Higher Between Body Mass Index Research Articles

#2652 ANTIPROTEINURIC EFFECT OF SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS IN GLOMERULAR AND SYSTEMIC DISEASES: A REAL-WORLD CLINICAL STUDY

Abstract Background and Aims Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have recently begun to be used in glomerular/systemic autoimmune diseases with glomerular involvement for the treatment of proteinuria, although the information on real-world clinical settings is very scarce. Method Retrospective, observational, international cohort study. Adult patients with biopsy-proven glomerular diseases were included. The main outcome was the percentage reduction in 24-hour proteinuria from SGLT2i initiation to 3, 6, 9, 12 months. Secondary outcomes included percentage proteinuria reduction by type of disease and a reduction of proteinuria ≥30% from SGLT2i initiation. Results The study group consisted of 493 patients with a median age of 55 years. All patients were on renin-angiotensin system blockade. Geometric mean percentage change of proteinuria from baseline was –35%, –41%, –45% and –48% at 3, 6, 9 and 12 months after SGLT2i initiation, respectively. Geometric mean percentage change of eGFR was –6%, –3%, –8%, –10.5% at 3, 6, 9 and 12 months, respectively. Results were similar irrespective of the underlying disease. However, a significant correlation was found between body mass index (BMI) and percentage proteinuria reduction at last follow-up (R = –0.11; p = 0.02). By mixed-effects binomial logistic regression model, serum albumin at the onset of SGLT2i emerged as the main predictor of a ≥30% proteinuria reduction (odds ratio for albumin <3.5 g/dl: 0.53; 95% CI 0.30–0.91; p = 0.02). Finally, a slower eGFR decline over time was observed in patients achieving a ≥30% proteinuria reduction: –3.7 versus –5.3 ml/min/1.73m2/year (p = 0.001). Conclusion The use of SGLT2i was associated with a significant reduction of proteinuria, irrespective of the underlying glomerular/systemic disease. This percentage change was higher in patients with higher BMI. Higher serum albumin at SGLT2i onset is associated with higher probability of achieving a ≥30% proteinuria reduction.

Associations of body mass index, body fat percentage and sarcopenia components with bone health estimated by second-generation high-resolution peripheral quantitative computed tomography in older adults with obesity

PurposeTo investigate associations between body mass index (BMI), body fat percentage, and components of sarcopenia (muscle mass and muscle strength/power), with bone microarchitecture measured by high-resolution peripheral computed tomography (HR-pQCT) in older adults with obesity. MethodsSeventy-four adults aged ≥ 55 years with body fat percentage ≥ 30 % (men) or ≥40 % (women) were included. Fat mass, lean mass and total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD) were measured by dual-energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated as the sum of lean mass in the upper- and lower-limbs. BMI was calculated and participants completed physical function assessments including stair climb power test. Distal tibial bone microarchitecture was assessed using HR-pQCT. Linear regression (β-coefficients and 95 % confidence intervals) analyses were performed with adjustment for confounders including age, sex, smoking status, vitamin D and self-reported moderate to vigorous physical activity. ResultsBMI and ALM/height2 were both positively associated with total hip, femoral neck and lumbar spine aBMD and trabecular bone volume fraction after adjusting for confounders (all p < 0.05). Body fat percentage was not associated with aBMD or any trabecular bone parameters but was negatively associated with cortical area (p < 0.05). Stair climb power (indicating better performance) was positively associated with cortical area and negatively associated with bone failure load (both p < 0.05). ConclusionHigher BMI, ALM/height2 and muscle power were associated with more favourable bone microarchitecture, but higher body fat percentage was negatively associated with cortical bone area. These findings suggest that high BMI may be protective for fractures and that this might be attributable to higher muscle mass and/or forces, while higher relative body fat is not associated with better bone health in older adults with obesity.

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population.

Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association. A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity. Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI. This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

Paradoxical Associations Exist Between BMI Category and Perioperative Complications Following Lower Extremity Arterial Bypass

Paradoxical Associations Exist Between BMI Category and Perioperative Complications Following Lower Extremity Arterial Bypass

Plasma Amyloid-β Homeostasis Is Associated with Body Mass Index and Weight Loss in People with Overweight and Obesity.

Obesity is linked to a higher incidence of Alzheimer's disease (AD). Studies show that plasma amyloid-β (Aβ) dyshomeostasis, particularly low 42/40 ratio indicates a heightened risk for developing AD. However, the relationship between body mass index (BMI) and circulating plasma Aβ has not been extensively studied. We hypothesized that people with a high BMI have altered plasma Aβ homeostasis compared with people with a lower BMI. We also tested whether reducing BMI by calorie-restriction could normalize plasma concentrations of Aβ. Plasma concentrations of Aβ40, Aβ42, and Aβ42/40 ratio were measured in 106 participants with BMIs classified as lean, overweight, or obese. From this cohort, twelve participants with overweight or obese BMIs entered a 12-week calorie-restriction weight loss program. We then tested whether decreasing BMI affected plasma Aβ concentrations. Plasma Aβ42/40 ratio was 17.54% lower in participants with an obese BMI compared to lean participants (p < 0.0001), and 11.76% lower compared to participants with an overweight BMI (p < 0.0001). The weight loss regimen decreased BMI by an average of 4.02% (p = 0.0005) and was associated with a 6.5% decrease in plasma Aβ40 (p = 0.0425). However, weight loss showed negligible correlations with plasma Aβ40, Aβ42, and Aβ42/40 ratio. Obesity is associated with aberrant plasma Aβ homeostasis which may be associated with an increased risk for AD. Weight loss appears to lower Aβ40, but large-scale longitudinal studies in addition to molecular studies are required to elucidate the underlying mechanisms of how obesity and weight loss influence plasma Aβ homeostasis.

The association of body mass index and its interaction with family history of dyslipidemia towards dyslipidemia in patients with type 2 diabetes: a cross-sectional study in Zhejiang Province, China.

This study aimed to investigate the association between body mass index (BMI) and dyslipidemia and to explore the interaction between BMI and family history of dyslipidemia towards dyslipidemia in patients with type 2 diabetes. This cross-sectional study was conducted between March and November 2018 in Zhejiang Province, China. A total of 1,756 patients with type 2 diabetes were included, physical examination data, fasting blood samples and face-to-face questionnaire survey data were collected. Restricted cubic spline analysis was used to evaluate the association between BMI and the risk of dyslipidemia. Unconditional multivariable logistic regression was used to estimate the interaction between BMI and family history of dyslipidemia towards dyslipidemia. The prevalence of dyslipidemia was 53.7% in the study population. The risk of dyslipidemia elevated with increased BMI value (p for non-linearity <0.05). After adjusting for covariates, individuals with high BMI (≥24 kg/m2) and a family history of dyslipidemia had a 4.50-fold (95% CI: 2.99-6.78) increased risk of dyslipidemia compared to the normal reference group, which was higher than the risk associated with high BMI alone (OR = 1.83, 95% CI: 1.47-2.28) or family history of dyslipidemia alone (OR = 1.79 95% CI: 1.14-2.83). Significant additive interaction between high BMI and a family history of dyslipidemia was detected, with RERI, AP, and SI values of 1.88 (95% CI: 0.17-4.10), 0.42 (95% CI: 0.02-0.62), and 2.16 (95% CI: 1.07-4.37), respectively. However, stratified by status of diabetes control, this additive interaction was only find significant among patients with controlled diabetes. Both high BMI and a family history of dyslipidemia were related with high risk of dyslipidemia. Moreover, there were synergistic interaction between these two factors. Patients with type 2 diabetes who had a family history of dyslipidemia were more susceptible to the negative impact of being overweight or obesity on dyslipidemia.

Metabolically Healthy Obesity Is a Misnomer: Components of the Metabolic Syndrome Linearly Increase with BMI as a Function of Age and Gender.

We aimed to examine the relationships between body mass index (BMI) and metabolic syndrome (MS) components as a function of age and gender across weight categories. This cross-sectional study included 19,328 subjects who participated in a health-screening program. We analyzed 14,093 apparently healthy subjects with a BMI ≥ 18.5 kg/m2 (ranging from 18.5 to 46 kg/m2). At a BMI of 18.5 kg/m2, 16% of subjects had one or more MS components (MS ≥ 1). The number of MS components increased linearly with BMI. The most prevalent components for MS1-4 were hypertension (in men) and increased waist circumference (in women). Among 6391 non-obese subjects with MS = 0, there was a linear increase in blood pressure, glucose, and triglycerides, as well as a decline in high-density lipoprotein cholesterol, as BMI increased. In 2087 subjects with a BMI ≥ 30 kg/m2, a true normometabolic state (MS = 0) was observed in only 7.5%, declining to less than 1% at a BMI ≥ 36 kg/m2 (ATP criteria). Women were metabolically protected relative to men between the ages of 30 and 50 years. (A) MS components increase linearly with BMI from the lowest normal BMI and continue to increase with age and BMI; (B) metabolically healthy obesity is rare in subjects with a high BMI and declines with age; (C) hypertension is the most common component in men; and (D) in women, MS components are seen at older ages than in men for the same BMI. Metabolic health declines with age and BMI in nearly all subjects with obesity.

Body mass index and its association with COVID-19 clinico-neurological outcomes: Findings from the Philippine CORONA study (P5-10.005)

<h3>Objective:</h3> To explore the association between body mass index (BMI) and clinico-neurological outcomes in a large cohort of patients with coronavirus disease 2019 (COVID-19). <h3>Background:</h3> We hypothesize that either abnormally low or high BMI significantly affects clinical and neurologic outcome measures in this subset of patients. <h3>Design/Methods:</h3> This is a secondary analysis of a 37-site, nationwide, multicenter, retrospective cohort study that investigated the clinical and neurological outcomes of adult patients with confirmed COVID-19 admitted from February to December 15, 2020. <h3>Results:</h3> We analyzed 4,463 patients with BMI and outcome data. A total of 790 (17.7%) and 710 (15.9%) had the primary outcome of in-hospital mortality and need for invasive mechanical ventilation (IMV), respectively. There was no significant association between WHO BMI groups and these outcomes. Using Asia-Pacific cutoffs showed a significant association between obesity and in-hospital mortality risk (P = 0.012). Being underweight was an independent predictor of prolonged IMV requirement regardless of BMI criteria used (P &lt; 0.01). Obesity correlated with the need for intensive care unit admission using Asia-Pacific cutoffs (P = 0.029). There was a significant association between any BMI abnormality and odds of severe/critical COVID-19 (P &lt; 0.05). Obese patients with concomitant acute neurological presentation/diagnosis during their COVID-19 admission were shown to have lower odds of neurologic recovery (P &lt; 0.05). <h3>Conclusions:</h3> We found BMI abnormalities to be associated with several adverse clinical and neurologic outcomes, although such associations may be more evident with the use of race-specific BMI criteria. <b>Disclosure:</b> Dr. Espiritu has nothing to disclose. Dr. Reyes has nothing to disclose. Carl Froilan Leochico has nothing to disclose. Marie Charmaine Sy has nothing to disclose. Emilio Villanueva III has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LabX Corporation. Michelle Anlacan has received personal compensation in the range of $0-$499 for serving as a Consultant for Torrent Philippines. Michelle Anlacan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Medichem Philippines. Michelle Anlacan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Hi Eisai Philippines. Michelle Anlacan has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Natrapharm Philippines. Michelle Anlacan has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Alzheimer’s disease association of the philippines. Michelle Anlacan has received research support from Philippine Council for Health Research and Development. Michelle Anlacan has received research support from Philippine Neurological Association. Roland Dominic Jamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for torrent. Roland Dominic Jamora has received research support from CCXDP.

Association of Body Mass Index with Insulin-like Growth Factor-1 Levels among 3227 Chinese Children Aged 2–18 Years

Insulin-like growth factor-1 (IGF-1) levels are affected by nutritional status, yet there is limited research exploring the association between body mass index (BMI) and IGF-1 levels among children. This cross-sectional study included 3227 children aged 2-18 years without specific diseases, whose height, weight, and pubertal stages were measured and assessed by pediatricians. BMI standard deviation scores (BMISDS) were used to categorize children as underweight (BMISDS < -2); normal-weight (-2 ≤ BMISDS ≤ 1); overweight (1 < BMISDS ≤ 2); and obese (BMISDS > 2). Children were divided into low-level (<-0.67 SD) and nonlow-level (≥-0.67 SD) groups based on IGF-1 standard deviation scores (IGF-1SDS). The association between IGF-1 and BMI as categorical and continuous variables was explored by Binary logistic regression, the restrictive cubic spline model, and the generalized additive model. Models were adjusted by height and pubertal development. Recursive algorithm and multivariate piecewise linear regression were further utilized to assess the threshold of the smooth curve. IGF-1 levels varied by BMI categories, with the highest levels observed in the overweight group. The proportion of low IGF-1 levels in underweight, normal-weight, overweight, and obese groups was 32.1%, 14.2%, 8.4%, and 6.5%, respectively. The risk odds of low IGF-1 levels in underweight children were 2.86-, 2.20-, and 2.25-fold higher than in children with normal weight before adjustment, after adjustment for height, and after adjustment for height and puberty, respectively. When analyzing the association between BMI and low IGF-1 levels, dose-response analysis demonstrated an inverted J-shaped relationship between BMISDS and low IGF-1 levels. Lower or higher BMISDS increased the odds of low IGF-1 levels, and significance was retained in underweight children but not in obese children. When BMI and IGF-1 levels were used as continuous variables, the relationship between the BMISDS and IGF-1SDS followed a nonlinear inverted U shape. IGF-1SDS increased with the increase of BMISDS (β = 0.174, 95% CI: 0.141 to 0.208, p < 0.01) when BMISDS was less than 1.71 standard deviation (SD) and decreased with the increase of BMISDS (β = -0.358, 95% CI: -0.474 to -0.241, p < 0.01) when BMISDS was greater than 1.71 SD. The relationship between BMI and IGF-1 levels was found to depend on the type of variable, and extremely low or high BMI values could result in a tendency toward low IGF-1 levels, emphasizing the importance of maintaining a normal BMI range for normal IGF-1 levels.

Increasing obesity is associated with lower postoperative bleeding in coronary bypass patients

Despite inherent comorbidities, obese cardiac surgical patients paradoxically had shown lower morbidity and mortality, although the nature of this association is still unclear. Thus, the authors intended in this large registry-based study to investigate the impact of obesity on short- and long-term postoperative outcomes, focusing on bleeding and transfusion requirements. Retrospective registry study. Three university hospitals. A cohort of 12,330 prospectively compiled data from coronary bypass grafting patients undergoing surgery between 2007 to 2020 were retrieved from the Western Denmark Heart Registry. The parameters were analyzed to assess the association between body mass index (BMI) and the selected outcome parameters. The crude data showed a clear statistically significant association in postoperative drainage from 637 (418-1108) mL in underweight patients with BMI <18.5 kg/m2 to 427 (295-620) mL in severely obese patients with BMI ≥40 kg/m2 (p < 0.0001, Kruskal-Wallis). Further, 50.0% of patients with BMI <18.5 received an average of 451 mL/m2 in red blood cell transfusions, compared to 16.7% of patients with BMI >40 receiving 84 mL/m2. The obese groups were less often submitted to reexploration due to bleeding, and fewer received perioperative hemostatics, inotropes, and vasoconstrictors. The crude data showed increasing 30-day and 6-month mortality with lower BMI, whereas the one-year mortality showed a V-shaped pattern, but BMI had no independent impact on mortality in logistic regression analysis. Patients with high BMI may carry protection against postoperative bleeding after cardiac surgery, probably secondary to an inherent hypercoagulable state, whereas underweight patients carry a higher risk of bleeding and worse outcomes.

Comment on: Textbook Outcomes Following Open Live Donor Right Hepatectomy and Open Right Hepatic Lobectomy for Cancer in 686 Patients: Re-Defining the Benchmark.

We read the article by Dogeas et al1 with great interest. This study used a prospective database to compare textbook outcomes (TO) rates between right hepatectomy (RH) for live donor purposes and RH for malignancy. The author found that the TO rates of RH for live donor purposes (92.2%) were significantly higher than that for malignancy (53.7%) and considered that these indicators represented a new benchmark for “real world” TO after open RH. Despite inspiring and thought-provoking, we have the following comments. First, in our experience, in the real world, regardless of the type of hepatectomy, the most common cause is hepatocellular carcinoma. However, among cancer patients in this study, the most common pathology was colorectal cancer liver metastases, accounting for 58.4% (184 patients). This also means that cirrhosis has a very low proportion of cancer patients, only 5.4% (17 patients). In fact, there may be a higher incidence of cirrhosis in all cancer patients who underwent RH. Although cirrhosis was only confirmed as an independent risk factor associated with a lower TO rate of hepatocellular carcinoma hepatectomy in our previous study,2 we still believe that cirrhosis may strongly affect the TO rate in all cases of hepatectomy. Therefore, it is reasonable to wonder whether the TO rate in the tumor patients in this study can be viewed as a new benchmark for the “real world” and whether independent factors associated with not achieving TO can be applied to all RH cancer patients. Second, this study noted that the live donor RH people had higher TO rates, as they were younger, healthier, and thinner, but logistic regression analysis showed no significant association between body mass index (BMI) and TO rates. The study did not mention the grouping method of BMI in the methods section. If BMI is analyzed as a continuous variable, it is likely to obtain negative results that BMI is not related to TO rates. However, high BMI often means that body obesity, while low BMI means body malnutrition or cachexia. Consequently, appropriate BMI grouping may directly determine the results of the study. We wanted to know how the authors analyzed of the association between BMI and TO rates. Third, TO rates were compared between RH for live donor purposes and RH for malignancy in this study. However, direct comparisons between the 2 groups may not be statistically appropriate due to the large difference between the 2 groups. Therefore, we believe that some statistical methods, such as propensity score matching or inverse probability of treatment weighting, should be used first to balance the baseline data between the 2 groups, perhaps to make the 2 groups more comparable. Although balancing may not have changed the final results of this study, we still believe that balancing the baselines of the 2 groups and then comparing them can make the results of this study more solid. Finally, we are still very appreciative of Dogeas et al1 for the new benchmark for “real world” TO after RH. We hold the belief that these findings will contribute to the further improvement and development of liver surgery.

Longitudinal metabolomics of increasing body-mass index and waist-hip ratio reveals two dynamic patterns of obesity pandemic

Background/ObjectiveThis observational study dissects the complex temporal associations between body-mass index (BMI), waist-hip ratio (WHR) and circulating metabolomics using a combination of longitudinal and cross-sectional population-based datasets and new systems epidemiology tools.Subjects/MethodsFirstly, a data-driven subgrouping algorithm was employed to simplify high-dimensional metabolic profiling data into a single categorical variable: a self-organizing map (SOM) was created from 174 metabolic measures from cross-sectional surveys (FINRISK, n = 9708, ages 25–74) and a birth cohort (NFBC1966, n = 3117, age 31 at baseline, age 46 at follow-up) and an expert committee defined four subgroups of individuals based on visual inspection of the SOM. Secondly, the subgroups were compared regarding BMI and WHR trajectories in an independent longitudinal dataset: participants of the Young Finns Study (YFS, n = 1286, ages 24–39 at baseline, 10 years follow-up, three visits) were categorized into the four subgroups and subgroup-specific age-dependent trajectories of BMI, WHR and metabolic measures were modelled by linear regression.ResultsThe four subgroups were characterised at age 39 by high BMI, WHR and dyslipidemia (designated TG-rich); low BMI, WHR and favourable lipids (TG-poor); low lipids in general (Low lipid) and high low-density-lipoprotein cholesterol (High LDL-C). Trajectory modelling of the YFS dataset revealed a dynamic BMI divergence pattern: despite overlapping starting points at age 24, the subgroups diverged in BMI, fasting insulin (three-fold difference at age 49 between TG-rich and TG-poor) and insulin-associated measures such as triglyceride-cholesterol ratio. Trajectories also revealed a WHR progression pattern: despite different starting points at the age of 24 in WHR, LDL-C and cholesterol-associated measures, all subgroups exhibited similar rates of change in these measures, i.e. WHR progression was uniform regardless of the cross-sectional metabolic profile.ConclusionsAge-associated weight variation in adults between 24 and 49 manifests as temporal divergence in BMI and uniform progression of WHR across metabolic health strata.

Association between body mass index (BMI) and severity of coronary artery disease in young onset acute coronary syndrome (ACS)

Abstract Funding Acknowledgements Type of funding sources: None. Background A high body mass index (BMI) is seems to be associated with an increased incidence of coronary artery disease. If the affected person is young, the consequences are more tragic. There are variable information on the relation of incidence and severity of coronary artery disease in high BMI populations. We have examined the association between BMI and severity of coronary artery disease in young onset Acute Coronary Syndrome (ACS). Methods In this prospective observational study a total number of 150 patients, aged ≤45 years presented with acute coronary syndrome were enrolled to analyze association between Body Mass Index (BMI) and severity of coronary artery disease. Results The mean BMI in male was 24.6±3.6 and the mean BMI in female was 25.4±3.3. Among the 150 patients, 2(1.3%) was underweight, 78(52%) was normal, 60(40%) was overweight &amp; 10(6.7%) was obese. All underweighted patients were diagnosed as STEMI. Among the normal BMI patients, 18(23.1%) had UA, 12(15.4%) had NSTEMI &amp; 48 (61.5%) had STEMI. Among the overweight patients, 23(38.3%) had UA, 9(15%) had NSTEMI &amp; 28(46.7%) had STEMI. And among the obese patients, 4(40%) had UA, 1 (10%) had NSTEMI &amp; 5(50%) had STEMI. Considering involving coronary artery, left main coronary artery involvement was 0(0%), 6 (7.7%), 5 (8.3%) &amp; 0(0%) in underweight, normal, overweight &amp; obese patients respectively. Left anterior descending coronary artery involvement was 2(100%), 54 (69%), 45 (75%) &amp; 7 (70%) in underweight, normal, overweight &amp; obese patients respectively. Left circumflex coronary artery involvement was 1(50%), 33 (42%), 25 (41.7%) &amp; 1 (9%) in underweight, normal, overweight &amp; obese patients respectively. And right coronary artery involvement was 1(50%), 35 (44.9%), 31 (51.7%) &amp; 5 (50%) in underweight, normal, overweight &amp; obese patients respectively. In underweight patients 1(50%) had SVD and 1 (50%) had TVD. In normal BMI patients 40 (51.3%) had SVD, 11(14.1%) had DVD and 19 (24.4%) had TVD. In overweight patients 27 (45%) had SVD, 15 (25%) had DVD and 13 (21.7%) had TVD. And in obese patients 5 (50%) had SVD, 3(30%) had DVD and 0 (0%) had TVD. In all BMI group SVD was more common. Conclusion There is no statistically significant differences in severity of coronary artery in respect to body mass index (BMI), in patients presented with acute coronary syndrome.

Mental health in children and adolescents with overweight or obesity

BackgroundOverweight and obesity represent huge concerns for children's physical and mental well-being. This study examined the relationship between body mass index (BMI) and health-related quality of life (HRQoL), somatoform complaints, and behavioral problems in children and adolescents. Additionally, the influence of sex, age, and socioeconomic status (SES) on these associations was considered.MethodsIn total, we studied 2350 participants between the ages of 4 and 18 years (1213 4- to 10-years-old (child sample) and 1137 11-to 18-year-olds (adolescent sample)). To assess HRQoL, somatoform complaints, and behavioral difficulties, we applied the KIDSCREEN-27, a short form of the Giessen Complaints Questionnaire, and the Strengths and Difficulties Questionnaire (SDQ). The BMI was transformed to BMI standard deviation scores (BMI-SDS), according to German gender- and age-specific reference data. Associations were investigated using linear regression analyses. Each association was checked for interaction with sex, age, and SES.ResultsRegarding HRQoL, we found worsening scores in physical well-being and psychological well-being with increasing BMI-SDS. Somatoform complaints were not significantly associated with BMI-SDS. Conduct problems, peer relationship problems, and emotional problems (the latter only in the adolescent sample) were positively associated with BMI-SDS. While we did not observe any significant interactions with sex, we found some significant interactions with age and/or SES.ConclusionOur findings highlight the importance of mental difficulties in children and adolescents with higher BMI and, consequently, underline the relevance of including psychological interventions in the treatment of overweight or obesity.

Selected Articles from This Issue

Shoushtari and colleagues report a pilot trial of ONCOS-102, a novel oncolytic adenovirus encoding GM-CSF, administered intratumorally either sequentially or in combination with pembrolizumab in patients with melanoma resistant to prior PD-1 blockade. Treatment was well tolerated. Objective responses were seen in 7 of 20 patients, and size reductions in noninjected lesions suggested local delivery of ONCOS-102 can drive a systemic anti-tumor effect. Serial biopsies of injected tumors at baseline, Week 3 (following ONCOS-102 and prior to pembrolizumab), and Week 9 (following ONCOS-102 and pembrolizumab) indicated that while most tumors experience CD8+ and CD4+ infiltration after ONCOS-102 injection, sustained infiltration at Week 9 was associated with clinical benefit. Future trials of ONCOS-102 and checkpoint inhibition are warranted in anti-PD-1-resistant melanoma. These findings suggest trials using viral agents in anti-PD-1-resistant disease should not solely rely on early onset of cytotoxicity to predict clinical response.Wainberg and colleagues report on the combination of very low doses of chemotherapy (10% of the usual dose) with a full dose of talazoparib (TAL). The study design reports preferentially increasing the dose of TAL before increasing the chemotherapy to improve the hematologic profile as well as exploring efficacy signals among non-BRCA patients. This phase I study demonstrates that TAL with low-dose temozolomide or irinotecan shows an improved hematologic toxicity profile than most prior chemo/PARP inhibitor combinations and has signals of clinical activity in small cell lung cancer and ovarian cancer. The results of this phase I study are supportive of ongoing trials with this combination.Obesity has been unexpectedly associated with improved outcomes with immune checkpoint inhibitors and BRAF-targeted therapies in metastatic melanoma; however, the biology underlying this observation is unknown. Hahn and colleagues examined associations between body mass index (BMI) and molecular, immune, and metabolic features of melanoma tumors as well as host microbiome in 782 patient specimens. Host BMI was associated with altered tumor metabolism, with downregulation of oxidative phosphorylation (OXPHOS) and other metabolic pathways in tumors from high BMI patients. OXPHOS has been associated with resistance to targeted and immune therapies, suggesting a potential mechanism underlying the “obesity paradox” in metastatic melanoma.Circulating tumor DNA (ctDNA) levels are associated with tumor volume and minimal residual disease in lymphoid malignancies. Fernández-Miranda and colleagues suggest that pre-treatment ctDNA levels in follicular lymphoma patients could be useful to predict response to treatment and early progression as an independent predictive biomarker or in combination with clinical variables. Circulating tumor DNA levels and cell-free DNA genotyping at mid-treatment and end-of-treatment are associated with treatment response and early progression follicular lymphoma. Circulating tumor DNA measurement at diagnosis and follow-up is a valuable tool that might feasibly be used in clinical trials and, eventually, in daily clinical practice.

Association of BMI with Semen Parameters in the Male Partners of Infertile Couples: A Cross-sectional Study

Introduction: In today’s scenario, obesity is increasing in children and young adolescents, and they are more likely to continue as obese adults. Temporal trends indicate that obesity is increasing while fertility is decreasing. Studies worldwide have reported a negative association between obesity and male fertility, but studies from India are scarce. Hence, there is a need to study the extent of the association between obesity and infertility. Aim: To evaluate the association between Body Mass Index (BMI) and semen parameters in the male partners of infertile couples. Materials and Methods: A cross-sectional study was conducted in the Department of Physiology, Government Medical College Aurangabad, Maharashtra, India, from August 2021 to August 2022. On total of 66 participants divided into two groups: Group A consisted of overweight and obese participants (BMI ≥23.0 kg/m2 ), and Group B consisted of participants with normal BMI (BMI &lt;23 kg/m2 ). The semen parameters studied were semen volume, sperm concentration, total sperm count, total motility, and progressive motility. Semen samples were analysed according to the WHO 2010 guidelines. Continuous variables were expressed as mean±standard deviation. Unpaired t-test was used to compare the groups. Results: The mean age in Group A and Group B was 30.18±4.5 and 28.27±4.35 years, respectively (p&lt;0.08). The mean BMI in Group A and Group B was 27.01±2.94 kg/m2 and 20.29±1.69 kg/m2 , respectively (p&lt;0.0001). The mean sperm concentration in Group A was 37.01±42.6 million, and in Group B, it was 90.24±56.11 million (p&lt;0.0001). Total motility in Group A was 27.8±31.36%, and in Group B, it was 57.9±28.41% (p&lt;0.0001). Progressive motility in Group A was 18.75±24.79%, and in Group B, it was 42.63±26.15% (p&lt;0.0003). Conclusion: In the present study, high BMI (obesity and overweight) was significantly associated with low sperm concentration, count, and motility

Association between BMI and Intraoperative Time and Length of Hospital Stay among Patients undergoing Laparoscopic Colorectal Surgery: A Retrospective Study

Introduction: Now-a-days, most surgeons are aware that obese patients face more difficulties during laparoscopic colorectal surgery compared to non obese patients, especially with the prevalence of advanced laparoscopic procedures. Aim: To investigate the association between Body Mass Index (BMI) and operative time, as well as the length of hospital stay after laparoscopic colorectal surgery. Materials and Methods: A retrospective observational study was conducted at Sri Guru Ram Das (SGRD) Charitable Hospital in Amritsar, Punjab, India, from January 2016 to January 2019. The study included 139 patients who underwent laparoscopic colorectal surgery. The dataset consisted of four variables: BMI (continuous), intraoperative time (continuous), diagnosis (nominal, including various diseases such as Crohn’s disease, colon cancer, ulcerative colitis, and diverticulitis), and length of stay (dichotomous, categorised as “yes” if the total length of stay in the hospital was greater than three days, and “no” if it was three days or under). Mean and standard deviations were calculated for both BMI and intraoperative time. The Pearson’s r correlation test was used to assess the association between BMI and intraoperative time. Results: A total of 139 patients were included in the study, with 72 (51.80%) having a length of stay less than three days and 67 (48.20%) having a length of stay greater than three days. Higher BMI was found to be associated with a prolonged length of stay (&gt;three days) in the hospital following colorectal surgery, with a p-value of 0.007. However, the study did not find a statistically significant association between BMI and intraoperative time, with a p-value of 0.1795. Conclusion: Obese patients tend to spend a longer time in the hospital compared to non obese patients. Therefore, caution should be exercised when performing elective laparoscopic procedures on obese patients.

Age, Sex, Metabolic and Pharmacologic Factors May Predict Nonresponse Status to Rheumatoid Arthritis Therapies.

A real challenge for patients with rheumatoid arthritis (RA) and rheumatologists is primary nonresponse status (PNRS) or secondary nonresponse status (SNRS) to various therapies. Despite their detrimental influence on patient life quality, PNRS and SNRS have no accurate definition and no early predictive criteria for their development exist. Patients with RA under 40 years of age are rare, hence PNRS and SNRS data for this age group are scarce. This study examined the PNRS and SNRS according to sex, age, BMI, therapy type, and duration. Retrospectively, 115 patients with RA having PNRS and/or SNRS were stratified by age (22-39, 40-59, and 60-81). The association between body mass index (BMI), proinflammatory cytokines inhibitors, JAK inhibitors, and TNF-alpha inhibitors, sex, age, and PNRS and SNRS was examined. All three proinflammatory cytokine inhibitors (rituximab, tocilizumab, and abatacept) were associated with PNRS and SNRS in women with a high BMI aged 40-59 years. Abatacept-related PNRS and SNRS was significant in women with normal BMI aged 60-81 years. Adalimumab, infliximab, and golimumab affected SNRS differently in women with normal BMI aged 22-39 years and women with high BMI aged 60-81 years. Etanercept and infliximab were associated with SNRS status in men with high-BMI aged 40-59 years. PNRS and SNRS development in patients with RA is significantly influenced by age, sex, and BMI, but most importantly is closely and differentially related to therapy type and duration.

Omega-3 supplementation increases omega-3 fatty acids in lipid compartments that can be taken up by the brain independent of APOE genotype status: A secondary analysis from a randomised controlled trial1

BACKGROUND: Omega-3 fatty acid (OM3) intake is associated with a lower risk of developing Alzheimer’s disease, but individuals carrying the ɛ4 allele of apolipoprotein E (APOE4) might not benefit from this prevention strategy. Indeed, they might have lower OM3 into plasma free fatty acid (FFA) and lysophosphatidylcholine (LPC) compartments, the two forms the brain can take-in. OBJECTIVE: To evaluate the docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) concentrations in the FFA and LPC pre- and post-OM3 supplementation in APOE4 carriers and non-carriers. DESIGN: Plasma samples from 25 APOE4 carriers and non-carriers before and six months after receiving 2.5 g/d DHA+EPA daily were analyzed. DHA and EPA concentrations in the LPC, and FFA were compared by supplementation and genotype. A secondary analysis investigated the interaction between body mass index (BMI) and APOE genotype status. RESULTS: There was no genotype x supplement interaction nor a genotype effect on LPC and FFA. However, there was a supplement effect where OM3 increased in all lipid compartment by &lt; 1-fold to 4-fold. Individuals with a low BMI had higher OM3 increase concentrations in the LPC than those with a high BMI. CONCLUSIONS: APOE4 carriers and non-carriers can both benefit from taking an OM3 supplement. However, individuals with a high BMI have lower OM3 increases than those with a lower BMI.

Body mass index as a predictor of the severity of coronavirus infection in patients with cardiovascular pathology

Aim. To investigate the association between body mass index (BMI) and the severity of COVID-19, respiratory failure, and fatal outcome in patients with cardiovascular disease.Materials and Methods. The study included 283 patients with confirmed COVID-19. COVID-19 severity was determined according to the Russian National Guidelines for the Prevention, Diagnostics, and Treatment of COVID-19. The degree of respiratory failure was defined according to the oxygen saturation. BMI was determined by the Quetelet's index, whereas overweight and obesity were diagnosed in accordance with the World Health Organization classification.Results. Comparison of BMI in patients with mild, moderate, and severe COVID-19 did not show statistically signifi differences, although patients with overweight and obesity had a higher frequency of respiratory failure. Further, grade 3 (severe) respiratory failure had average BMI of 28.7 kg/m2 (men) and 34.2 kg/m2 (women), while those with grade 1 (mild) respiratory failure had average BMI of 26.1 kg/m2 (men) and 31.2 kg/m2 (women). In keeping with these fi patients with a fatal outcome had higher BMI than those with a favorable outcome (31.1 kg/m2 and 27.2 kg/m2, respectively). After an adjustment for the chronic heart failure, BMI between the patients with a fatal and favourable outcome remained different (28.4 kg/m2 and 26.3 kg/m2, respectively). Logistic regression analysis showed that BMI itself had low prognostic signifi yet is became higher if combined with a COVID-19 severity and degree of respiratory failure.Conclusion. Patients with a high BMI are more likely to have a severe respiratory failure and fatal outcome. Therefore, this parameter can be used as an additional factor for the risk stratification.