Higher BMI Values Research Articles

Instrumental variable analysis using offspring BMI in childhood as an indicator of parental BMI in relation to mortality

Childhood BMI shows associations with adult mortality, but these may be influenced by effects of ill health in childhood on BMI and later mortality. To avoid this, we used offspring childhood BMI as an instrumental variable (IV) for own BMI in relation to mortality and compared it with conventional associations of own childhood BMI and own mortality. We included 36,097 parent–offspring pairs with measured heights and weights from the Copenhagen School Health Records Register and register-based information on death. Hazard ratios (HR) were estimated using adjusted Cox regression models. For all-cause mortality, per zBMI at age 7 the conventional HR = 1.07 (95%CI: 1.04–1.09) in women and 1.02 (95%CI: 0.92–1.14) in men, whereas the IV HR = 1.23 (95%CI: 1.15–1.32) in women and 1.05 (95%CI: 0.94–1.17) in men. Per zBMI at age 13, the conventional HR = 1.11 (95%CI: 1.08–1.15) in women and 1.03 (95%CI: 0.99–1.06) in men, whereas the IV HR = 1.30 (95%CI: 1.19–1.42) in women and 1.15 (95%CI: 1.04–1.29) in men. Only conventional models showed indications of J-shaped associations. Our IV analyses suggest that there is a causal relationship between BMI and mortality that is positive at both high and low BMI values.

Eating disinhibition and food liking are influenced by variants in CAV1 (caveolin 1) gene

Eating behavior is influenced by a combination of environmental and genetic factors. Although candidate gene studies have been conducted, much remains to be understood about genetic influences. Therefore, we conducted a Genome-Wide Association Study (GWAS) aims to identify new variants that influence eating disinhibition. Moreover, we test the possible association of these variants with food liking and metabolic phenotypes.We measured disinhibition in two cohorts of Italian samples using three selected statements from the Three-Factor Eating Questionnaire. Personal and clinical data were collected, as well as liking for different foods and beverages. GWAS was carried out in 1124 individuals; then the best signals (p-value < 1×10−5) were studied for replication in 426 independents participants. To study the link of eating disinhibition and associated variants with food liking and metabolic traits, we used linear mixed models and Structural Equation Modeling (SEM).A significant association with CAV1 (caveolin 1) gene (p < 5×10−8) was identified. The top SNP (rs6961694) resulted also associated with the liking for sweet foods and alcoholic beverages (p-value < 0.05). Moreover, we observed significant eQTL associations between this SNP and CAV1 expression levels in human tissues such as adipose subcutaneous tissue, pancreas and brain hippocampus (p-value = 0.00022, 0.00015 and 0.017, respectively). Although higher values of BMI, waist, hips and triglycerides were significantly associated with increasing eating disinhibition (p-value < 0.05), no association emerged between the rs6961694 SNP and anthropometric or lipids phenotypes.In conclusion, we describe a significant association between eating traits and CAV1 gene, providing new knowledge on the link existing between genetics, eating behaviour and health status.

2D-shear wave elastography: number of acquisitions can be reduced according to clinical setting

BackgroundThe factors affecting intra-operator variability of two-dimensional shear wave elastography (2D-SWE) have not been clearly established. We evaluated 2D-SWE variability according to the number of measurements, clinical and laboratory features, and liver stiffness measurements (LSM).MethodsAt least three LSM were performed in 452 patients who underwent LSM by 2D-SWE (supersonic shear imaging) out of an initial database of 1650 patients. The mean value of the three LSM was our best measurement method. Bland–Altman plots were used to evaluate intra-operator variability when considering only one, or the first two measurements. Variability was assessed by taking the absolute value of the difference between the first LSM and the mean of the three LSM. Logistic regression was used to assess the factors associated with the highest tertile of variability.ResultsThe limit of agreement was narrower with the mean of the first and second measurements than with each measurement taken separately (− 2.83 to 2.99 kPa vs. − 5.86 to 6.21 kPa and − 5.77 to 5.73 kPa for the first and second measurement, respectively). A BMI ≥ 25 kg/m2 and a first LSM by 2D-SWE ≥ 7.1 kPa increased the odds of higher variability by 3.4 and 3.9, respectively. Adding a second LSM didn’t change the variability in patients with BMI < 25 and a first LSM by 2D-SWE < 7.1 kPa.ConclusionsIntra-operator variability of LSM by 2D-SWE increases with both a high BMI and high LSM value. In patients with BMI < 25 kg/m2 and a first LSM < 7.1 kPa we recommend performing only one LSM.

Association Between Body Mass Index with Cognitive Function and Activities of Daily Living In Elderly: A Cross-Sectional Study

Background: Higher BMI has been often attributed with decline in cognitive function, mortality, and morbidity in elderly. However, few studies have reported high BMI as protective towards cognition and Activities of Daily Living (ADL). Accurate quantification of the role of BMI in the incidence of cognition and performance is desirable in the face of the increasing prevalence of individuals with overweight and obesity and prolonged life span in the population. This study aimed to investigate the association of BMI with cognition and ADL in community living elderly. Method: A cross sectional study was conducted among community living elderly. BMI and KATZ index scores were recorded from the respondents. Data were analyzed using SPSS version and a p value of less than 0.05 was considered statistically significant. Results: A total of 53 respondents enrolled in this study and was predominated by (54.7%) males and (45.30%) females. Karl Pearson correlation coefficient test found a positive correlation (r= 0.33) between BMI and Cognition and was found to be statistically significant (p&lt;0.05). Also, it was observed that moderately positive correlation exists between BMI and ADL (r =0.64) and was found to be statistically very highly significant (p&lt;0.001) Conclusion: This study concluded that among elderly, higher BMI values were associated with better performance in daily activities and lower cognitive impairment. KEY WORDS: Elderly, Body mass index, Activities of Daily Living, Cognition.

Evaluation of C-Reactive Protein and Associated Factors Among Patients Suffering from Rheumatoid Arthritis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder, which is associated with increased pro-inflammatory mediators to induce an elevation in acute-phase response, migration of immune cells and swelling of synovial joints. Evaluation of the level of C-reactive protein and associated risk factors in RA patients was the main aim of this study. Identifying the association between disease activity of RA (hsCRP) and socio-demographic characteristics was another aim of the study.MethodsInstitution-based cross-sectional study was conducted at the Rheumatology Clinic of Tikur Anbessa Specialized Hospital. In this study, the level of hsCRP was measured in both case and control groups. Simple descriptive statistics, multivariate analysis, independent sample t-test were utilized for statistical analysis. The strength of association between different risk factors and hsCRP was measured using odds ratio and 95% confidence interval. P-value < 0.05 was considered as statistically significant.ResultThe result of this study showed that the hsCRP level was significantly higher among RA patients as compared to the control groups (P-value = 0.004). There was an association between smoking and high disease activity status (AOR= 20.03, p= 0.40). Low economic status had a statistically significant association with high hsCRP level (AOR = 12.79, p=0.00). In this study, 42 RA patients had >3mg/l hsCRP level with different occupational exposures. On the other hand, 31 RA patients had <3mg/l hsCRP level among different exposures. Although there was no statistically significant association, the association between associated risk factors (oil consumption, physical exercise, educational status) and disease activity was computed in this study.ConclusionThe inflammatory marker, hsCRP was significantly higher among patients as compared to controls. The higher hsCRP showed a high grade of systemic inflammation in RA patients. C-reactive protein was elevated in rheumatoid factor positive patients and patients with high BMI value. Additionally, the result of our study showed that different socio-economic factors had an association with disease activity of RA.

Comparison of Clinical Manifestations and Risk Factors of Death in Two Age Groups Less and More Than 50 Years in Patients with COVID-19

Background: The COVID-19 pandemic has affected more than 180 countries and has killed more than half a million people up to now. Risk factors for death are not yet fully identified. Objectives: The present study aimed at comparing the clinical manifestations and risk factors for death between two groups of patients with COVID-19 aged under and above 50 in Qom Province, Iran. Methods: The current retrospective cohort study was conducted on 178 patients with COVID-19 in Qom Province. Patients were followed up until recovery or death. The source population was divided into four groups, of which 45 patients were randomly enrolled in the study. The first group included patients aged less than 50 discharged after recovery; the second group included patients less than 50 years who died from COVID-19; the third group consisted of patients above 50 discharged after recovery, and the fourth group included patients above 50 who died from COVID-19. The data, including COVID-19 clinical symptoms and presumptive risk factors for death, were collected and compared between groups. Results: The most common symptoms in hospitalized patients were shortness of breath (82.6%), cough (73.6%), and fever (71.9%), respectively. In the age group above 50, the prevalence of fever in the recovered subjects was higher than that of the ones who died from the disease (81.8% Vs. 53.3%). Headache and loss of senses of smell and taste were also more common in both age groups in the recovered subjects. In the age group under 50, subjects who died had higher BMI values, but in the age group above 50, subjects who died had lower BMIs. Conclusions: The results of the present study showed that obesity could be a risk factor for death in the age group under 50. The results also indicated that in both age groups, extrapulmonary symptoms were more common in recovered patients.

Evaluating the Accuracy of the Risk Assessment Tools in Predicting CVD Events in Tertiary Care Hospital, Bangalore, India

Aim: To evaluate the accuracy of the risk assessment tools in predicting CVD events in tertiary care hospital, Bangalore, India. Methodology: A Prospective observational study conducted in medicine wards of a tertiary-care hospital for eight months. We collected all the details like inpatient number, age, sex, social status, laboratory data, weight, height, Blood Pressure (BP), family history, and therapeutic management. Then introduced the data to FRS and ASCVD risk score calculators and determined the risk for development of CVD in each patient and observed risk score for each risk factor in the study sample. Results: FRS and ASCVD predicted the risk factor for developing CHD; BMI values, tobacco use, alcohol consumption, diabetes, Total Cholesterol. FRS and ASCVD risk scores were used to classify individuals according to Low, Moderate and High-risk factor, the percentage was respectively (70%, 22%, 8%) for ASCVD and (61%,21%, 18%) for FRS. Using FRS and ASCVD, we observed that patients with high BMI values, smokers, alcoholics, diabetics, and patients with high TC, LDL, and TG levels with Low HDL levels were more likely to have a high risk of developing CVDs. Conclusion: The Risk Scores helped in investigating the status of cardiovascular patients and predicting the incidence of CVD events by determining risk factors. This study emphasizes the importance of good planning and predicting of CVDs in advance as a way to prevent the disease or lower its risk in individuals by studying the risk factors and calculating the risk using Framingham Risk Score and AHA/ACC risk score (ASCVD). Keywords: Atherosclerosis Cardiovascular Disease (ASCVD), Risk Factors, cardiovascular disease

Relation of Type 1 Diabetes Mellitus with Familial Hypercholesterolemia in Children; A Review Study

Background: Type 1 diabetes mellitus (T1DM) and familial hypercholesterolemia (FH) are two different genetic disorders with serious health consequences. T1DM is an immune mediated disease that impacts the pancreas and causes a lack of insulin levels, whereas FH is an inherited condition that causes high cholesterol levels in the blood. FH and type 1 diabetes mellitus are both linked to substantial morbidity and premature mortality due to atherosclerotic cardiovascular disease. Material and Methods: To better understand the ongoing debate regarding the relationship of type 1 Diabetes mellitus with familial hypercholesterolemia. Medline search of the literature was held between 2016 and 2022. From this search, 35 articles with relevant material were selected. Results: The data from the previous conbined studies show that there is a link between types 1 dm with familial hypercholesterolemia in children. Less physical activity, higher BMI value and obesity are some of the areas that link hypercholesterolemia with diabetes mellitus 1. Therefore, it is advised to have metabolic control to treat hyperlipidemia. Conclusion: Familial hypercholesterolemia is significantly linked with type 1 diabetes mellitus and is more common among children and adolescents. Dyslipidemia is more frequently reported among female patients. The most of the patients of dyslipidemia shows elevated LDL-C and low HDL-C. Keywords: Type 1 diabetes mellitus, familial hypercholesterolemia, low-density lipoprotein, blood glucose level and cardiovascular disease.

Physical fitness in children in Cabo Verde: differences between gender, eutrophic vs. overweight subjects, and practitioners vs. non-practitioners of sports.

There are few or even rare studies conducted in Cabo Verde (Republic of Cabo Verde) that address the issue of physical fitness and body composition in the juvenile population. This investigation aims to study the physical fitness in children in Cabo Verde: differences between gender, eutrophic, and overweight subjects, between practitioners and non-practitioners of sports. The sample consisted of 93 individuals aged between 10 and 15 years, from the 2nd and 3rd cycles and secondary school of the Portuguese College based in Cabo Verde. The instruments used for data collection were the FITescola® test battery (Lisboa, Portugal), and the questionnaire Quantification de l'activite physique en altitude chez les enfants (QAPACE) for assessment of physical activity level. Regarding the statistical analysis using the SPSS 23.0 software (SPSS Inc., Chicago, IL, USA), the first analysis was performed to verify the distribution of the sample (Kolmogorov-Smirnov Test and Shapiro-Wilk Test). Then, for variables with normal distribution we used the t-test and for the remaining variables with non-normal distribution we used the Mann-Whitney Test, with a significance level of 5%. Gender differences were found, in which the male gender obtained more favorable mean values in the "sit-ups," "push-ups," "horizontal impulsion," "shuttle" and "agility" variables, while the females showed superiority in the variables "sit and reach;" differences between the eutrophic and overweight group where, as expected, more favorable mean values for eutrophics than the overweight group in all PF tests. Finally, differences between practitioners and non-practitioners of sports, with the best results being attributed to practitioners of sports. We concluded that male subjects have greater proficiency in strength and aerobic fitness tests while female subjects have greater flexibility. High BMI values in overweight children have been found to be associated with increased abdominal fat as well as a reduction in overall PF. As expected, sports practitioners show better results in motor performance on PF tests.

Walking Initiated 20 Minutes before the Time of Individual Postprandial Glucose Peak Reduces the Glucose Response in Young Men with Overweight or Obesity: A Randomized Crossover Study

Although a single bout of postmeal exercise can lower postprandial glucose (PPG), its optimal timing remains unclear. This study aimed to investigate the effect of exercise timing using an individualized approach on PPG in overweight or obese young men. Twenty men [age: 23.0±4.3y; BMI (kg/m2): 27.4±2.8] each completed three 240-min trials in a randomized order separated by 6-14 d: 1) sitting (SIT), 2) walking initiated at each participant's PPG-peak time (PPGP) (iP), and 3) walking initiated 20min before the PPGP (20iP). For each participant, PPGP was predetermined using continuous glucose monitoring. Walking was performed at 50% maximal oxygen consumption for 30min. Venous blood was collected at 15- and 30-min intervals for 0-120min and 120-240min, respectively. The primary outcome was plasma PPG. Generalized estimating equations were used for comparison between trials. Compared with SIT, the 4-h incremental AUCs (iAUCs) for plasma PPG (-0.6 mmol · L-1 · h; P=0.047) and insulin (-28.7%, P < 0.001) were reduced in 20iP only, and C-peptide concentrations were lower after iP (-14.9%, P=0.001) and 20iP (-28.7%, P < 0.001). Plasma insulin (-11.1%, P=0.006) and C-peptide (-8.3%, P=0.012) were lower due to the 20iP compared with iP treatment. Finally, PPG reductions due to iP and 20iP occurred only in men with a BMI > 27.5 kg/m2 (iP, -11.2%; 20iP, -14.7%; P=0.047) and higher glucose iAUC values during SIT (iP, -25.5%; 20iP, -25.7%; P < 0.001). Walking initiated 20min before PPGP lowered PPG and plasma insulin and C-peptide concentrations in young men with overweight or obesity, in particular in those with high BMI or glucose iAUC values during SIT; it also lowered plasma insulin and C-peptide concentrations more effectively than did exercise initiated at PPGP. This trial was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) as ChiCTR1900023175.

Frequency of caesarean section in diabetic vs. non diabetic females undergoing induction of labour at term

Introduction: Gestational diabetes mellitus (GDM) is a common complication of pregnancy characterized by glucose intolerance recognized during pregnancy. Gestational diabetes is associated with adverse maternal and fetal outcome. Majority of patients with diabetes had induction of labour at term (≥37weeks) to prevent maternal and fetal morbidity especially shoulder dystocia, macrosomia and intrauterine fetal death at term&#x0D; Objectives:&#x0D; &#x0D; To find frequency of gestational diabetes (GDM) in patients undergoing induction of labour.&#x0D; To compare the frequency of caesarean section in diabetic (GDM) and non-diabetic females undergoing induction of labour&#x0D; &#x0D; Methodology:&#x0D; Study Type; It was a descriptive case series conducted at the department of Obstetrics and Gynecology, Shalamar Hospital Lahore. Duration of study was six months after approval from IRB.&#x0D; Sample size; Sample size of 214 cases undergoing induction of labour at term during study period; calculated with 95%confidence level and 3.4% margin of error and taking expected percentage of GDM is 6.9%.&#x0D; Sampling Technique; purposive sampling&#x0D; Methodology:&#x0D; 214 females who will fulfill the inclusion criteria were enrolled in the study from labour room of Department of Obstetrics and Gynecology, Shalamar Hospital Lahore. Induction of labour done with tab prostin 3mg single dose and patients having gestational diabetes were identified and frequency of caesarean section in Diabetic and non-diabetic calculated.&#x0D; Results:&#x0D; In current study, mean age of the patients was 27.8±4.4 years. Mean gestational age was 37.1±3.8 weeks and mean BMI was 28.6±4.1 kg/m2. Primigravida were 88 (41.1%) and multigravidas were 126 (58.9%). Gestational diabetes was found to be in 36 patients (16.8%). Caesarean section was performed in 77 patients (36%). Comparison of frequency of cesarean section in diabetic (GDM) and non-diabetic females undergoing induction of labour revealed majority of the caesarean sections performed in GDM patients (p=0.007).&#x0D; Conclusion&#x0D; In conclusion, our study found a higher incidence of cesarean section than normal delivery in pregnant women with gestational diabetes. Major factors for operational delivery in GDM population included: advanced maternal age and high BMI value.

Prevalence of metabolic syndrome and its associated factors among Iranian steel workers.

Metabolic syndrome (MetS) is composed of a collection of risk factors for heart diseases and diabetes. In recent decades, metabolic syndrome has been identified as one of the important risk factors leading to the development of work-related diseases. Since few studies have been conducted on evaluating the prevalence of MetS among Iranian workers, this cross-sectional study aimed at assessing the prevalence of MetS and the factors affecting it among Iranian steel workers. This study was carried out on 510 employees working in a large steel producing company. The data pertaining to blood pressure, triglycerides, cholesterol, glucose, and demographic information were collected and the Adult Treatment Panel (ATP III) criteria were implemented to diagnose MetS. The prevalence of Mets was obtained equal to 13% and a significant positive relationship was observed between age and the prevalence of metabolic syndrome. From among MetS elements, low HDL cholesterol and increased waist circumference were recognized as the most and the least frequently involved elements with 39.3% and 6.5% prevalence, respectively. Chi-square test was run and the results showed that the prevalence of MetS and some of its components rose at higher BMI values. It was also indicated that MetS and its components had no significant relationship with shift work. The current findings revealed that the prevalence of MetS increased with aging. Low HDL and high triglycerides levels were among the main risk factors for MetS. Therefore, considering these risk factors, it should be attempted to develop relevant strategies at workplace to encourage workers to go for a healthier lifestyle so that they can prevent the incidence of MetS.

Comparison of Airway Measurements in Rheumatoid Arthritis and Non-rheumatoid Patients using Lateral Cephalometric Radiographs.

The aim of this study was to investigate the potential relationship between the volumetric area of the upper airway and rheumatoid arthritis (RA) by comparing upper airway measurements between patients with and without RA. This case-control study compared upper airway measurements between patients with and without RA using lateral cephalometric radiographs. Two distinct measurements were made: the area of the upper airway, which is defined as "the area extending from the point of the retro-palatal region to the base of the epiglottis," and the distance of the upper airway, which is defined as "the distance between the anterior border of the third cervical vertebra (C3) and the anterior border of the soft tissue of the neck". A single examiner performed all measurements, and the intra-examiner reliability was assessed. Sixty-one RA patients and 95 non-RA patients were included in the case and control groups, respectively. RA patients were significantly older in age and with higher BMI values. Patients with or without RA had Angle Class II as the most prevalent orthodontic classification. The upper airway was slightly narrower in RA patients, resulting in a smaller area, and the length of the upper airway was significantly longer in RA patients. Patients with RA have narrower upper airways as measured on lateral cephalometric radiographs. This may partially explain the high prevalence of obstructive sleep apnea among patients with RA. Focusing on airways measurements when cephalometric radiographs are taken for patients with RA could give some idea about which patient is likely to have OSA.

Contribution of rs3211938 polymorphism at CD36 to glucose levels, oxidized low-density lipoproteins, insulin resistance, and body mass index in Mexican mestizos with type-2 diabetes from western Mexico

Background: type-2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance (IR), and abnormal fatty acid metabolism in which the CD36 receptor has been implicated in glucose and lipid dysregulation. Objective: to evaluate the contribution of polymorphism CD36 rs3211938 to metabolic profile in T2DM Mexican mestizos from western Mexico. Methods: we included 115 individuals classified as non-T2DM (NT2DM) adults and T2DM patients. Polymorphism CD36 rs3211938 was assessed by PCR-RFLP. Anthropometric and metabolic markers were measured by routine methods, and insulin and oxidized LDL (ox-LDL) were measured by ELISA. Results: the distribution of genotypes between NT2DM and T2DM patients was different (p < 0.001), as was the allele frequency (p = 0.002). NT2DM TG carriers showed the lowest levels of basal insulin and HOMA-IR index in comparison with TT carriers (p < 0.05 and p < 0.05, respectively). In the T2DM group TG carriers showed high BMI, WHR, and weight values (p = 0.001; p ≤ 0.05 and p < 0.05, respectively), and the highest levels of basal glucose, HDL-cholesterol, ox-LDL, and HOMA-IR (p < 0.001; p < 0.001; p < 0.001, and p = 0.001, respectively) in comparison with diabetic TT carriers. Conclusion: the CD36 rs3211938 TG genotype is associated with high levels of glucose, ox-LDL, HDL-cholesterol, and IR, and with increased BMI in Mexican mestizo T2DM patients from western Mexico.

Comparação de indicadores antropométricos em atletas de ginástica rítmica satisfeitas e insatisfeitas com a imagem corporal

This study aimed to compare body mass index [BMI], triceps skinfold (DCTR), subscapular skinfold (DCSE) and body fat (%BF) in rhythmic gymnastics (GR) athletes, satisfied and dissatisfied with body image (CI). Through a cross-sectional study with 38 athletes practicing GR from Oeste Paranaense. The CI was assessed with the Body Shape Questionnaire, body mass and height were measured, and the BMI was calculated. The DCTR and DCSE were used to calculate the %GC (Slaughter equation). The economic level was verified with the Brazil Economic Classification Criterion, and sexual maturation was self-reported with Tanner boards. Independent T-test and Chi-square and covariance analysis (ANCOVA) were employed to control the interference of economic level and maturational stage, with p <0.05. Gymnasts dissatisfied with HF presented higher BMI values (mean: 19.01 Kg/m²; standard deviation [SD]: 0.65 Kg/m²), DCTR (mean: 9.26 mm; SD: 0, 65 mm), DCSE (mean: 7.33 mm; SD: 0.55 mm) and %BF (average: 20.75; SD: 0.96) when compared to gymnasts satisfied with HF, even after control economic level and maturational stage. GR athletes dissatisfied with HF presented higher values for anthropometric indicators.

Effect of Physical Activity on Obesity in Second Stage Pupils of Elementary Schools in Northwest Bohemia

Obesity is a serious problem in our society. An evaluation of obesity development performed in the second half of the previous century already indicated a long-term positive trend in terms of body weight increase in children and the youth, which still persists today. Paediatric obesity arises from a changed lifestyle of children, characterised by an important restriction of their spontaneous physical activity. A lack of physical activity is one of the most important causes of paediatric obesity, which associated with a number of serious disorders. In the current study, the incidence of obesity and overweight as well as the relationship between physical activity and obesity in second stage pupils of elementary schools in northwest Bohemia is presented. The data collection was based on questions from the NAS 2001 questionnaire (nationwide anthropological survey) and BMI-for-age. 2001. NAS 2001 is a questionnaire for children and evaluates areas focused on engagement in physical activities and other daily activities, eating habits, drinking regime and care of the body habitus. Problems with obesity and overweight are present, particularly in boys. Only a third of boys and girls engage in sufficient physical activity. Differences were shown in the study group, where groups with higher BMI values had lower values of physical activity. Subsequently, a relationship was shown between those who use their bicycle as a means of transport and spend their leisure time bicycling at the same time. More than two-thirds of the study subjects reported using a bicycle as a means of transport and using their bicycle in their leisure time as a means of being active; 93% of these subjects had normal body weight. Our results confirm the continued pandemic prevalence of obesity and indicate that appropriate physical activity should be included in the everyday life of children both at school and outside of school.

Nutritional Transition and Associated Epidemiological Transition in India

Overnutrition and associated health risks are no longer confined to high-income countries and have now become an emerging problem among the low- and middle-income countries. In India, overweight and obesity prevalence has doubled amongst men and has become more than one and a half times amongst women over a ten-year period, 2005 – 2015. The increase in overnutrition at state level is even more striking, with some states experiencing more than 100% increase in the prevalence of overweight and obesity during the above period. Overnutrition is linked to increase in the health burden in the form of rise in non-communicable diseases such as diabetes, cardiovascular diseases, heart strokes, certain type of cancers, etc. This article examines the recent trends in overnutrition and prevalence of diabetes in India and analyses the effects of overnutrition on diabetes considering state level data. Our analysis suggests that India is experiencing a nutritional transition with more than 24 states and union territories having higher overnutrition prevalence as compared to undernutrition prevalence. Diabetes has been rising in India, and our empirical analyses finds that a rise in overweight and obesity prevalence adversely affects diabetes prevalence. Important finding is that the marginal effect of a rise in obesity prevalence on diabetes is are more than twice than that for overweight and obesity prevalence suggesting that higher BMI values further elevates the risk of diabetes. These results suggest that the nutritional transition in India is leading to an epidemiological transition.

Update on adrenarche.

Adrenarche is the pubertal maturation of the innermost zone of the adrenal cortex, the zona reticularis. The onset of adrenarche occurs between 6 and 8 years of age when dehydroepiandrosterone sulfate (DHEAS) concentrations increase. This review provides an update on adrenal steroidogenesis and the differential diagnosis of premature development of pubic hair. The complexity of adrenal steroidogenesis has increased with recognition of the alternative 'backdoor pathway' and the 11-oxo-androgens pathways. Traditionally, sulfated steroids such as DHEAS have been considered to be inactive metabolites. Recent data suggest that intracellular sulfated steroids may function as tissue-specific intracrine hormones particularly in the tissues expressing steroid sulfatases such as ovaries, testes, and placenta. The physiologic mechanisms governing the onset of adrenarche remain unclear. To date, no validated regulatory feedback mechanism has been identified for adrenal C19 steroid secretion. Available data indicate that for most children, premature adrenarche is a benign variation of development and a diagnosis of exclusion. Patients with premature adrenarche tend to have higher BMI values. Yet, despite greater knowledge about C19 steroids and zona reticularis function, much remains to be learned about adrenarche.

Nonalcoholic fatty liver disease in women with polycystic ovary syndrome: associated factors and noninvasive fibrosis staging in a single Brazilian center.

Polycystic ovary syndrome (PCOS) is a recognized risk factor for nonalcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence and factors associated with NAFLD in women with PCOS and evaluate noninvasive indices of hepatic fibrosis in patients with PCOS and NAFLD. Patients with PCOS (n = 87) and women without PCOS (n = 40; controls) were included. NAFLD was diagnosed by abdominal ultrasonography after exclusion of alcohol consumption and viral or autoimmune liver disease. Anthropometric, clinical and metabolic variables, homeostasis model assessment of insulin resistance (HOMA-IR) index, lipid accumulation product (LAP), FIB-4 index, NAFLD score, and transient elastography (TE; FibroScan) were obtained in subsets of patients with PCOS and NAFLD. A total of 87 patients with PCOS were included (mean age: 34.4 ± 5.7 years, mean body mass index [BMI]: 34.7 ± 4.7 kg/m 2 ). NAFLD was present in 67 (77.0%) patients with PCOS versus 21 of 40 (52.5%) controls (p = 0.005). Women with PCOS and liver steatosis, compared with their NAFLD-free counterparts, had higher values of BMI, waist circumference, triglycerides, total cholesterol, alanine and aspartate aminotransferases, and γ-glutamyltransferase, along with higher frequencies of obesity, metabolic syndrome, and insulin resistance. NAFLD was independently associated with waist circumference, serum triglycerides, and alanine aminotransferase levels. The FIB-4 index was not compatible with advanced fibrosis in any of the evaluated patients, while NAFLD score and TE were compatible with advanced liver fibrosis in 1 of 26 (3.8%) and 3 of 25 (12%) patients, respectively. Women with PCOS had a high risk of NAFLD, and a combination of both was associated with central obesity, dyslipidemia, insulin resistance, and metabolic syndrome. Noninvasive methods suggested low rates of severe hepatic fibrosis in Brazilian women with PCOS. Arch Endocrinol Metab. 2020;64(3):235-42.

Consumption of sugar-sweetened beverages in patients with established atherosclerosis disease.

This study investigated the association between consumption of sugar-sweetened beverages and anthropometric and biochemical variables in a cross-sectional study conducted with secondary data from the first visit of the randomized clinical trial of the Brazilian Cardioprotective Nutritional Program (BALANCE Program) (2013-2014). Weight, height, waist circumference, lipid profile and fasting glycemia and a 24-hour diet recall were collected. Differences between consumption and non-consumption of sugar-sweetened beverages were evaluated by Student's t-test. The Chi-square test was employed to analyze the association between consumption and non-consumption of sugar-sweetened beverages and biochemical and anthropometric factors. The sample consisted of 2,172 individuals, mostly men (58.5%), elderly (63.6%), C-rated economic class (57.3%), and overweight (62.7%). A statistically significant difference was found between the consumption of sugar-sweetened beverages and higher BMI values (p=0.029), waist circumference (p=0.004) and triglycerides (p=0.023). These results emphasize the need for nutritional intervention regarding the consumption of sugar-sweetened beverages as part of the dietary treatment of this population.