompliant with PAP therapy. Conclusions: The findings suggest that PAP therapy is associated with improvement in pulmonary hypertension with congestive heart failure and sleep disordered breathing.

Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients.

Although laparoscopic adjustable gastric banding (LAGB) has been found to be a generally successful weight loss operation, many patients require revision for weight regain, mechanical complications or intolerance to restriction. We report our experience with laparoscopic mini-gastric bypass (LMGB) as a revisional procedure for failed primary LAGB. From June 2007 to November 2012, 48 patients, who had undergone LAGB, underwent revisional surgery to LMGB. Patient demographics, reasons for band removal, interval between removal and LMGB, operative times, complications, change in comorbidities, and weight loss were collected. The revisions to a mini-gastric bypass (MGB) were completed laparoscopically in all cases except in four, when the MGB was deferred because of gastric tube damage. Mean age was 38 years (range 20-59) and BMI was 43.4 ± 4.2 kg/m(2); 82 % of patients were females. Revision was performed after a mean of 28.6 months. The mean hospital stay was 3.25 days. Within 60 days of the MGB, mortality and morbidity were nil. We observed a significant difference in mean BMI after 6 months' follow-up (P < 0.001). Diabetes remission was observed in 88 % of patients, apnea remission in 66 %, and hypertension remission in 66 % after LMGB (p < 0.001). Moreover, four patients with GERD were cured. All LAGB patients had positive outcomes after the conversion to MGB, with a mean gain of 1.7 points in the bariatric analysis and reporting outcome system questionnaire. Our results suggested that LMGB is a safe, feasible, effective and easy-to-perform revisional procedure for failed LAGB.

Giant craniopharyngiomas in children: short- and long-term implications.

Craniopharyngiomas (CPs) are histologically benign tumors, yet they may carry an unfavorable prognosis. "Giant" tumors are associated with worse prognosis. Our aim was to evaluate the impact of tumor's size on different short- and long-term clinical factors. Between 2002 and 2012, a total of 36 consecutive CP patients less than 18years of age and with at least 12months of post-operative follow-up (FU) underwent a total of 54 operations for excision of CPs. Gross total resection (GTR) was the goal for all the first surgical resections. Twenty-seven patients were identified as eligible for inclusion in this study. Data were retrospectively collected by reviewing pertinent clinic/office notes and inpatient records as well as pre- and post-operative imaging. Long-term neurosurgical, ophthalmological, and endocrinological outcomes were obtained from records of the most recent FU office visit. Statistical analysis was performed to compare data from patients with tumors greater than or equal to 4.5cm (nine patients) to those with smaller ones (<4.5cm; 18 patients). Mean age at the time of surgery was 5.4years (median 5years, range 1.3-15.3years) for patients in the large-tumor group (LTG) and 8.9years (median 9.6years, range 2.1-17.1years) for the small-tumor group (STG). Average duration of follow-up was 82.1 and 105.4months for LTG and STG patients, respectively. There was a noticeable difference in the rate of emergent surgeries between the two groups (33.3 vs. 5.5% in the LTG and STG, respectively; p = 0.055) as well as in recurrent surgeries (RR = 3.76; CI = 95%, 1.793-7.877) and radiotherapy (RR = 2, 95% CI 0.775-5.154). Rates of residual tumor on both initial post-operative imaging and last FU imaging were significantly increased in LTG patients (44.5 vs. 27.7% and 66.6 vs. 16.6%; respectively). Progression-free survivals (PFS) assessed at 2 and 5years were 33.3 vs. 73.3% (RR = 2.2, 95% CI = 0.171-1.202) and 33.3 vs. 53.3% (RR = 1.6, 95% CI 0.221-1.765) in favor of smaller tumors. No difference in 2-, 5-, and 10-year overall survival was found. We found no significant difference in mean BMI at last follow-up between the two groups (23.83 ± 4.86 and 27.33 ± 8.09, respectively; p = 0.27), although significantly more patients in the LTG had shorter stature (mean height SDS -1.72 ± 1.88 and -0.17 ± 1.08 in LTG and STG patients, respectively; p = 0.027). Tumor's size has significant impact on the management of CP in children. It affects both short-term factors (initial symptoms, urgency of surgical resection, extent of resection, and perioperative morbidity) as well as long-term parameters (PFS, rate of adjuvant treatments/recurrent surgeries, and metabolic/endocrinal/ophthalmological and functional outcomes). We think that a proper, world-wide accepted definition of what is "large," "giant," or even "monstrous" CP should be established. This will enable carrying multi-institutional studies on a larger group of patients, allowing further determining the importance of tumor's size in the management and outcome of craniopharyngiomas in children.

Abstract 17101: Vasoprotective Properties of HDL Improve Early Ater Roux-en-y Gastric Bypass but Not After Diet Treatment: The Superior Cardiometabolic Benefits of RYGB

Introduction: Roux-en-Y gastric bypass (RYGB) reduces cardiometabolic risk through different potential mechanisms. High density lipoprotein cholesterol (HDL-C) changes might explain part of this benefit. Hypothesis: We assessed the effect of RYGB on HDL vasoprotective properties in comparison with a hypocaloric diet-induced weight loss. Methods: HDL was isolated from serum of obese patients (BMI &gt; 35 kg/m2) before and 6 months after RYGB (n=32) or diet (n=32). In endothelial cells stimulated with HDL, we quantified nitric oxide (NO) production by DAF-2 fluorescence and paraoxonase-1 antioxidant activity (PON-1). Total cholesterol, low density lipoprotein (LDL-C), HDL-C, and triglycerides (TG) as well as glucose plasma fasting levels were measured. Results: At baseline there was no significant difference in mean body weight (BW) and BMI between RYGB and diet patients (119.9 Kg; 42kg/m2 vs. 110.9 kg; 37.4 kg/m2, respectively, p=0.06). At 6 months, BW and BMI were not different (RYGB: 94kg; 33 kg/m2; diet: 99kg; 33.4 kg/m2, p=ns). In both groups, mean total cholesterol and TG were reduced; LDL-C decreased only after RYGB. Total HDL-C increased 6 months after both interventions (RYGB: 1.2±0.5 baseline vs 1.3±0.4 after 6months; diet 1.1±0.25 baseline vs 1.3±0.3 after 6months, p&lt;0.05). However, only RYGB improved the vasoprotective HDL-stimulated NO production (RYGB: 234.2±178.0 vs diet 98.8±76.4 arbitrary units, p&lt;0.0001) and HDL-associated PON-1 activity (RYGB: 40% vs diet: 9% increase compared to baseline; p&lt;0.0001). Fasting glucose levels improved in both groups and were not different at 6 months between the two interventions. Conclusions: Our study shows that although HDL concentration increased after RYGB and diet-induced BW loss, only RYGB restored endothelial protective HDL properties even though patients were still obese. This suggests that BW loss is not sufficient or critical to improve the protective properties of HDL, unless accompanied by yet unknown surgery-specific effects.

IVF success in a cohort of very young women

To evaluate the success of In Vitro Fertilization in a cohort of very young women. Retrospective chart review. We examined the incidence of positive pregnancy tests as well as clinical intrauterine pregnancy rates in a cohort of women undergoing In Vitro Fertilization at a single IVF center in Utah over a period of 5 years (2010-2014). Success rates were compared based on a woman’s age at the start of her cycle. Very young women were considered to be age less than 24 years at the start of their cycle. These women were compared to their slightly less young counterparts age 24-34 years. Success rates were defined as follows: positive pregnancy was defined as an hCG level >5mIU/mL 10 days after blastocyst transfer or 12 days after cleavage stage transfer. Clinical intrauterine gestation was defined as the presence of at least one gestational sac with a fetal pole and cardiac activity noted on ultrasound at or after 6.5 weeks gestation. Number of embryos transferred, BMI and smoking history were also compared between the age groups. Variables were compared using Chi square or t-test as appropriate. From the period of January 1, 2010 to December 31, 2014 a total of 2,157 IVF cycles were initiated at a single IVF clinic in Utah. Of these, 1,457 were completed in women age <35. Complete data was available for 1,325. Positive pregnancy for the entire cohort was 63.1% (836/1325), while the incidence of clinical intrauterine gestation was 55.3% (732/1325. The percentage of cycles leading to a clinical intrauterine gestation in women age <24 was 32.4% (35/108) versus 57.3% (697/1217) in women age 24-34 (p<.001). There was no difference between the groups in the number of embryos transferred (1.84 vs. 1.91, p=NS) or in current or past tobacco use (2.7% in both groups, p=NS). Interestingly, there was a statistically significant difference in mean BMI between the groups; women age <24 had a mean BMI of 22.6 (95% CI 21.9-23.4), whereas women age 24-34 had a mean BMI of 24.4 (95% CI 24.1-24.7, P=0.001). The clinical significance of this finding is uncertain, as both ranges fall within a healthy weight BMI category. In this cohort of women undergoing IVF, very young women had significantly lower success rates when compared to their slightly older counterparts. Further evaluation is indicated as appropriate counseling of patients is critical. Consideration should also be made for changing SART-reported age groups.

PP.01.30

Objective: Patients with STEMI have many complications and new-onset atrial fibrillation (AF) is one of them. The aim of the study was to evaluate the prognosis of patients with STEMI and new-onset AF during the 4-year follow-up in relation to fibrinolytic therapy or primary PCI. Design and method: We enrolled 290 patients with STEMI in the study. At entry, all patients were in sinus rhythm. The primary PCI (PPCI) group included patients with STEMI treated with primary PCI and fibrinolytic group included patients with STEMI treated with fibrinolytic therapy during the hospital course. The patients were followed up for four years with visits every 6 months. Results: We included 53 patients with STEMI treated with primary PCI (18.28%) and 209 patients (72.07%) treated with fibrinolytic therapy, the minority of 28 patients (9.65%) were not treated either with PPCI or either with fibrinolytic therapy. There was no significant difference in mean age, male/female ratio and BMI between patients treated with PPCI and patients treated with fibrinolytic therapy. In the PPCI group there were 4 patients (7.55%) with AF and in the fibrinolytic group there were 17 patients (8.13%) with AF, p > 0.05. During the hospital course died 1 patient (1.89%) in PPCI group without AF and 7 patients (3.35%) in fibrinolytic group, 1 of them with AF and 6 without AF, p > 0.05. During the follow up period died 3 patients (5.66%) in PPCI group, 1 patient (1.89%) with AF and 2 patients (3.77%) without AF versus 23 patients (11.00%) in fibrinolytic group, 6 of them (2.87%) with AF and 17 patients (8.13%) without AF, p > 0.05. After all, mortality was 25% in PPCI group with AF vs. 41.18% in the fibrinolitic group with AF, p > 0.05. Conclusions: There was no difference in incidence of new-onset AF in STEMI patients in relation to fibrinolytic therapy or PPCI. Mortality was lower in PPCI group (7.55%) then in fibrinolytic group (19.14%). but there was no difference in mortality in patients with new-onset AF and without AF.

Medical Prevention of Barrett's Esophagus: Effects of Statins, Aspirin, Non-aspirin NSAIDs, Calcium, and Multivitamins.

Barrett's esophagus (BE) is a complication of gastroesophageal reflux disease (GERD) that is a precursor to esophageal adenocarcinoma. There is limited information regarding whether medications can reduce the risk of developing BE. We analyzed medical records at a large veterans hospital to determine the effects of statins, aspirin, non-aspirin NSAIDs, calcium, or multivitamins on the risk of developing BE. In this retrospective case-control study, 250 patients with biopsy-confirmed Barrett's esophagus were compared with 250 controls with acid-peptic symptoms but no endoscopic BE. Medication histories were reviewed for the use of the above substances prior to endoscopic evaluation. Logistic and linear regression was used to determine predictors of the outcomes. Mean age at diagnosis was significantly older in the Barrett's population compared with controls (61.2 vs. 56.7 years, P < 0.001), with no difference in mean BMI (29.1 vs. 29.0, respectively). On multivariate analysis, independently significant factors for risk of BE were found with multivitamins (OR 0.41, P = 0.001), statins (OR 0.53, P = 0.003), age (OR 1.033/year, P = 0.001), and Hispanic ethnicity (OR 0.38, P = 0.007). Furthermore, statin use was associated with less long-segment (3 cm or longer) BE and was inversely correlated with continuous BE length. GERD patients with BE are less likely to use multivitamins and statins, as well as less likely to be of Hispanic ethnicity. Additionally, statins were inversely associated with BE length. Prospective studies of this topic are indicated.