Function Of BMI Research Articles

Evaluation of the scapulohumeral distraction technique for anterior shoulder dislocation: a randomized controlled trial

IntroductionShoulder dislocation is a common injury presenting in emergency Department. Numerous methods have been described in the literature for glenohumeral reduction. These methods can be divided into two groups: traction maneuvers and the combination of traction with scapula manipulation techniques. In this article, we introduced a new maneuver for shoulder reduction, namely, the combination of traction with handling the scapula (scapulohumeral distraction, SHD) and compare it to the Hippocratic Method (HT). Materials and methodsThe study took place from November 2021 to September 2023. A total of 96 patients with acute anterior shoulder dislocation were enrolled in the study. Eighty-seven patients, who met all inclusion criteria, were randomly assigned to one of the two groups (SHD and HM). We evaluated each method for success rate, time to relocation, complications over a follow-up period of one month, patients’ satisfaction and pain level during the procedure. ResultsBoth methods had comparable success rates (SHD 95.3% vs. HM 93.2%, p=.833) while no complications where observed. However, SHD method required significantly less procedure time (p=.001). Moreover, patients in SHD group reported significantly less pain (p=.012) and greater satisfaction (p=.003) levels. Furthermore, when we assessed relocation time, pain and patient satisfaction as a function of recurrence, there were no statistically significant differences between the 2 techniques. Similarly, the evaluation of relocation time for both techniques as a function of BMI and age did not indicate statistically significant differences. ConclusionScapulohumeral distraction technique (SHD) represents a safe, anatomically based and simple method for shoulder reduction. It showed a statistically significant decrease in relocation time and pain, with patients mentioned higher satisfaction rates compared to the classical Hippocratic method. Nonetheless, there were no statistically significant differences between the two techniques regarding success rate.

Dynamic fronto-amygdalar interactions underlying emotion-regulation deficits in women at higher weight.

The regulation of negative emotions entails the modulation of subcortical regions, such as the amygdala, by prefrontal regions. There is preliminary evidence suggesting that individuals at higher weight may present with hypoactivity in prefrontal regulatory systems during emotional regulation, although the directionality of these pathways has not been tested. In this study, we compared fronto-amygdalar effective connectivity during cognitive reappraisal as a function of BMI in 48 adult women with obesity and 54 control participants. Dynamic causal modeling and parametric empirical Bayes were used to map effective connectivity between the dorsomedial prefrontal cortex, orbitofrontal cortex, dorsolateral prefrontal cortex, and the amygdala. Difficulty in Emotion Regulation Scale scores were higher in the obesity group compared with control participants (p < 0.001). A top-down cortical model best explained our functional magnetic resonance imaging data (posterior probability = 86%). Participants at higher BMI were less effective at inhibiting activity in the amygdala via the orbitofrontal cortex and dorsomedial prefrontal cortex during reappraisal compared with those at lower BMI. In contrast, increased excitatory modulation of dorsolateral prefrontal cortex-to-amygdalar connectivity was found in participants at lower BMI. These findings support a framework involving alterations in fronto-amygdalar connectivity contributing to difficulties in regulating negative affect in individuals at higher weight.

Social and Individual Factors Associated with Eating Disorders in Young Athletes: Effects on Concentration and Fatigue.

Eating disorders are a growing societal problem, especially among young people. This study aims to determine the individual and social factors that support and perpetuate the risk of eating disorders (ED) and their possible consequences on an individual's athletic and academic performances. The sample consisted of 395 athletes between 12 and 16 years of age (M = 14.07; SD = 1.35), of whom 142 (35.9%) were female, and 253 (64.1%) were male. A questionnaire was administered to collect information on sociodemographic data, body image, use of social networks, social relationships, sports practice, risk of developing ED, and academic and sports performance. In the resulting analysis, an initial cross-tabulation was carried out to observe the body distortion of the respondents as a function of BMI, followed by a linear regression to analyze the factors influencing the risk of suffering from ED. In addition, correlations were made to determine the relationship between the risk of manifesting ED and academic and sports performance. The main results show that 77.7% of the young athletes present a risk of ED (M = 13.3; DT = 3.33) due to a high body image distortion, which becomes the determining factor. In addition, relationships with family and friends have a significant influence on this. On the other hand, behaviors related with eating disorders affect concentration (r = -0.122; p = 0.01) and fatigue (r = -0.376; p < 0.01). For all these reasons, generating and promoting prevention and early detection guidelines during adolescence is necessary.

Body weight and mortality in takotsubo syndrome: insights from the International Takotsubo (InterTAK) registry

Abstract Background/Introduction The obesity paradox has been described in different cardiovascular conditions. Data on the association between obesity and outcomes in patients with Takotsubo syndrome (TTS) are lacking. Purpose The aim of this study was to determine the relation of body weight to mortality in TTS patients. Methods Patients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to July 2021 and with available data on BMI were included in the analysis. Patients were stratified according to BMI (underweight, &amp;lt;18.5 kg/m2; normal weight, 18.5–24.9 kg/m2; overweight, 25.0–29.9 kg/m2; obese, 30.0–34.9 kg/m2; and very obese, ≥35.0 kg/m2). The primary endpoint was mortality at 1 year. Results Of the 2'707 patients, 222 (8.2%) were underweight, 1340 (49.5%) of normal weight, 759 (28.0%) overweight, 268 (9.9%) obese, and 118 (4.4%) very obese. Mortality at 1 year as a function of BMI with 95% confidence interval is given in Figure 1. Mortality at 1 year was 11.3%, 6.9%, 5.5%, 4.9%, and 9.3% in underweight, normal weight, overweight, obese, and very obese patients (p=0.02, Figure 2). Being overweight or obese was significantly associated with a lower mortality at 1 year (HR 0.70, 95% CI 0.51–0.96, p=0.03), and associations remained significant after multivariable adjustments (adjusted HR 0.67, 95% CI 0.46–0.97, p=0.03). Associations were observed when including patients without emotional stressors (adjusted HR 0.64, 95% CI 0.43–0.94, p=0.02), but not when including those with emotional stressors (adjusted HR 1.14, 95% CI 0.30–4.27, p=0.85). Conclusion A U-shaped mortality curve across BMI categories was observed in TTS patients, with lowest mortality rates in obese patients. These observations provide first evidence for the existence of the obesity paradox in TTS. Funding Acknowledgement Type of funding sources: Foundation.

Do Overweight, Arterial Hypertension and Type 2 Diabetes Worsen Cognitive Impairment in Patients with Alcohol Use Disorders?

Objective: Overweight, Arterial Hypertension (AH) and diabetes are frequently associated with alcohol use disorders. As each of these co-morbidities is independently associated with cognitive impairment, we studied whetherthey could worsen alcohol-related cognitive impairment. Methods: A retrospective analysis of a clinical database of patients with an alcohol use disorder admitted to an addiction treatment unit of a teaching hospital. Patient weight was classified using WHO recommendations; arterial hypertension and Type 2 diabetes were diagnosed according to the most recent guidelines. Cognitive status was assessed using the MoCA administered on admission and at discharge by trained staff members. Results: Among the 387 patients included (69.3% male, mean age 50.4), 6.4% suffered from Type II diabetes, AH was present in 22.4% of the sample, and 20.6% were obese (BMI&gt;=30). MoCA scores at admission did not differ as a function of BMI, or AH or Type II diabetes status. At discharge, MoCA scoreshad improved in all subgroups; however, a multivariate analysis showed that they had improved significantly less in the AH group compared to the non-AH group. Conclusions: Our results confirm the impact of hypertension on cognitive dysfunction, including in patients with severe alcohol use disorders. Monitoring of blood pressure levels is, therefore, an important preventive measure for cognitive dysfunction in these patients.

Gene-body mass index interaction on coronary heart disease in Chinese adult twins

Objective: To explore the gene-body mass index (BMI) interaction on coronary heart disease (CHD) in the Chinese adult twins. Methods: A total of 20 340 same-sex twin pairs registered in the Chinese National Twin Registry (CNTR) were enrolled in this study. Classical twin structure equation model was used to estimate the gene-BMI interaction on CHD. Results: After adjusting for age, we found that genetic variance of CHD differed as the function of BMI in male twins, which indicated the presence of a gene-BMI interaction on CHD (P=0.008).The genetic moderating effect (βa) was -0.14 (95%CI: -0.22--0.04), indicating that for each logarithmic transformation value of BMI increase, genetic path parameters would decrease by 0.14, which would result in the decrease of genetic variance of CHD. And the heritability of CHD was 0.77 (95%CI: 0.65-0.86) among the male twins with lower BMI (<24.0 kg/m2), but 0.56 (95%CI: 0.33-0.74) among the male twins with high BMI (≥24.0 kg/m2). However, there was no evidence suggesting that BMI could moderate genetic variants of CHD in female. Conclusion: We found a significant gene-BMI interaction on CHD in the Chinese male adult twins in China, and the heritability of CHD was higher among the twins whose BMI was <24.0 kg/m2.

Effectiveness of a Global Multidisciplinary Supportive and Educational Intervention in Thermal Resort on Anthropometric and Biological Parameters, and the Disease-Free Survival after Breast Cancer Treatment Completion (PACThe).

A growing knowledge highlights the strong benefit of regular physical activity in the management of breast cancer patients, but few studies have considered biological parameters in their outcomes. In the prospective randomised trial after breast cancer treatment completion “PACThe,” we determined the effects of physical activity and nutritional intervention on the biological and anthropometric status of patients after one year of follow-up, and clarified the link between biomarkers at allocation and disease-free survival. 113 patients from the population of the “PACThe” study (n = 251) were analysed for biological parameters. Patients were randomized after chemotherapy in two arms: the intervention “SPA” receiving a 2-week session of physical training, dietary education, and physiotherapy (n = 57), and the control “CTR” (n = 56). Diet questionnaire, anthropometric measures, and blood parameters were determined at allocation and one year later. Survival and recurrence were checked over 7 years. Data were considered as a function of BMI, i.e., ≤25 for normal, 25–30 for overweight, and >30 for obese patients. At allocation, the large standard deviation for nutrient-intake values reflected an unbalanced diet for some patients in the three groups. At one-year follow-up, we noticed an increase in glucose (p < 10−6), insulin (p < 10−7), and adiponectin (p < 0.022) plasma levels for both intervention arms, which were more accentuated for the >30 groups. Using the Cox model, we demonstrated that the highest testosterone plasma values were linked to an increase of the recurrence risk (HR [CI–95%] = 5.06 [1.66–15.41]; p=0.004). One-year after a global multidisciplinary supportive and educational intervention, we found few anthropometric and biological changes, mainly related to the patient's initial BMI. We highlighted the importance of plasma testosterone in the evaluation of patient's recurrence risk. Future studies would help better understand the mechanisms by which such multidisciplinary interventions could interact with breast cancer recurrence and define the most effective modalities.

Insights into smell and taste sensitivity in normal weight and overweight-obese adolescents

Research examining connections between BMI and smell and taste sensitivity in adolescents has been minimal, methodologically inconsistent, and inconclusive. We sought to address this issue with an exploratory study of smell and taste sensitivity in overweight-obese (high BMI) and normal BMI male and female adolescents (ages 12–16 years), using previously validated chemosensory testing measures (Sniffin’ Sticks, Taste Strips, 6-n-propylthiouracil: PROP), and taking pubertal stage into account. Puberty was evaluated with the validated Pubertal Development Scale and participants were then classified as either “early” or “late” pubertal stage. We used the phenylethyl alcohol (PEA) version of the Sniffin’ Sticks olfactory threshold test and found that high BMI adolescents had significantly greater olfactory sensitivity than normal BMI adolescents. This observation contradicts previous results in overweight adults tested with the n-butanol version of Sniffin’ Sticks. We also found that participants in early puberty had significantly higher olfactory sensitivity than participants in late puberty. No significant findings for taste sensitivity were obtained, though there is a suggestion that puberty may affect salty taste thresholds. Our results illuminate a potentially important difference in sensitivity to pure olfactory versus olfactory-trigeminal stimuli as a function of BMI, which the PEA and n-butanol versions of the Sniffin’ Sticks respectively assess; and for the first time demonstrate variation in chemosensory acuity in relation to pubertal stage. These findings have implications for eating behavior during adolescence.

Analyzing Facial Asymmetry in Children as a Function of BMI

Childhood obesity is a major public health concern in the US with a prevalence of nearly 19% for all children and adolescents. During growth, environmental factors such as poor diet can result in increased developmental stress. Given the symmetric patterning of facial growth in humans, any random deviations from symmetry, referred to as fluctuating asymmetry (FA), are considered a reflection of stress during growth. In this study, we examine whether childhood obesity serves as a source of developmental stress resulting in increased facial asymmetry. We hypothesize that a significant relationship between facial asymmetry and BMI exists, with higher BMI individuals demonstrating increased levels of facial asymmetry.To test our hypothesis, we obtained n=354 3D facial scans of children (age 3–19) from the University of Pittsburgh Center for Craniofacial and Dental Genetics. A total of n=286 facial scans represented children with a normal weight and n=68 faces were from children with obesity. Obesity status was determined using BMI values at or above the 95th percentile. Facial scans were digitized using 34 coordinate landmarks to capture asymmetry in the eyes, nose, mouth, and lower jaw. Coordinate data was submitted to a Generalized Procrustes Analysis (GPA) to align the facial landmarks and geometric morphometrics (GM) was then employed to quantify facial shape phenotypes in MorphoJ. Principal Component Analysis (PCA) was used to identify patterns of facial asymmetry throughout the entire sample. Canonical Variate Analysis (CVA) was then employed to identify differences in facial shape due to BMI. Lastly, a Procrustes ANOVA was ran to quantify levels of fluctuating asymmetry in the sample and the resulting FA scores were regressed against BMI percentile to test for a significant relationship.The results from the PCA identified 43 principal components (PCs), with the first three PCs accounting for 44.3% of total facial asymmetry. PC1 (accounting for 20.6% of facial asymmetry) identified asymmetry in the position of the eyes and a slight deviation of the nose, mouth and lower jaw to the left or right. PC2 (12.9%) demonstrated asymmetry primarily between the jaw and nose. PC3 (10.7%) further illustrated asymmetries through the eyes and jaw. The results of the CVA showed a significant difference (p=0.023) in overall asymmetry between normal weight children with children with obesity. Normal weight children demonstrated a trend toward facial symmetry while obese children showed marked asymmetry with respect to the eyes, nose, and chin. Finally, the results of the regression between FA scores and BMI percentile did not produce any significant association (p=0.72).While these results indicate a significant difference in the patterning of facial asymmetry between normal and obese children, evidence for increased FA levels (and therefore developmental instability) was not observed. Although we reject our hypothesis, the results demonstrate interesting facial asymmetries between BMI groups that may be promising for future analysis with longitudinal data.Support or Funding InformationGrant support: R01‐DE016148

Relationship between body mass index and sagittal vertical axis change as well as health-related quality of life in 564 patients after deformity surgery.

Obesity, a condition that is increasing in prevalence in the United States, has previously been associated with poorer outcomes following deformity surgery, including higher rates of perioperative complications such as deep and superficial infections. To date, however, no study has examined the relationship between preoperative BMI and outcomes of deformity surgery as measured by spine parameters such as the sagittal vertical axis (SVA), as well as health-related quality of life (HRQoL) measures such as the Oswestry Disability Index (ODI) and Scoliosis Research Society-22 patient questionnaire (SRS-22). To this end, the authors sought to clarify the relationship between BMI and postoperative change in SVA as well as HRQoL outcomes. The authors performed a retrospective review of a prospectively managed multicenter adult spinal deformity database collected and maintained by the International Spine Study Group (ISSG) between 2009 and 2014. The primary independent variable considered was preoperative BMI. The primary outcome was the change in SVA at 1 year after deformity surgery. Postoperative ODI and SRS-22 outcome measures were evaluated as secondary outcomes. Generalized linear models were used to model the primary and secondary outcomes at 1 year as a function of BMI at baseline, while adjusting for potential measured confounders. Increasing BMI (compared to BMI < 18) was not associated with change of SVA at 1 year postsurgery. However, BMIs in the obese range of 30 to 34.9 kg/m2, compared to BMI < 18 at baseline, were associated with poorer outcomes as measured by the SRS-22 score (estimated change -0.47, 95% CI -0.93 to -0.01, p = 0.04). While BMIs > 30 appeared to be associated with poorer outcomes as determined by the ODI, this correlation did not reach statistical significance. Baseline BMI did not affect the achievable SVA at 1 year postsurgery. Further studies should evaluate whether even in the absence of a change in SVA, baseline BMIs in the obese range are associated with worsened HRQoL outcomes after spinal surgery.

Abstract 642: Increasing BMI is associated with tumor volume and uterine weight in endometrial cancer

Abstract Obesity and diabetes is associated with increased risk and worse outcomes in endometrial cancer (EC). Our previous work has found that obesity leads to more aggressive tumor behavior and a doubling of tumor size in EC mouse models. Thus, we explored the association between endometrial tumor volume (TV) and uterine weight (UW) as a function of BMI in EC patients. We performed a retrospective review of EC patients diagnosed and treated from 2005-2010 at a single tertiary care center. Tumor histology, dimensions, stage, grade, and UW were extracted from surgical pathology reports. Patient age, BMI, and diabetic status were also collected. TV was determined using the formula TV=l*d*w*pi/6. Independent variables include obesity classification, BMI, and diabetic status. Univariable and multivariable regression models were used to assess strength of association. A total of 564 EC patients were evaluated, with either endometrioid (n=522) or serous (n=42) histologies (Table 1). Within the endometrioid subgroup, associations were noted for both increased TV and UW with obesity (TV p=0.02; UW p&amp;lt;0.001) and BMI (TV p=0.007; UW p&amp;lt;0.001). Within the serous subgroup, increased TV was associated with obesity and BMI (p&amp;lt;0.001; p=0.007), but UW was only associated with obesity (p=0.005) and not BMI (p=0.07). Controlling for stage and grade, multivariable models demonstrated similar patterns with obesity status and BMI within both subgroups. Multivariable analyses also demonstrated that having diabetes (n=160) was associated with both higher TV and UW in the endometrioid subgroup (TV p=0.004; UW p=0.02), but not in the serous subgroup (TV p=0.71; UW p=0.12). Obesity and increasing BMI appear to be associated with both increased TV and UW in EC patients, consistent with our previously described findings in murine models. Diabetes was also associated with higher TV and UW, but was only significant in patients with endometrioid ECs. Our results may partially account for the worse outcomes seen in obese EC patients. Table 1EC HistologyMedianIQREndometrioid (n=522)Uterine Weight (g)Non-obese118.183.0-157.5Obese140.0103.8-200.0Tumor Volume (cm3)Non-obese3.6950.927-9.664Obese4.3591.419-14.216Serous (n=42)Uterine Weight (g)Non-obese116.667.4-166.6Obese189.8127.6-252.6Tumor Volume (cm3)Non-obese3.2490.601-9.382Obese23.8247.356-59.494 Citation Format: Yingao Zhang, Nerlyne Desravines, Dominic T. Moore, Paola A. Gehrig, Leslie H. Clark, Victoria L. Bae-Jump. Increasing BMI is associated with tumor volume and uterine weight in endometrial cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 642.

Quantitative analysis of midface fat compartments mass with ageing and body mass index, anatomical study

Volume restoration is not a new concept in facial rejuvenation. The deep fat compartments would appear to be more greatly subjected to age-related volumetric deflation. However, this view lacks scientific evidence. The purpose of the present study is to quantify fat mass variability in the superficial and deep compartments of the midface as a function of age and BMI. A cadaveric anatomical study was performed by dissection of superficial and deep facial fat compartment of 40 body. The studied compartments were identified by methylene blue injection and were weighed. The data obtained were analyzed as a function of subject age (two groups: ≤75 or >75), sex, and BMI (three groups: <20, ≥20≤25, or >25). The mean weight of the deep compartments was significantly lower in the group with subjects aged >75 years (1.48g vs 3.41g, P<0.001) and the deep-to-superficial fat ratio decreased significantly by more than 50% (0.2 vs 0.44, P<0.001). No statistically significant difference as concerns the mean weight of the superficial compartments (7.93g vs 6.73g). The deep-to-superficial fat ratio as a function of BMI was largely significantly lower in subjects with BMIs<20 (0.15, vs 0.31 and 0.34, P<0.001). The present anatomical study confirmed that fat atrophy affects in priority the deep midface compartments with ageing and in subjects with a BMI less than 20. Thus to obtain natural-looking results in facial rejuvenation, the volumetric restoration of these deep compartments should be considered a priority.

Assessment of inferior vena cava diameter by echocardiography in normal Indian population: A prospective observational study

BackgroundThe assessment of the IVC diameter is self explanatory for evaluation of the individuals’ volume status. Studies regarding IVC diameter estimation in normal individuals are scarce. AimThe present study aimed to define normal criteria of size and dynamics of the inferior vena cava (IVC) by M-mode echocardiography in normal individuals. MethodsThis was a prospective, single-center, observational study carried out at Sri Jayadeva Institute of Cardiovascular Sciences and Research between December 2011 and April 2014. A total of 4126 consecutive individuals were enrolled. Normal IVC diameter was measured both during inspiration and expiration by M-mode echocardiography in subcostal view. ResultsThe IVC diameter varied from 0.46 to 2.26cm in the study individuals. The IVC diameter ranged from 0.97 to 2.26cm during expiration and from 0.46 to 1.54cm during inspiration. A strong correlation was observed between IVC diameter and height, weight and BMI of the individuals, calculated using Pearson correlation. The correlation coefficients for expiratory and inspiratory IVC diameters as a function of BMI were 0.686 and 0.7, respectively. ConclusionsOur findings corroborate the correlations between height, weight and BMI with IVC diameter. Future studies could be focused to bring about a steadfast formula for calculating IVC diameter based on demographic parameters of an individual.

Educational outcomes associated with childhood obesity in the United States: cross-sectional results from the 2011-2012 National Survey of Children's Health.

BackgroundPast research examining the effects of childhood obesity has largely focused on its projected effects into adulthood. However, there is emerging evidence that childhood obesity may have more immediate effects on school-related outcomes. We examine a range of educational attainment indicators to examine the possible pathway between obesity status and academic performance, while investigating the proximal effects of childhood obesity on health and utilization of health services, and whether these variables attenuate the relationship between obesity status and educational outcomes.MethodsData for the current study come from the 2011-2012 National Survey of Children’s Health, which details the impacts of childhood obesity on a range of outcomes among a nationally representative sample of children and adolescents aged 10-17 years (N=45,255). Educational outcomes (school absences, school problems, repeating a grade and school engagement) were modeled by logistic regression as a function of BMI, overall health status, health care utilization, and a range of sociodemographic variables.ResultsBMI status was significantly associated with all educational outcomes (p<0.001 for all), overall health status (p<0.001), and health care utilization (p=0.016). Prior to adjustment for covariates, obese children were significantly more likely to have school absences and school problems, to repeat a grade, and to have lower school engagement than non-overweight children. After adjustment for sociodemographic and health/healthcare variables, these outcomes remained significant for all but repeating a grade. The odds of having school problems, repeating a grade, and low school engagement that were associated with obesity were attenuated by the addition of sociodemographic variables into the model, while the addition of health and health care variables in the model decreased the odds of school absences.ConclusionsThis study provides evidence that increased weight status in children is associated with poorer educational outcomes. While recognizing that these are cross-sectional data, we suggest that 1) health-related and sociodemographic factors should be a focus point of intervention, and 2) a socio-structural approach including Coordinated School Health intervention is crucial to reducing childhood obesity and improving educational outcomes in this population.

Insula tuning towards external eating versus interoceptive input in adolescents with overweight and obesity

This study was aimed to examine if adolescent obesity is associated with alterations of insula function as indexed by differential correlations between insula activation and perception of interoceptive feedback versus external food cues. We hypothesized that, in healthy weight adolescents, insula activation will positively correlate with interoceptive sensitivity, whereas in excess weight adolescents, insula activation will positively correlate with sensitivity towards external cues. Fifty-four adolescents (age range 12–18), classified in two groups as a function of BMI, excess weight (n = 22) and healthy weight (n = 32), performed the Risky-Gains task (sensitive to insula function) inside an fMRI scanner, and completed the heartbeat perception task (measuring interoceptive sensitivity) and the Dutch Eating Behaviour Questionnaire (measuring external eating as well as emotional eating and restraint) outside the scanner. We found that insula activation during the Risky-Gains task positively correlated with interoceptive sensitivity and negatively correlated with external eating in healthy weight adolescents. Conversely, in excess weight adolescents, insula activation positively correlated with external eating and negatively correlated with interoceptive sensitivity, arguably reflecting obesity related neurocognitive adaptations. In excess weight adolescents, external eating was also positively associated with caudate nucleus activation, and restrained eating was negatively associated with insula activation. Our findings suggest that adolescent obesity is associated with disrupted tuning of the insula system towards interoceptive input.

Plasma phospholipids, non-esterified plasma polyunsaturated fatty acids and oxylipids are associated with BMI

The obese lipid profile is associated with increased free fatty acids and triacylglycerides. Currently, little is known about the plasma lipid species associated with obesity. In this study, we compared plasma lipid fatty acid (FA) profiles as a function of BMI. Profiling phospholipid (PL) FAs and their respective oxylipids could predict which obese individuals are more likely to suffer from diseases associated with chronic inflammation or oxidative stress. We investigated the relationship between BMI and plasma PL (PPL) FA composition in 126 men using a quantitative gas chromatography analysis. BMI was inversely associated with both PPL nervonic and linoleic acid (LA) but was positively associated with both dihomo-γ-linolenic and palmitoleic acid. Compared to lean individuals, obese participants were more likely to have ω-6 FAs, except arachidonic acid and LA, incorporated into PPLs. Obese participants were less likely to have EPA and DHA incorporated into PPLs compared to lean participants. Non-esterified plasma PUFA and oxylipid analysis showed ω-6 oxylipids were more abundant in the obese plasma pool. These ω-6 oxylipids are associated with increased angiogenesis (i.e. epoxyeicosatrienoates), reactive oxygen species (i.e. 9-hydroxyeicosatetraenoate), and inflammation resolution (i.e. Lipoxin A4). In summary, BMI is directly associated with specific PPL FA and increased ω-6 oxylipids.

Serum folate and whole blood global DNA methylation response to chronic folic acid supplementation in normal weight and obese women of child‐bearing age (817.2)

Folate is a water‐soluble vitamin important for normal fetal development. Maternal obesity is associated with increased risk for birth defects; however the relationship between obesity and folate metabolism is not well understood. Recently, our lab reported a lower short‐term pharmacokinetic response to an acute oral dose of folic acid in obese vs normal weight women of child‐bearing age. This study determined the serum folate (microbiological assay) and whole blood DNA methylation (LC/MS) response to 8 wks of supplementation with 800 µg/d folic acid (FA) in healthy normal weight (n=13, BMI=21.5±0.4) and obese (n=7, BMI=37.6±0.8) women of child‐bearing age. Samples were collected at baseline and after 4 and 8 wks of supplementation. At baseline, serum folate was lower in obese vs normal weight women, whereas global DNA methylation was similar in both groups. Repeated measures ANOVA indicated an effect of FA on increasing serum folate over time (p &lt; 0.0001) for all subjects combined, and a time x group interaction for global methylation (p &lt; 0.05) characterized by a reduction in methylation from baseline to 8 wks in normal weight but not obese women. These data provide additional evidence suggesting differences in metabolic response to folic acid as a function of BMI in women of child‐bearing age and provide support for consideration of a BMI‐adjusted folic acid intake recommendation.Grant Funding Source: Funded in part by HATCH #GEO00706, #GEO00707, #FLA‐FOS‐004797 and the Obesity Initiative at the Univ

Validation study of a pooled electronic healthcare database: the effect of obesity on the revision rate of total knee arthroplasty

The objective of this study was to validate the use of a software platform (Explorys, Inc., Cleveland, OH) by determining whether the association observed between obesity and revision of total knee arthroplasty (TKA) was obtained within this database. Risk of revision in cohorts with a BMI > 30, as well as cohorts with a BMI between 30-35, 35-40 and >40 was compared to patients with a BMI between 18 and 30 (relative risk, RR). Risk in men versus women was examined. From this database, 70,070 patients were identified that had undergone a TKA. Risk of revision increased as a function of BMI; RR achieved significance in the following cohorts: all patients with a BMI > 30, all patients with a BMI > 40, men with a BMI > 30 and men with a BMI > 40. All other subgroups showed increased RR but did not reach significance. In obese patients, RR was greater in men than in women, and the effect was significant in all groups examined except patients with a BMI between 35 and 40. Data from this study contribute to the process of demonstrating the Explorys software platform is a valid and useful method to investigate associations across large populations.

Obesity and dental decay: inference on the role of dietary sugar.

ObjectiveTo evaluate the relationship of children’s obesity and dental decay.MethodsWe measured parameters related to obesity and dental decay in 8,275 4th and 5th grade Kuwaiti children (average age = 11.36 years) in a cross-sectional study. First to determine body weight, height, age for computation of BMI . Second, to determine numbers of teeth, numbers of fillings and numbers of untreated decayed teeth to determine extent and severity of dental disease. From these measurements, we computed measures of dental decay in children from four body weight categories; obese, overweight, normal healthy weight and underweight children.ResultsThe percentage of children with decayed or filled teeth varied inversely with the body weight category. The percentage of decayed or filled teeth decreased from 15.61% (n=193) in underweight children, to 13.03% (n=4,094) in normal healthy weight children, to 9.73% (n=1,786) in overweight children to 7.87% (n=2,202) in obese children. Differences between all groups were statistically significant. Male children in this population had more dental decay than female children but the reduction of tooth decay as a function of BMI was greater in male children.ConclusionsThe finding of an inverse obesity-dental decay relationship contradicts the obesity-sugar and the obesity-dental decay relationship hypotheses. Sugar is well recognized as necessary and sufficient for dental decay. Sugar is also hypothesized to be a leading co-factor in obesity. If the later hypothesis is true, one would expect dental decay to increase with obesity. This was not found. The reasons for this inverse relationship are not currently clear.

Relation of respiratory muscle strength, cachexia and survival in severe chronic heart failure

BackgroundRespiratory muscle (RM) function predicts prognosis in non-cachectic patients with chronic heart failure (CHF). We hypothesized that weakness of RM (maximum inspiratory mouth occlusion pressure, Pimax) is a function of body mass index, and that outcome is more a function of BMI than of Pimax or ventilatory drive (P0.1).Subjects and methodsWe enrolled 249 CHF patients (11.2 % female, median age 54.2 years) at the German Heart Institute Berlin. Patients were in NYHA classes I/II/III/IV by n = 16/90/108/35. All patients underwent tests of pulmonary function, RM (Pimax, P0.1), cardiopulmonary exercise testing (peakVO2, VE/VCO2-slope), and right heart catheterization.ResultsMean follow-up time was 18 (1–36) months, 47 patients (18.9 %) died or underwent cardiac assist implantation. Pimax correlated weakly with BMI (r = 0.19), peakVO2 (r = 0.15), and FEV1 (r = 0.34, all p < 0.02), and was lower in females compared to males (3.9 ± 1.7 vs. 6.6 ± 2.7 kPa; p < 0.001). P0.1 correlated with pulmonary pressure (rho = 0.2; p < 0.01) and peakVO2 (rho = −0.14; p < 0.02). Neither Pimax [hazard ratio (HR) 0.98; confidence interval (CI) 0.88–1.08] nor P0.1 (HR 0.52; 0.06–4.6) predicted survival. Multivariate regression analysis revealed gender, BMI, and FEV1 as cofactors of Pimax, with only BMI (HR 0.87; CI 0.80–0.95) predicting survival independently. The lowest quintile in BMI had the worst outcome (log-rank χ² = 13.5, p = 0.009).SummaryIn CHF patients including cachexia and NYHA IV, Pimax does not predict survival. Pimax depends on gender, BMI, FEV1, and peakVO2, with only BMI and peakVO2 predicting survival. The impaired Pimax in CHF might be a result of catabolism and weight loss and is not a predictive factor in itself.