Excess Body Mass Research Articles

Analysis of Outcomes of the Nutritional Status in Patients Qualified for Aortic Valve Replacement in Comparison to Healthy Elderly.

Severe aortic stenosis (AS) is associated with the reduction of muscle mass and may be associated with deterioration of nutritional status. Furthermore, malnourished cardiac patients are characterized by a higher risk of postoperative complications and mortality. The aim of this study was the evaluation and comparison of nutritional status, appetite and body composition in older people with severe aortic stenosis before aortic valve replacement and healthy elderly volunteers. One hundred and one patients, aged >65 years old with severe AS were included in the study. Nutritional status was assessed. Body composition was estimated using bioelectrical impedance analysis. Concentrations of albumin, prealbumin, triglycerides, total cholesterol and C-reactive protein were measured, and a complete blood count was done. About 40% of AS patients were at risk of malnutrition. They had decreased hand grip strength and they lost more body mass than the control group. Malnourished AS patients were older, had lower body mass indexes (BMIs) and lower aortic valve areas in comparison to well-nourished patients. Older AS patients, like their peers, show excessive body mass and, at the same time, the features of malnutrition. They have additional factors such as unintentional weight lost and decreased muscle strength which may be associated with worse outcomes.

Body dimensions and weight to height indices in rescuers from the State Fire Service of Poland

Few studies have been published in Poland concerning body dimensions of firefighters from the State Fire Service although this knowledge is needed for e.g. development of personal protective equipment. The aim of the study was to evaluate body dimensions and weight-to-height ratio in firefighters from the State Fire Service. Using the anthropological procedures, body mass (BM) and body height (BH) were examined in 178 men at the chronological age (CA) of 19.5 to 53 years who were rescuers from the national rescue and fire brigades of the State Fire Service. The study participants were divided into three categories of CA: up to 25 years, between 24 and 44 years, and over 44 years. The results were compared to population standards. It was found that BH of the youngest rescuers was significantly higher (0.05) than in other study participants. Based on the standardized values of BM and BMI, population of firefighters aged over 25 years was found to be characterized by overweight and, in certain cases, even by obesity. The excess level of body mass index (BMI ≥ 25 kgm2) was found in nearly 60% of study participants, with half of the group classified as overweight (n=31, BMI ranging from 25 to 29.9 kg/m2), and 10% classified as obese. Due to the worrying high percentage of cases of excess body mass in firefighters from the State Fire Service, it was found that it is recommended to evaluate the relationships between body height and mass on regular basis during periodical obligatory tests of physical fitness of rescuers from the State Fire Service and to increase the frequency and duration of training sessions.

Impact of age on postoperative outcomes in bariatric surgery

Background: Age is often related to the increase of perioperative complications and reoperation rates. The authors aimed to determine the influence of age on outcomes of most commonly performed bariatric procedures.Methods: The retrospective study included patients qualified for primary Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) in two academic hospitals. Patients were divided into two groups: ≥50 (21.2–26.9%) and <50 (57.6–73.1%) years old. Endpoints assessed the influence of patients’ age on the perioperative and the one-year postoperative period.Results: Operative time was longer in the ≥50-year-old group, but only for LRYGB. There were no differences in the intraoperative adverse events, postoperative morbidity, reoperation and readmission rates between the groups. The risk of port site hernia was increased (OR: 4.23, CI: 1.49–12.06) in the ≥50-year-old group. The mean % of total weight loss 12 months after the bariatric procedure was comparable, but % of excess weight loss and % of excess body mass index loss were lower in the ≥50-year-old group (p = .033 and .032).Conclusions: Bariatric surgery is safe and feasible in patients over 50 years old. The weight loss effect can be worse among patients over 50 years old; nevertheless, the treatment should be considered as effective.

Influência do Índice de Massa Corporal e da Dieta na Fisiopatologia da Acne Vulgaris

Acne vulgar é uma patologia multifatorial que afeta principalmente adolescentes e jovens adultos e que se pode manifestar como lesões inflamatórias ou não inflamatórias. Esta doença acarreta morbilidade significativa, tanto física como psicológica. Está cientificamente comprovada a importância de diversos fatores, tanto genéticos como ambientais, na sua patogénese, tendo sido descritas nomeadamente associações com a dieta ocidental, índice de massa corporal excessivo e a resistência à insulina. Neste artigo é efetuada revisão da atual literatura relativa à acne vulgar, com enfoque na fisiopatologia e influência destes fatores na sua desregulação. O melhor conhecimento da fisiopatologia da acne e a avaliação crítica do papel da dieta, bem como da obesidade e da desregulação do sistema endócrino, podem contribuir para uma abordagem mais científica dos fatores exógenos que contribuem no início e agravamento desta interessante e frequente patologia.

Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity

Sleeve gastrectomy is increasingly used in the treatment of morbid obesity, but its long-term outcome vs the standard Roux-en-Y gastric bypass procedure is unknown. To determine whether there are differences between sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss, changes in comorbidities, increase in quality of life, and adverse events. The Swiss Multicenter Bypass or Sleeve Study (SM-BOSS), a 2-group randomized trial, was conducted from January 2007 until November 2011 (last follow-up in March 2017). Of 3971 morbidly obese patients evaluated for bariatric surgery at 4 Swiss bariatric centers, 217 patients were enrolled and randomly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass with a 5-year follow-up period. Patients were randomly assigned to undergo laparoscopic sleeve gastrectomy (n = 107) or laparoscopic Roux-en-Y gastric bypass (n = 110). The primary end point was weight loss, expressed as percentage excess body mass index (BMI) loss. Exploratory end points were changes in comorbidities and adverse events. Among the 217 patients (mean age, 45.5 years; 72% women; mean BMI, 43.9) 205 (94.5%) completed the trial. Excess BMI loss was not significantly different at 5 years: for sleeve gastrectomy, 61.1%, vs Roux-en-Y gastric bypass, 68.3% (absolute difference, -7.18%; 95% CI, -14.30% to -0.06%; P = .22 after adjustment for multiple comparisons). Gastric reflux remission was observed more frequently after Roux-en-Y gastric bypass (60.4%) than after sleeve gastrectomy (25.0%). Gastric reflux worsened (more symptoms or increase in therapy) more often after sleeve gastrectomy (31.8%) than after Roux-en-Y gastric bypass (6.3%). The number of patients with reoperations or interventions was 16/101 (15.8%) after sleeve gastrectomy and 23/104 (22.1%) after Roux-en-Y gastric bypass. Among patients with morbid obesity, there was no significant difference in excess BMI loss between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass at 5 years of follow-up after surgery. clinicaltrials.gov Identifier: NCT00356213.

Factors Affecting Health-Related Quality of Life in Liver Transplant Patients.

This study seeks to evaluate the metabolic parameters such as body mass index (BMI), percentage of total body fat percentage (%BF), blood glucose, homeostatic index for quantification of insulin resistance and beta-cell function (HOMA-IR), sleep efficiency, and physical activity in liver transplant patients. The study group consisted of 24 male and 18 female patients, which enabled the inter-gender comparison. We found that a majority of patients had exceeded the norms for BMI and %BF. The excessive weight was distinctly accentuated in male patients. Only 40.5% of patients have a correct BMI and 21.4% of patients have a correct %BF. The indices of glucose metabolism were increased, pointing to enhanced insulin resistance. Resting energy expenditure and metabolic equivalent of task were characteristic of sedentary lifestyle, and they were lower in female patients. Almost 65% of patients had sleep efficiency below the desired 85% cut-off level. Further, sleep efficiency was decreasing with increasing BMI, %BF, and blood glucose level. In conclusion, liver transplant patients are characterized by excessive body mass and less physical activity and have a shortened sleep duration, all of which may lead to a worse glucose metabolism and increased disease risk and may also have an impact on quality of life.

Ранние маркеры сердечно-сосудистого риска у женщин с наследственной отягощенностью по сердечно-сосудистым заболеваниям

to identify early markers of development of cardiovascular diseases (CVD) in women. Female firstdegree relatives from 39 families formed 2 groups: families (n=19) containing mothers with arterial hypertension (AH) (group 1) and healthy daughters (group 1a); families (n=20) containing practically heathy mothers (group 2) and healthy daughters (group 2a). We assessed data of anamnesis, including registration of cardiovascular risk factors, and family history of CVD. Examination included registration of anthropometric parameters, automatic and manual measurement of intima-media thickness (IMT) and resistance indexes of brachiocephalic arteries (BCA). We also determined cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), and measured magnitude of β-adrenoreception of membranes (β-ARM) of erythrocytes in micro-quantities of venous blood. Mothers in both groups of families had excessive body mass or obesity. Mothers of group 1 had more pronounced signs of abdominal obesity (AO). They also had abnormalities of IMT and sings of subclinical atherosclerosis of BCA. CAVI in this group was significantly higher than in group 2. In group 1a median BMI (25.5 kg/m2) and waist/hip ratio were significantly higher than in group 2a. Daughters of group 1a contrary to group 2a had abnormalities of vascular wall: increased automatically measured IMT of carotid arteries and elevated CAVI. Arterial pressure and heart rate (HR) in group 1a were within limits of physiological norm but significantly higher than in group 2a. All included women had elevated β-ARM values but in group 1a this parameter was significantly higher than in group 2a and moderately correlated with HR. Risk factors of CVD development in women are AH, AO, high activity of the sympathoadrenal system. These factors provoke changes of vascular wall (elevation of its stiffness and early subclinical atherosclerosis). In daughters of mothers with AH important prognostic components of CVD risk in addition to family history of CVD are AO, systolic blood pressure (BP) >120 mm Hg, diastolic BP >78 mm Hg, HR approaching upper limit of physiological norm, and high CAVI (indicator of vascular wall stiffness).

Biological and Social Determinants of Maximum Oxygen Uptake in Adult Men.

The maximum rate of O2 uptake (V̇O2max) is one of the most important positive indicators of health. While the V̇O2max decreases with age, reducing the capacity for physical effort, it can be considerably upregulated through optimal environmental interventions, including systematic physical activity. This study seeks to determine variations in the cardiorespiratory function, estimated from the level of V̇O2max, in 798 employed men aged 20-59, according to biological (age, physical activity, body mass index (BMI), and limb muscle strength and agility) and social (place of residence, education, occupation, economic status, and smoking) predictors. We found that the variables abovementioned, with the exception of smoking and hand strength, were significant predictors of V̇O2max in univariate logistic regression, with age (OR=0.52; 95%CI 0.47-0.57) and BMI (OR=0.91; 95%CI 0.90-0.93) having the greatest effect on V̇O2max. The additional predictors, established in multivariate analysis, were the place of residence, education, and hand and arm strength. The multivariate model was fairly well-fitted (Nagelkerke r 2=0.54) and had a satisfactory prognostic value, with over 80% of cases classified correctly. Social variance in the V̇O2max makes it desirable to develop and implement the intervention programs with physical activity dedicated for men, especially men who are over the age of 50years and have an excessive body mass, as this could reduce the risk of disorders and help improve the quality of life and workplace effectiveness of this group.

NARRATIVE REVIEW. How should we assess body fatness? 2. Quantitative field methods available to the epidemiologist and the practitioner.

Objective. The objectives of this narrative review are to consider the simple qualitative field methods that have been used to describe inter-individual differences in body form over the centuries, to explore attempts to use such measures in predicting personality characteristics, susceptibility to disease, and athletic aptitudes, to understand the significance of regional differences in the distribution of body fat, and to decide the current relevance of subjective descriptions of body build. Methods. Information obtained from Ovid/Medline and Google Scholar through to January 2018 was supplemented by a search of the author's personal files. Results. Although a variety of nomenclature has been proposed, most observers from antiquity to the present day have described 3 main body types, now generally termed ectomorphic (a lean and elongated body form), mesomorphic (a thick-set, muscular individual) and endomorphic (the person with a rounded figure, and a substantial accumulation of body fat). Although extreme examples of each of these body types are readily recognized, most people have an intermediate body form, incorporating feature of 2 if not 3 of the potential body types, and this seriously limits the usefulness of such a classification. Correlations between body type and personality have now been largely discredited, and correlations with disease susceptibility reflect in part the effect of disease on body build rather than the converse. Top athletes in a given sport discipline tend to have a common somatotype, but a substantial range of body builds are still compatible with outstanding performance. An android distribution of body fat continues to be of prognostic value; this body type is more common in men than in women, and is associated with a substantial increase in the risk of cardiovascular disease. Conclusions. Earlier interest in the subjective assessment of body build has waned as it has become recognized that extreme body types are uncommon, and that numerical classifications of somatotype make little contribution to the definition of an individual's personality, susceptibility to disease or athletic aptitude. Nevertheless, simple subjective ratings of body fatness ad muscularity can help to distinguish the cause of an excessive body mass in relation to height, and simple determinations of the distribution of body fat provide helpful prognostic information.

Health Behaviour among Parents of Overweight and Obese Children

&lt;b&gt;Introduction:&lt;/b&gt; The period of puberty is especially important in the shaping of behaviours with respect to adequate diet and physical activity. Habits established during this period are repeated later in life. &lt;br/&gt;&lt;b&gt;Aim of the study:&lt;/b&gt; The purpose of the thesis was to determine the extent of influence of parents’ health behaviour on the physical activity of children with an excess body mass problem. &lt;br/&gt;&lt;b&gt;Material and methods:&lt;/b&gt; The research was conducted in the period from November 2015 to March 2016 at the University Children’s Hospital of Cracow among 88 parents whose children suffer from overweight and obesity. For this purpose, the research used the diagnostic survey method and the measurement method (body mass and height). The research tools included the Health Behaviour Inventory (HBI) by Juczyński, an authorial survey questionnaire, an anthropometer and the Tanita BF350 scales. Basic descriptive statistics were used to describe the results, the differences between variables were verified using the χ2 test of independence. The materiality level was assumed to be p&lt;0.05. &lt;br/&gt;&lt;b&gt;Results:&lt;/b&gt; As many as 32 parents of children with excess body mass (36.36%) were overweight as well, while 28 (31.82%) kept their body mass within the norm. A large proportion of the respondents, 33 parents (37.50%), stated that it was not customary to do sports in their family, and less then a half of the children (n=36; 40.91%) regularly participated in physical education classes. Children of the parents whose BMI was normal participated in physical education classes significantly more often than children of the other parents (p&lt;0.001). The average number of points obtained by the respondents in the HBI questionnaire equals 70.81 (SD=22.41 pp). Parents rated their health behaviour the highest on the “positive psychical attitude” subscale (avg. 18.01; SD=5.77 pp), and the lowest on the “health practices” subscale, which includes e.g. physical activity (avg. 17.24; SD=6.21 pp). &lt;br/&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Health promoting activities shaping health behaviours should be performed by schools, with an active participation of parents. It is necessary to carry out educational programmes in the area of adequate nutrition and physical activity, which would expand knowledge of the problem.

PECULIAR FEATURES OF STRUCTURAL AND FUNCTIONAL INDICES OF CARDIOVASCULAR SYSTEM IN YOUNG MEN WITH ARTERIAL HYPERTENSION ASSOCIATED WITH METABOLIC SYNDROME

Aim. To carry out dynamic assessment of the structural and functional indices of cardiovascular system in young men with arterial hypertension (AH) associated with excess body mass (Ebm) against the background of therapy. Materials and methods. Examination of 86 young men aged 18-27 years, including the group of comparison with practically healthy persons ( n = 24) and the group of observation ( n = 62) was performed. The group of observation joined patients with AH without EBM and AH+EBM. The study was conducted initially and 6 months later. Patients with AH+EBM ( n = 25) were divided into 2 subgroups: group 1 (12 persons) without therapy and group 2 (13 persons) against the background of antihypertensive therapy. Results. Six months later, in group 1 there was observed a growth of “office” systolic arterial pressure (SAP) by 3,8 % (145,0 ± 2,88 and 150,54 ± 2,99 Hg mm), p = 0,001, but in the group with antihypertensive therapy, SAP decreased by 12,7 % (145,75 ± 2,80 and 129,33 ± 1,5 Hg mm), p = 0,01 and DAP - by 12,1 % (86,5 ± 1,95 and 77,16 ± 2,41 Hg mm), p = 0,02. Pulse wave propagation velocity (PWPV) along the vessels of muscular and elastic types among patients without therapy was found to grow in dynamics by 12,2 and 16,2 %, respectively. Against the background of therapy, there was a tendency to a reliable reduction in PWPV indices. Conclusions. Antihypertensive therapy in patients with AH+EBM, while decreasing AP, leads to reduction of LVMM, LVMMI, PWPV and IMCV. The early diagnosed lesion of target organs among young men with AH+EBM and timely antihypertensive therapy can improve structural and functional characteristics of cardiovascular complications.

Global burden of obesity

Global burden of obesity Introduction The burden of nutritional disorders is increasing despite advances in scientific research and health promotion. Nutritional disorders include excess body mass conditions especially obesity (body mass index [BMI] &gt; 30 kg/m2) and being overweight (BMI &gt; 25 and &lt; 30 kg/m2). These conditions are now considered as precursors to several diseases including diabetes, heart disease, musculoskeletal disorders as well as psychiatric illnesses. We studied the global burden of obesity to assess temporal trends and regional variations of this highly prevalent nutritional disorder. Methods We used the Global Burden of Disease database from the Institute of Health Metrics (www.healthdata.org) at the University of Washington, Seattle. This database collates data from a very large number of studies and census figures to generate regional estimates for health statistics. We analyzed the data from 1990 to 2015 using global averages for years lived with disability (YLD). The primary risk factor analyzed was ‘High body-mass index’. The effect of high BMI on all causes of health reduction (including diabetes) were studied for temporal (1990 to 2015) and regional/national patterns. Results The global of burden of diseases due to high BMI is rising continuously, from 213 YLDs per 100,000 in 1990 to 388 YLDs in 2015. A high burden of YLDs was seen in developed regions including North America and Australasia. Northern Europe and Middle East were also disproportionately affected. Areas with low rates of YLDs from obesity included sub-Saharan Africa, south Asia and south east Asia. Marked increases in the rates per 100,000 populations were seen over 1990 to 2015 in countries such as Fiji, USA, Egypt and Ukraine. The burden of suffering is higher among women than men. Conclusion The global burden of suffering due to illnesses caused by high body mass index is continuing to rise. Existing public health measures appear to be ineffective and more efficacious nutritional education and health promotion strategies are urgently needed. Conflicts of interest disclosure: no external or commercial funding source, and no holding of significant equity in a company relevant to the study.

Microvascular insulin resistance in skeletal muscle and brain occurs early in the development of juvenile obesity in pigs.

Impaired microvascular insulin signaling may develop before overt indices of microvascular endothelial dysfunction and represent an early pathological feature of adolescent obesity. Using a translational porcine model of juvenile obesity, we tested the hypotheses that in the early stages of obesity development, impaired insulin signaling manifests in skeletal muscle (triceps), brain (prefrontal cortex), and corresponding vasculatures, and that depressed insulin-induced vasodilation is reversible with acute inhibition of protein kinase Cβ (PKCβ). Juvenile Ossabaw miniature swine (3.5 mo of age) were divided into two groups: lean control ( n = 6) and obese ( n = 6). Obesity was induced by feeding the animals a high-fat/high-fructose corn syrup/high-cholesterol diet for 10 wk. Juvenile obesity was characterized by excess body mass, hyperglycemia, physical inactivity (accelerometer), and marked lipid accumulation in the skeletal muscle, with no evidence of overt atherosclerotic lesions in athero-prone regions, such as the abdominal aorta. Endothelium-dependent (bradykinin) and -independent (sodium nitroprusside) vasomotor responses in the brachial and carotid arteries (wire myography), as well as in the skeletal muscle resistance and 2A pial arterioles (pressure myography) were unaltered, but insulin-induced microvascular vasodilation was impaired in the obese group. Blunted insulin-stimulated vasodilation, which was reversed with acute PKCβ inhibition (LY333-531), occurred alongside decreased tissue perfusion, as well as reduced insulin-stimulated Akt signaling in the prefrontal cortex, but not the triceps. In the early stages of juvenile obesity development, the microvasculature and prefrontal cortex exhibit impaired insulin signaling. Such adaptations may underscore vascular and neurological derangements associated with juvenile obesity.

Metabolic Reponses to a physical exercise session in women with excess body mass: randomized clinical trial

BackgroundThere are various factors that influence the effect of physical exercise on the lipid profile, among them the body mass index and calorie expenditure of the exercise are some of the main factors. To test the hypothesis that a physical exercise session based on caloric expenditure may acutely modify the glycemia and lipid values of women with excess body mass.MethodsThe study included 66 women, randomly divided into two groups, control and experimental, with BMI of 29 ± 4.4 kg/m2 vs 29 ± 4.3 kg/m2 (p = 0.45) sedentary and aged 23 ± 3.8 vs 24 ± 3.5 years, respectively (p = 0.25). After 12 h fasting, the volunteers underwent the first blood collection. The experimental group was submitted to a physical exercise session corresponding to energy expenditure of 250Kcal, of light intensity based the Borg Rating of Perceived Exertion (RPE), 12 h after the first blood collection. The control and experimental group volunteers underwent a second blood collection 24 h after the first. Glycemia, insulin status and lipid profile were measured and Homa IR and Homa-beta were calculated. The t-test for independent and dependent samples was used, and a level of significance of 5% was adopted.ResultsPhysical exercise changed the glycemic response in both the intragroup analysis (before = 96 ± 6.6 mg/dL vs after = 92 ± 6.6 mg/dL), (p = 0.01), and in the intergroup analysis (control = Δ 0.9 ± 6.1 vs experimental = Δ -4.1 ± 6.3) (p = 0.02). No changes were shown for the Homa IR, Homa Beta and Insulin indexes. When the lipid profiles were evaluated, differences in HDL were shown in the intragroup analysis (before = 89 ± 10.5 mg/dL vs. after = 91 ± 10.3 mg/dL) (p = 0.04). For the other parameters (LDL, TG, Total Cholesterol, TG/HDL), no changes were shown.ConclusionIn women with excess body weight, a low intensity exercise session diminished the glycemia, but did not change the lipid response.Trial registrationNCT03170973. Retrospectively registered.

ВПЛИВ ОЖИРІННЯ НА ПЕРЕБІГ ТА ПРОГНОЗ ГОСТРОГО ПАНКРЕАТИТУ

Вступ. Ожиріння є фактором ризику виникнення гострого панкреатиту (ГП). Сьогодні аналіз несприятливого впливу ожиріння на тяжкість перебігу та прогноз ГП не застосовують на практиці для прогнозування та оптимізації лікувальної тактики.&#x0D; Мета дослідження: проаналізувати вплив індивідуальних параметрів ожиріння на тяжкість перебігу ГП.&#x0D; Матеріали і методи. Проведений проспективний аналіз результатів лікування 30 хворих з приводу ГП. Досліджене співвідношення індивідуальних параметрів ожиріння за даними комп’ютерної томографії (КТ) та тяжкості перебігу ГП, його локальних та системних ускладнень.&#x0D; Результати. Найбільш значуща кореляція встановлена між площею вісцерального жиру і електронним індексом маси тіла (еІМТ) та тяжкістю синдрому поліорганної недостатності (СПОН), тривалістю SIRS (systemic inflammatory response syndrome), тяжкістю локальних ускладнень за шкалою Balthazar. На основі результатів кореляційного аналізу відзначено, що найбільше на тривалість лікування хворих у стаціонарі впливали тривалість SIRS, тяжкість СПОН, КТ індекс тяжкості за Balthazar. На основі мультиваріантного аналізу, єдиним параметром, що впливає на тривалість лікування хворого у стаціонарі, є тривалість SIRS, решта параметрів, в тому числі індивідуальні параметри ожиріння, на цей показник не впливали. У хворих при ожирінні достовірно частіше виявляли інфікування скупчень рідини в поєднанні з інфікуванням вогнищ некрозу порівняно з такими у хворих за збільшеної та нормальної маси тіла, проте, у них частіше спостерігали формування псевдокіст підшлункової залози (р &lt; 0,05). При дослідженні інфікування скупчень рідини і вогнищ некрозу достовірно частіше інфікування спостерігали у хворих при ожирінні. У пацієнтів при ожирінні спостерігали більш раннє інфікування скупчень рідини і вогнищ некрозу (p = 0,006).&#x0D; Висновки. Ожиріння є фактором, що впливає на тяжкість перебігу ГП, частоту локальних і системних ускладнень.&#x0D; Ключові слова: гострий панкреатит; ожиріння; ускладнення; синдром системної запальної відповіді; поліорганна недостатність.

Autonomic cardiac function, body composition and cardiorespiratory fitness changes in adolescents after a multidisciplinary obesity treatment program: a feasibility study

This feasibility study aimed to analyze the effects of a multidisciplinary (e.g., psychological, nutritional and water-based exercise interventions) obesity treatment program on resting heart rate variability (rHRV) indices according to the degree of excess body mass (overweight vs obesity) in adolescents. Additionally, we tested the association between changes in rHRV indices with changes in body composition and cardiorespiratory fitness. Twenty-five adolescents completed the study, 11 from the overweight group (OWG) and 14 from the obese group (OBG) classified according to body mass index. Anthropometric measures, autonomic cardiac function (measured by rate-to-rate interval analyses), lean mass and body fat, and cardiorespiratory fitness were assessed prior to and after the 16-week intervention period. Both groups increased their parasympathetic indices (e.g., standard deviation 1) [OWG: Δ = 8.5 (1.7–15.3) ms; magnitude of change: “likely”; OBG: Δ = 11.4 (4.3–18.4) ms; “very likely”] and cardiorespiratory fitness [OWG: Δ = 2.0 (1.1–2.8) mL/kg/min; “likely”; OBG: Δ = 2.4 (1.5–3.3) mL/kg/min; “Almost certain”] with a slightly greater magnitude of change for the OBG. The OWG showed greater changes in body composition [e.g., body fat: Δ = −3.2 (–4.6 to −1.8) kg “Very likely”] when compared to the OBG [Δ = −2.8 (−4.4 to −1.3) kg “Possible”]. Inverse and large correlations were noted for changes in body fat markers (%) and changes in parasympathetic indices of rHRV (%) (i.e., rMSSD and SD1). These results provide evidence that a multidisciplinary program improves parasympathetic indices, body composition, and cardiorespiratory fitness independent of the degree of excess body mass.

The Role of Age and Excess Body Mass Index in Progression to Type 1 Diabetes in At-Risk Adults.

Given the global rise in both type 1 diabetes incidence and obesity, the role of body mass index (BMI) on type 1 diabetes pathophysiology has gained great interest. Sustained excess BMI in pediatric participants of the TrialNet Pathway to Prevention (PTP) cohort increased risk for progression to type 1 diabetes, but the effects of age and obesity in adults remain largely unknown. To determine the effect of age and sustained obesity on the risk for type 1 diabetes in adult participants in the TrialNet PTP cohort (i.e., nondiabetic autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI >25 kg/m2 was calculated to generate a cumulative excess BMI (ceBMI) for each participant, with ceBMI values ≥0 kg/m2 and ≥5 kg/m2 representing sustained overweight or obese status, respectively. Recursive partitioning analysis yielded sex- and age-specific thresholds for ceBMI that confer the greatest risk for type 1 diabetes progression. In this cohort of 665 adults (age 20 to 50 years; median follow-up, 3.9 years), 49 participants developed type 1 diabetes. Age was an independent protective factor for type 1 diabetes progression (hazard ratio, 0.95; P = 0.008), with a threshold of >35 years that reduced risk for type 1 diabetes. In men age >35 years and women age <35 years, sustained obesity (ceBMI ≥5 kg/m2) increased the risk for type 1 diabetes. Age is an important factor for type 1 diabetes progression in adults and influences the impact of elevated BMI, indicating an interplay of excess weight, age, and sex in adult type 1 diabetes pathophysiology.

The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins

Obesity is a growing global health concern, with a rapid increase being observed in morbid obesity. Obesity is associated with an increased cardiovascular risk and earlier onset of cardiovascular morbidity. The growing obesity epidemic is a major source of unsustainable health costs and morbidity and mortality because of hypertension, type 2 diabetes mellitus, dyslipidemia, certain cancers and major cardiovascular diseases. Similar to obesity, hypertension is a key unfavorable health metric that has disastrous health implications: currently, hypertension is the leading contributor to global disease burden, and the direct and indirect costs of treating hypertension are exponentially higher. Poor lifestyle characteristics and health metrics often cluster together to create complex and difficult-to-treat phenotypes: excess body mass is such an example, facilitating a cascade of pathophysiological sequelae that create such as a direct obesity-hypertension link, which consequently increases cardiovascular risk. Although some significant issues regarding assessment/management of obesity remain to be addressed and the underlying mechanisms governing these disparate effects of obesity on cardiovascular disease are complex and not completely understood, a variety of factors could have a critical role. Consequently, a comprehensive and exhaustive investigation of this relationship should analyze the pathogenetic factors and pathophysiological mechanisms linking obesity to hypertension as they provide the basis for a rational therapeutic strategy in the aim to fully describe and understand the obesity-hypertension link and discuss strategies to address the potential negative consequences from the perspective of both primordial prevention and treatment for those already impacted by this condition.

The nutritional status and actual food of patients with metabolic syndrome and intestinal dysbiosis

The article presents the study of the nutritional status and actual nutrition in patients with metabolic syndrome and intestinal dysbiosis under outpatient observation for subsequent correction of nutrition. The nutritional status and actual nutrition in the conditions of outpatient care was studied in 117 patients aged 18-60 years (60 men and 57 women) living in the service of one of the clinics of St Petersburg. Patients Body composition was studied by impedance monitoring with diagnostic complex “Diamond”. Power studied questionnaire-ballot method, and using the computer program “Analysis of Human Nutrition states” (version 1.2.4 Institute of Nutrition, 2003-2006). Characteristic body components imbalance in these patients on a background of excess weight and body mass index was an increase in fat mass and total fluid. Structure of food packages, and nutrientny caloric composition of the diet of patients with metabolic syndrome and intestinal dysbiosis unbalanced and can not serve the purpose of preventing and treating this disease.

Impact of physical activity on obesity and lipid profile of adults with intellectual disability.

This study assessed overweight, obesity and lipid profiles in adults with intellectual disability and compared these metrics with their physical activity. Basic somatic parameters, lipid profile and weekly physical activity were examined in 27 adults with moderate intellectual disability. Chi-square independence tests and Pearson's linear correlation coefficients were used. The participants had excess body mass, excess body fat and abdominal obesity. Very high positive correlations were shown between body mass index and both waist circumference and %fat. The lipid profiles were more favourable in the general population. Healthy levels of physical activity were observed in 8% of women and 26% of men. A high negative correlation was found between physical activity and body mass index. The study group was characterized by excess body mass and insufficient levels of physical activity. Body mass index and waist circumference are sufficient indicators for identifying obesity in adults with intellectual disability.