Female Body Mass Index Research Articles

The relationship of reproductive factors with adiposity and body shape indices changes overtime: findings from a community-based study

BackgroundStudies focusing on the relationships of adiposity and body shape indices with reproductive factors have reported conflicting results. This study aimed to investigate the influence of reproductive factors on adiposity and body shape indices changes overtime.Materials and methodsIn this community-based prospective study, 1636 postmenopausal women were selected from Tehran Lipid and Glucose Study (TLGS). The unadjusted and adjusted Generalized Estimating Equation models (GEE) were applied to investigate secular longitudinal trends of adiposity and body shape indices.ResultsAccording to the adjusted GEE models, mean changes in body mass index (BMI) in women with early menarche was 1.18 kg/m2 higher than those with normal menarche age (P = 0.030). Moreover, the mean changes in BMI overtime were 0.11 kg/m2 higher in women with premature/early menopausal age than those with normal menopausal age (P = 0.012). Mean changes of waist circumference (WC) in women with late menopause were 2.27 cm higher than those with normal menopausal age (P = 0.036). We also observed higher mean changes in a body shape index (ABSI) in women with late menopause (P = 0.037), compared to those with normal menopausal age. We found a marginal effect of parity on BMI and WC as well.ConclusionsThis study demonstrated higher BMI in females with earlier menarche age. We also showed higher values of BMI overtime in women with premature/ early menopause, whereas women with late menopausal age had higher WC and ABSI values. However, more longitudinal studies investigating body composition indices by adjusting all potential confounders are still required to confirm our study findings.

Biomarkers in patients with suspected obstructive sleep apnea and obstructive lung disease: Associations among polysomnographic, demographic and spirometric parameters

PURPOSE: The purpose of this study was to characterize the associations between inflammatory and oxidative stress biomarkers, demographic, polysomnographic and spirometric parameters in patients with suspected obstructive sleep apnea (OSA) and/or obstructive airway disease. METHODS: This was a cross-sectional exploratory study of patients referred to the University of British Columbia Sleep Clinic who had a diagnostic polysomnogram for suspected OSA. All patients had samples collected for measurements of IL-10, IL-6, e-selectin, endostatin, VCAM-1, ICAM-1, PDGF, thrombospondin-2, 8-OHdG, 8-isoprostane and superoxide dismutase. Spearman correlation and multiple linear regression were used to identify predictors of biomarkers. RESULTS: A total of 63 patients were included: 65% male, mean age 53 years and body mass index (BMI) 33 kg/m2. Inflammatory biomarkers were associated with female sex (IL-6, coefficient 0.51, p = 0.032), FEV1 (IL-6, coefficient −0.02, p = 0.013) and BMI (VCAM-1, coefficient 0.009, p = 0.051). The oxidative stress marker, 8-OHdG, was associated with hypoxemia in rapid eye movement (REM) sleep (coefficient 0.006, p = 0.02). Age and BMI were both independently associated with percentage of time spent below SpO2 90%. REM sleep and patients with overlap conditions and OSA had greater degree of REM and nonrapid eye movement (NREM) sleep hypoxemia than control group. Lastly, there were no differences in oxidative or inflammatory biomarkers between control, OSA, obstructive airway disease and overlap groups though the number of patients in each group were small. CONCLUSION: Female sex, lower FEV1 and increased BMI were independent predictors of increased inflammatory biomarker levels. The oxidative stress marker 8-OHdG was associated with hypoxemia indices of REM. Larger studies are warranted to delineate biomarker profiles in patients with overlap conditions.

Ultrasonic Measurement of Left Ventricular Mass Index of Hypertensive and Normotensive Adults in a Tertiary Hospital in South-South Nigeria

Background: Hypertension is a known cause of heart disease which may manifest as an increase in left ventricular mass index. Echocardiography is a painless, safe and reliable test using sound waves for measuring Left Ventricular Mass (LVM) from which Left Ventricular Mass Index (LVMI) can be derived.
 Aims and Objectives: This study was aimed at evaluating and comparing the ultrasonic measurement of the left ventricular mass index of hypertensive patients and normotensive participants and correlating the Left Ventricular Mass Index (LVMI) to the Body Mass Index (BMI) and Gender in the study populations.
 Methodology: This was a prospective hospital-based case-control study of adult hypertensive participants and normotensive controls. Echocardiography was done with measurements of the Left Ventricular Mass (LVM) obtained. The LVMI of the study groups was correlated to their BMI and gender.
 Results: The mean BMI was statistically higher in the hypertensive group (25.98 4.40 kg/m2) (p-value=0.001).The mean Left Ventricular Mass Index (LVMI) was significantly higher in the hypertensive group (79.5961.67g/m2.7) than in normotensive group (55.36 34.77g/m2.7) (p-value 0.0001). In this study, the high BMI category (obese/overweight) was the strongest predictors of LVMI above 51g/m2.7 (p-value= 0.0001) and females were almost 1.8 times more likely to have increased LVMI than men
 Conclusion: This study revealed that the female gender, BMI and hypertension were significant predictors of increased left ventricular mass index. High BMI category (obese/overweight) was the strongest predictors of LVMI above 51g/m2.7. Periodic ultrasonic measurement of the ventricular mass index will help in early detection and reducing this common and potentially modifiable risk that leads to increased morbidity and mortality.

Obesity is a risk factor for COVID-19 infection in Saudi Arabia

Background: Obesity is a global health hazard that has recently been linked to adverse clinical outcomes of COVID-19 infection. Objective: The aim of this study is to determine the obesity risk factors among hospitalized COVID-19 patients and their influence on the clinical outcomes of the disease Methods: This is a retrospective observational cohort study of COVID-19 patients admitted to one tertiary hospital in Saudi Arabia from May to July 2020. Patients’ demographics, comorbidities and clinical manifestations were collected from the medical records. The clinical outcomes were compared between patients with different categories of body mass index (BMI). Results: Out of 260 patients who were included in the study, 41.6% were obese. Compared to those patients with normal and overweight BMI, obese patients with COVID-19 were more likely to have hypertension, ischemic heart disease, chronic lung disease and heart failure. Pneumonia (81.1%), ARDS (80.8%), mechanical ventilation (80%), acute kidney injury (74.2%) and heart failure (86.7%) were more prevalent in patients who were either overweight or obese. More than 50% of the patients admitted to the intensive care unit were either overweight or obese, representing nearly 55% of the mortalities. On an average, the BMI of females (32.2 ± 8.3 kg/m²), was significantly higher than males (28.3 ± 5.1 kg/m²), (P<0.01) and with higher BMI, the chance of having hypertension increases by threefold (P<0.01). Conclusion: Obesity is very common among hospitalized patients with COVID-19, particularly females. Obese patients were more likely to have cardiovascular risk factors and adverse clinical outcomes. Keywords: COVID-19, Obesity, BMI, Risk factors, Outcome

Effect of Combined Oral Contrraceptive Pills on Serum Total Cholesterol and Body Mass Index in Females of Reproductive Age Group

Objective: to find out the effect of combined oral pills on serum total cholesterol as well as Body mass Index (BMI) in two groups: females who were not using any method of hormonal contraceptives (controls) and the subjects using combined oral contraceptive pills in their reproductive age (15-49yrs) Material and Methods: This study was created and executed for this goal at Hazara University in Mansehra. Two groups of 200 married, fertile women who were not pregnant or nursing were created: Group 1 consisted of controls (females who did not use any hormonal contraception), and Group 2 consisted of participants taking combination oral tablets (COCs). The laboratory derived variables studied was serum total cholesterol. BMI was calculated. It was decided to use a 5% level of significance (p0.05). With the help of Pearson's correlation coefficient r, the relation was established. Results: Serum total cholesterol showed a statistically significant difference. BMI and serum TC did not statistically associate with one another. BMI and serum total cholesterol were positively connected in group 1 and negatively correlated in group 2, respectively. Conclusion: This study facilitated to find out a simple and save method for an efficient and reliable mode of hormonal contraception for practice by general population Keywords: Hormonal contraception, combined oral pills, serum total cholesterol

Prospective evaluation of digital therapeutic intervention on blood pressure control in Indian patients with uncontrolled primary hypertension

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Terrals Technologies Private Limited Background Digital therapeutics (DTx) has emerged as a new approach in recent years making use of connected devices, smartphone software and electronic communication tools to help manage chronic cardiovascular diseases such as hypertension. Considering its nascent stage, many questions still remain with respect to its applicability, effectiveness and limitations. Purpose Assess the effectiveness of digital therapeutic intervention in controlling blood pressure in Indian patients with primary hypertension Methods We conducted a prospective, 12 week, single arm, interventional study, including 125 subjects at multiple sites in India. Subjects with uncontrolled primary hypertension (≥140 mmHg systolic and/or ≥90 mmHg diastolic) in the age group of 30-65 years who were under routine antihypertensive treatment were enrolled. They were provided supplementary DTx intervention comprising of smartphone application based personalized management of diet, exercise, self monitoring and health education by nutritionists and health coaches. Efficacy endpoints such as blood pressure (BP), body mass index (BMI), lipids, etc. were measured before and after the intervention. Results A total of 122 subjects who completed the trial had mean age of 47.44 ± 9.43 years, comprising 58 (48%) male and 64 (52%) female patients and mean BMI of 27.21 ±4.7 kg/m². Post-intervention change in mean systolic BP (SBP) was -25.61 mmHg (95% CI 22.55 - 28.66, 154.98 mmHg vs 129.37 mmHg, P<.001). The post-intervention change in mean diastolic BP (DBP) was -18.62 mmHg (95% CI 16.29 - 20.96, 100.04 mmHg vs 81.42 mmHg, P<.001). Patients with stage 1 hypertension (69.6%) achieved mean systolic reduction of 20.87 ± 13.9 mmHg, (148.54 mmHg vs 127.67 mmHg, P<.001). The patients with stage 2 (27.04%) and stage 3 (3.27%) hypertension achieved a higher mean SBP reduction of 34.67 ± 15.19 mmHg (167.24 mmHg vs 132.58 mmHg, P<.001) and 51.5 ± 40.45 mmHg (190.75 mmHg vs 139.25 mmHg, P=.084), respectively. Male and female patients showed almost similar reduction in systolic BP of 25.47 ± 14.72 and 25.73 ± 19.39 mmHg, respectively. Also, the subjects with other chronic comorbidities (23.9%) achieved a mean systolic BP reduction of 29.51 ± 15.25 mmHg. A total of 79.51% (n=97) patients achieved the SBP <140 mmHg, while 59.84% (n=73) patients achieved SBP <130 mmHg. Combining both the systolic and diastolic targets together, 65.57% (n=80) patients achieved the target of <140/90 mmHg, while ESC/ESH 2018 recommended BP target of <130/80 mmHg was achieved by 31.15% (n=38) patients. Conclusion The implementation of Digital therapeutic application integrated with primary healthcare resulted in significant reduction in blood pressure in participants with uncontrolled hypertension. Greater improvement was observed in participants with higher baseline blood pressure.

Analysis of clinical features of patients with psoriasis and metabolic syndrome in Xinjiang

Objective: The clinical characteristics of a large sample of patients with psoriasis and metabolic syndrome (MS) in Xinjiang were retrospectively analyzed. Methods: The prevalence of MS, age, height, weight, body mass index (BMI), red blood cell count (RBC), white blood cell count (WBC), platelet count, aspartate aminotransferase level, alanine aminotransferase (ALT) level, and other clinical data were analyzed in 2,492 inpatients with psoriasis in our hospital. The patients were divided into two groups based on the presence of MS. Results: Among the 2,492 patients, 349 had MS and 1,269 were considered overweight/obese. There were significant differences in sex, age, disease course, age at onset, BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the two groups (P < 0.05). The RBC, WBC, erythrocyte sedimentation rate, blood urea nitrogen level, creatinine level, triglyceride level, total cholesterol level, and low-density lipoprotein cholesterol level were significantly higher in the MS group than in the psoriasis-only (PO) group (P < 0.05). The high-density lipoprotein cholesterol (HDL-C) level was significantly lower in the MS group than in the PO group (P < 0.05). The ALT and albumin levels were not significantly different between the two groups (P > 0.05). Binary logistic regression analysis showed that sex, age, BMI, SBP, DBP, and fasting plasma glucose (FPG) were independent risk factors for MS in patients with psoriasis, and HDL-C was considered a protective factor for these patients. Conclusion: The prevalence of MS in patients with psoriasis is high. Female sex, age, BMI, SBP, DBP, and FPG may be risk factors for psoriasis complicated by MS.

The influence of male and female overweight/obesity on IVF outcomes: a cohort study based on registration in Western China

BackgroundOverweight/obesity can affect fertility, increase the risk of pregnancy complications, and affect the outcome of assisted reproductive technology (ART). However, due to confounding factors, the accuracy and uniformity of published findings on IVF outcomes have been disputed. This study aimed to assess the effects of both male and female body mass index (BMI), individually and in combination, on IVF outcomes.MethodsThis retrospective cohort study included 11,191 couples undergoing IVF. Per the Chinese BMI standard, the couples were divided into four groups: normal; female overweight/obesity; male overweight/obesity; and combined male and female overweight/obesity. The IVF outcomes of the four groups were compared and analysed.ResultsRegarding the 6569 first fresh IVF-ET cycles, compared with the normal weight group, the female overweight/obesity and combined male/female overweight/obesity groups had much lower numbers of available embryos and high-quality embryos (p < 0.05); additionally, the fertilization (p < 0.001) and normal fertilization rates (p < 0.001) were significantly decreased in the female overweight/obesity group. The combined male/female overweight/obesity group had significant reductions in the available embryo (p = 0.002), high-quality embryo (p = 0.010), fertilization (p = 0.001) and normal fertilization rates (p < 0.001); however, neither male or female overweight/obesity nor their combination significantly affected the clinical pregnancy rate (CPR), live birth rate (LBR) or abortion rate (p > 0.05).ConclusionOur findings support the notion that overweight/obesity does not influence pregnancy success; however, we found that overweight/obesity affects the fertilization rate and embryo number and that there are sex differences.

Pulmonary functions and anthropometric parameters of young male and female adults participating in moderate aerobic exercise

Respiratory disorders may be one of the adverse effects of sedentary lifestyle. This study investigated respiratory functions (FEV1, FVC and PEFR) and anthropometric parameters (body weight and body mass index) of healthy young males and females participating in moderate aerobic exercise. Forty young healthy untrained non-athletes, twenty males and twenty females (age, 25 ± 5.6 years; body weight, 65 ± 4.0 kg; body height, 176.9 ± 2.5 cm) volunteered to participate in this study. The exercise regimen was of moderate intensity lasting for 20 min daily on a treadmill consistently at the speed of 13 km/h for 14 days. The weight and height of participants were measured using medical scale and wall-mounted stadiometer respectively. The forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow rate (PEFR) were assessed using digital spirometer. The results showed a significant (p < 0.05) decrease in body weight and body mass index of female participants after 14 days of exercise regimen. The FEV1, FVC and PEFR were significantly increased (p < 0.05) in both male and female subjects after exercise. The Pearson correlation showed a significant (p < 0.05) positive correlation between BMI with FEVI/FVC% in female participants. There was an increase in calories burnt from day 4 of the study in both male and female participants. It is concluded that moderate aerobic exercise improved respiratory functions (FEV1, FVC and PEFR) in both male and female subjects with greater improvement in females while reducing body weight and body mass index in females.

Factors Associated with Physical Activity Increases and Decreases Among a Sample of Appalachian Residents During the COVID-19 Pandemic: A Cross-Sectional Study.

Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic. This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia. Methods: Surveys were collected from a convenience sample of adults from eight counties in West Virginia from January to March 2021. Logistic regression analysis was used to identify sociodemographic, health, and rurality factors associated with (1) increased PA and (2) decreased PA during the pandemic, assessed retrospectively via self-report. Analysis of 1,401 survey responses revealed that better self-rated health, lower body mass index, and higher income and education were associated with a greater likelihood of more time spent doing PA during the pandemic ( p ≤ .05). Respondents with lower self-rated health, higher body mass index, lower income, and lower levels of education-plus females and those living in a more urban county-were more likely to spend less time doing PA during the pandemic ( p ≤ .05). Analyses suggest that pre-pandemic disparities in PA by health, wealth, and education were exacerbated during the pandemic. These must be addressed before physical inactivity and ill health become endemic to the Appalachian Region.

Repetitive Eating Questionnaire: Reliability and Validity of Turkish Version and Correlates of Grazing Behavior

Objectives: Grazing behaviour which is defined as repetitive and unplanned eating behaviour with small amounts of food over a period of time , has been increasingly recognised among people with obesity and eating disorders, as well as in the general population The Repetitive Eating Questionnaire (Rep(eat)-Q) is a 12 item self-report scale which was designed to measure the grazing behaviour. It demonstrating a compulsive and non-compulsive forms of grazing in previous studies. The aim of the present study was to assess the validity and reliability of the Turkish version Rep(eat)-Q in a community sample from Turkey. Method: Permission was taken from the designer of the measure . Ethical approval was granted from the local ethic Committee. The Turkish version was developed by translation and back-translation and the opinion from the local experts were obtained. The Rep(eat)-Q along with a purpose-designed socio-demographic form and other self-report measures (SCOFF eating questionnaire,, Yale Food Addiction Scale, Eating Disorder Examination Questionnaire ) were administered online to 263 of people from a convenient sample using a snowball technique. Internal consistency, convergent and divergent validity were calculated. Confirmatory factor analyses were also conducted for the factor structure. Results: The mean age of participants were 34.4 with 77.2 % female and mean body mass index (BMI) of 24.7. As in the original scale, the fit of the two-factor structure (compulsive grazing and repetitive eating) was analysed by Confirmatory factor analysis (CFA). CFA showed that the Turkish version had a two-dimensional structure as with the original form and indicated good fit (ε2 = 122, df = 48, ε2 / df = 0.77; RMSEA = 0.973; CFI = 0.962; TLI = 0.981; SRMR = 0.028). In our study, positive and moderately significant correlation between BMI and Rep(eat)-Q compulsive subscale was found; no significant correlation was found between the repetitive subscale and the BMI (r= 0.156; p=0.07). The Rep(eat)-Q scales showed excellent internal consistency both for the whole scale and the two subscales (total score Cronbach's alpha 0.947; compulsive grazing Cronbach's alpha 0.931; repetitive eating Cronbach's alpha 0.916). Conclusions: The results of this study suggest that Turkish version of Rep(eat)-Q seems to be a valid and reliable tool in assessing grazing behaviour in a non-clinical Turkish sample . It also confirmed the proposed two factor structure ( compulsive and non-compulsive) supporting the two subtypes of grazing behaviour.. Further studies are needed to assess its validity and reliability in clinical subgroups.

Prediction of functional proteins associated with the gut microbiome of an adult population in Lagos State, Nigeria

BackgroundThe human gut microbiome is implicated in health and disease. Yet, its functions in healthy adults from a divergent population like those seen in Africa are quite unclear. We set to reveal the roles of the gut microbiome of a healthy rural and urban Yoruba population of Lagos State. MethodologySociodemographic and clinical data, and fecal samples were obtained from rural (n = 10) and urban (n = 10) participants. fecal DNA extraction was done using ZR Fecal DNA MiniPrep™ D6010 and metagenomic next generation sequencing performed on Illumina Miseq platform. Functional roles prediction and antibiotics resistance genes (ARGs) were done using the Clusters of Orthologous Groups (COG) and Comprehensive Antibiotic Resistance Database (CARD) tools, respectively. The potential link between phenotypes and COG abundance were inferred using principal component analysis (PCA). ResultsWe found 12 (urban) and 11 (rural) COG classes of proteins from the gut microbes. Class E protein which denotes amino acid transport and metabolism was unique to urban respondents and was dominated by 5-enolpyruvylshikimate-3-phosphate synthase (45%) and asparagine synthase (30%), implying a high protein-based diet. Class S was found in both groups. COG families of proteins revealed the presence of exo-beta-1,3-glucanase (31%), pyruvate-decarboxylase, and thiamine pyrophosphate-requiring enzymes (22%) among the rural respondents’ indicative of carbohydrate-rich diets. In addition, uncharacterized protein linked to hypothetical functions was found in both. The COG proteins clustered with female sex, BMI (body mass index) and BP (blood pressure) for urban while for the rural populace, it clustered with height, BMI, and BP. CARD analysis showed ARGs in both groups (urban 90%; rural 10%) and all were Escherichia coli 16S rRNA (rrsB) mutation conferring resistance to streptomycin with gene variant model A523C n/a to aminoglycoside antibiotics. ConclusionThe study defined the classes of proteins from gut microbes of urban and rural respondents and highlighted the presence of uncharacterized proteins linked to hypothetical and unknown functions. Differences seen among the predicted roles appear to be driven by diet, clinical and sociodemographic factors. The higher abundance of ARGs observed in the urban population poses a serious public health concern with regards to the spread of antibiotic resistance.

Anthropometric status of nurses working at a private hospital in Pietermaritzburg, KwaZulu-Natal.

The prevalence of overweight and obesity among nurses in South Africa (SA) is increasing. This is a concern as overweight and obesity increase the risk for non-communicable diseases (NCDs). This study aimed to determine the anthropometric status of nurses working at a private hospital and to identify the factors related to a high body mass index (BMI). This study was conducted at a private hospital in Pietermaritzburg (PMB), KwaZulu-Natal (KZN). Weight, height and waist circumference (WC) measurements were taken, using standardised procedures. A self-administered questionnaire was developed to collect data on factors associated with a high BMI. Most participants were overweight or obese (86.2%; n = 112). The mean BMI of females (33.55 kg/m2) was significantly higher than that of males (28.08 kg/m2) (p = 0.043). Nurses who did not smoke had a significantly higher BMI (33.84 kg/m2) than those who smoked (29.58 kg/m2) (p = 0.030). Nurses who skipped meals had a higher mean BMI (33.75 kg/m2) than those who did not skip meals (29.63 kg/m2) (p = 0.005). Most females had a WC above 88 cm (66.2%; n = 86), indicating a substantially increased risk for metabolic complications. There was a high prevalence of overweight and obesity among the nurses according to BMI. According to WC, most female nurses had an increased risk for metabolic complications. Being female, not smoking and skipping meals were associated with a higher BMI. This study highlights the increasing prevalence of overweight and obesity among nurses.

Age-Related Sex Differences in Glucose Tolerance by 75 g Oral Glucose Tolerance Test in Japanese.

To elucidate the age-related sex difference in glucose tolerance, we conducted 75 g oral glucose tolerance tests in 1156 participants. Participants were divided into four groups, namely, young (22-29) males, young females, middle-aged (&gt;50) males, and middle-aged females. According to the Japanese Clinical Practice Guideline for Diabetes 2019, the prevalence of normal glucose tolerance (NGT) was significantly lower in middle-aged than in young participants. The prevalence of high-normal fasting plasma glucose (FPG) was higher, and NGT was lower in young males (high-normal FPG 15.2%, NGT 82.0%) than young females (high-FPG 3.9%, NGT 94.3%). Combined glucose intolerance (CGI) was higher and NGT was lower in middle-aged males (CGI 10.2%, NGT 25.2%) than in middle-aged females (CGI 3.3%, NGT 39.8%). FPG and body mass index (BMI) were the lowest and Homeostatic model assessment beta cell function (HOMA-β) was the highest in young females, followed by young males, middle-aged females, and middle-aged males. Multiple linear regression analysis revealed that BMI weakly correlated with HOMA-β and Matsuda index in all subjects except young females. The superior glucose tolerance in females was apparent in young, but attenuated in middle-aged females. The differences are due to the higher insulin secretion potential and lower BMI in young females.

Symptom: Runny Nose Six Years After Acoustic Neuroma Surgery

Symptom: Runny Nose Six Years After Acoustic Neuroma Surgery

The value of combining the simple anthropometric obesity parameters, Body Mass Index (BMI) and a Body Shape Index (ABSI), to assess the risk of non-alcoholic fatty liver disease

BackgroundBody mass index (BMI) and A Body Shape Index (ABSI) are current independent risk factors for non-alcoholic fatty liver disease (NAFLD). The aim of this study was to explore the value of combining these two most common obesity indexes in identifying NAFLD.MethodsThe subjects in this study were 14,251 individuals from the NAfld in the Gifu Area, Longitudinal Analysis (NAGALA) cohort who underwent routine health examination. We integrated BMI with WC and with ABSI to construct 6 combined obesity indicators—obesity phenotypes, the combined anthropometric risk index (ARI) for BMI and ABSI, optimal proportional combination OBMI+WC and OBMI+ABSI, and multiplicative combination BMI*WC and BMI*ABSI. Several multivariable logistic regression models were established to evaluate the relationship between BMI, WC, ABSI, and the above six combined indicators and NAFLD; receiver operating characteristic (ROC) curves were drawn to compare the ability of each obesity indicator to identify NAFLD.ResultsA total of 2,507 (17.59%) subjects were diagnosed with NAFLD. BMI, WC, ABSI, and all other combined obesity indicators were significantly and positively associated with NAFLD in the current study, with BMI*WC having the strongest correlation with NAFLD in female subjects (OR per SD increase: 3.13) and BMI*ABSI having the strongest correlation in male subjects (OR per SD increase: 2.97). ROC analysis showed that ARI and OBMI+ABSI had the best diagnostic performance in both sexes, followed by BMI*WC (area under the curve: female 0.8912; male 0.8270). After further age stratification, it was found that ARI and multiplicative indicators (BMI*WC, BMI*ABSI) and optimal proportional combination indicators (OBMI+WC, OBMI+ABSI) significantly improved the NAFLD risk identification ability of the basic anthropometric parameters in middle-aged females and young and middle-aged males.ConclusionIn the general population, BMI combined with ABSI best identified obesity-related NAFLD risk and was significantly better than BMI or WC, or ABSI. We find that ARI and the multiplicative combined indicators BMI*WC and BMI*ABSI further improved risk prediction and may be proposed for possible use in clinical practice.

Respiratory symptoms and their determinants in the general Spanish population: changes over 20 years.

Few large epidemiological studies have analysed the prevalence of respiratory symptoms and their determinants in the general adult population. We investigated the prevalence and determinants of respiratory symptoms and compared their prevalence with that of two previous studies conducted in 1999 and 2009. EPISCAN II was a multicentre, cross-sectional, population-based epidemiological study in individuals older than 40 years. A total of 9092 individuals were included. Up to 47.5% reported at least one respiratory symptom, being more frequent in women than in men (49.4% versus 45.5%, p=0.0002) and with wheezing being the most frequent (33.7%) followed by dyspnoea (26.8%). The presence of any symptom was associated with female sex, higher body mass index (BMI), lower forced expiratory volume in 1 s (FEV1 % pred), reduced physical activity, a higher Charlson index and the presence of anxiety and depression. Smoking was also significantly associated with having at least one respiratory symptom in a dose-response fashion (OR: 1.415, 1.916, 2.192 and 2.987 for 0-10, 10-20, 20-30 and >30 pack-years, respectively, all p<0.0001). The prevalence of symptoms remained quite similar over the last 20 years (wheezing 40%, 36% and 33.7% and dyspnoea 10.4%, 9.9% and 13.1% in 1999, 2009 and 2019, respectively). Approximately half of the adult Spanish population have respiratory symptoms and this prevalence has remained quite stable over the last 20 years. Smoking remains the main factor associated with respiratory symptoms, but female sex, comorbidities, high BMI and low FEV1 and low physical activity are also significantly associated with respiratory symptoms.

Correlation of uric acid with body mass index based on NHANES 2013-2018 data: A cross-sectional study.

Clinical investigation of obesity-related risk factors aids in the early detection, prevention, and management of obesity. We aimed to examine the association between obesity and serum uric acid (sUA). A cross-sectional study was conducted including 18473 subjects from the National Health and Nutrition Examination Survey (NHANES). The exposure and outcome variables were sUA and body mass index (BMI), respectively. The weighted multivariate linear regression models and smooth curve fittings were conducted to assess the association between sUA and BMI. There were significantly positive correlations between sUA and BMI in both males and females (β = 1.414, 95% CI: 1.323−1.505, P < .0001, β = 1.853, 95% CI: 1.740−1.966, P < .0001, respectively). Furthermore, individuals in the higher sUA quartiles had higher BMI than those in the lowest quartile in both males and females. Subgroup analyses were stratified by race/ethnicity, results indicated the positive association of sUA with BMI in males remained in all races including Mexican American (β = 1.203, 95% CI: 0.965−1.442, P < .0001), other Hispanic (β = 1.126, 95% CI: 0.858−1.395, P < .0001), non-Hispanic White (β = 1.493, 95% CI: 1.343−1.642, P < .0001), non-Hispanic Black (β = 1.331, 95% CI: 1.122−1.540, P < .0001), and other races (β = 1.329, 95% CI: 1.115−1.544, P < .0001). And the positive association of sUA with BMI in females also remained in all races including Mexican American (β = 1.806, 95% CI: 1.520−2.092, P < .0001), other Hispanic (β = 2.033, 95% CI: 1.687−2.379, P < .0001), non-Hispanic White (β = 1.847, 95% CI: 1.657−2.037, P < .0001), non-Hispanic Black (β = 2.141, 95% CI: 1.874−2.408, P < .0001), and other races (β = 1.348, 95% CI: 1.081−1.615, P < .0001). The current cross-sectional study with 18473 US participants found that an elevated sUA was positively correlated with a higher BMI in males, females, and all kinds of races.

Predictive Models for Knee Pain in Middle-Aged and Elderly Individuals Based on Machine Learning Methods.

Aim This study used machine learning methods to develop a prediction model for knee pain in middle-aged and elderly individuals. Methods A total of 5386 individuals above 45 years old were obtained from the National Health and Nutrition Examination Survey. Participants were randomly divided into a training set and a test set at a 7 : 3 ratio. The training set was used to create a prediction model, whereas the test set was used to validate the proposed model. We constructed multiple predictive models based on three machine learning methods: logistic regression, random forest, and Extreme Gradient Boosting. The model performance was evaluated by areas under the receiver (AUC), sensitivity, specificity, positive predictive value, and negative predictive value. Additionally, we created a simplified nomogram based on logistic regression for better clinical application. Results About 31.4% (1690) individuals were with self-reported knee pain. The logistic regression showed that female gender (odds ratio [OR] = 1.28), pain elsewhere (OR = 4.64), and body mass index (OR = 1.05) were significantly associated with increased risk of knee pain. In the test set, the logistic regression (AUC = 0.71) showed similar but slightly higher accuracy than the random forest (AUC = 0.70), while the performance of the Extreme Gradient Boosting model was less reliable (AUC = 0.59). Based on mean decrease accuracy, the most important first five predictions were pain elsewhere, waist circumference, body mass index, age, and gender. Additionally, the most important first five predictions with the highest mean decrease Gini index were pain elsewhere, body mass index, waist circumference, triglycerides, and age. The nomogram model showed good discrimination ability with an AUC of 0.75 (0.73-0.77), a sensitivity of 0.72, specificity of 0.71, a positive predictive value of 0.45, and a negative predictive value of 0.88. Conclusion This study proposed a convenient nomogram tool to evaluate the risk of knee pain for the middle-aged and elderly US population in primary care. All the input variables can be easily obtained in a clinical setting, and no additional radiologic assessments were required.

A pragmatic randomised controlled trial of tailored pulmonary rehabilitation in participants with difficult-to-control asthma and elevated body mass index

BackgroundDifficult-to-control asthma associated with elevated body mass index (BMI) is challenging with limited treatment options. The effects of pulmonary rehabilitation (PR) in this population are uncertain.MethodsThis is a randomised controlled trial of an eight-week asthma-tailored PR programme versus usual care (UC) in participants with difficult-to-control asthma and BMI ≥ 25 kg/m2. PR comprised two hours of education and supervised exercise per week, with encouragement for two individual exercise sessions. Primary outcome was difference in change in Asthma Quality of Life Questionnaire (AQLQ) in PR versus UC groups between visits. Secondary outcomes included difference in change in Asthma Control Questionnaire-6 (ACQ6), and a responder analysis comparing proportion reaching minimum clinically important difference for AQLQ and ACQ6.Results95 participants were randomised 1:1 to PR or UC. Median age was 54 years, 60% were female and median BMI was 33.8 kg/m2. Mean (SD) AQLQ was 3.9 (+/-1.2) and median (IQR) ACQ6 2.8(1.8–3.6). 77 participants attended a second visit and had results analysed. Median (IQR) change in AQLQ was not significantly different: 0.3 (− 0.2 to 0.6) in PR and − 0.1 (− 0.5 to 0.4) in UC, p = 0.139. Mean change in ACQ6 was significantly different: − 0.4 (95% CI − 0.6 to − 0.2) in PR and 0 (− 0.3 to + 0.3) in UC, p = 0.015, but below minimum clinically important difference. In ACQ6 responder analysis, minimum clinically important difference was reached by 18 PR participants (54.5%) versus 10 UC (22.7%), p = 0.009. Dropout rate was 31% between visits in PR group, and time to completion was significantly prolonged in PR group at 94 (70–107) days versus 63 (56–73) in UC, p < 0.001.ConclusionsPR improved asthma control and reduced perceived breathlessness in participants with difficult-to-control asthma and elevated BMI. However, this format appears to be suboptimal for this population with high drop-out rates and prolonged time to completion.Trial registration Clinicaltrials.gov. ID NCT03630432. Retrospectively registered, submitted May 26th 2017, posted August 14th 2018.