Higher Body Mass Index Levels Research Articles

Obesity around Retirement Age: International Comparison Using SHARE

Abstract In this article, we aim to explain international differences in socio-demographic structure of population among people around retirement age. We further test if transition into retirement is an important factor for obesity. Using Survey of Health, Ageing and Retirement in Europe (SHARE) data, we first document that the Czech Republic has a significant and increasing trend in body mass index (BMI) and obesity (BMI > 29.99) for both men and women aged 50–70 years compared to other countries. Men have much higher level of BMI in comparison to many other European countries, whereas BMI of women is comparable to Estonia and Slovenia. However, we show a little evidence that underlying structure of Czech population with respect to education, occupation, health, age, and so on may explain increasing trend as well as higher level of obesity when compared to other European countries. Furthermore, we show that the transition into retirement is not associated with an increase in BMI. Using fixed effect model, we found that the obesity is directly related to increasing trend in obesity already before entering the retirement.

The Early Results of the Laparoscopic Mini-Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index.

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients' BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (Conclusion Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.

Mitochondrial DNA Copy-Number Variation and Pancreatic Cancer Risk in the Prospective EPIC Cohort.

Mitochondrial DNA (mtDNA) copy number in peripheral blood has been found to be associated with risk of developing several cancers. However, data on pancreatic ductal adenocarcinoma (PDAC) are very limited. To further our knowledge on this topic, we measured relative mtDNA copy number by a quantitative real-time PCR assay in peripheral leukocyte samples of 476 PDAC cases and 357 controls nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. We observed lower mtDNA copy number with advancing age (P = 6.54 × 10-5) and with a high body mass index (BMI) level (P = 0.004) and no association with sex, smoking behavior, and alcohol consumption. We found an association between increased mtDNA copy number and decreased risk of developing PDAC with an odds ratios (OR) of 0.35 [95% confidence interval (CI), 0.16-0.79; P = 0.01] when comparing the fifth quintile with the first using an unconditional logistic regression and an OR of 0.19 (95% CI, 0.07-0.52; P = 0.001) with a conditional analysis. Analyses stratified by BMI showed an association between high mtDNA copy number and decreased risk in the stratum of normal weight, consistent with the main analyses. Our results suggest a protective effect of a higher number of mitochondria, measured in peripheral blood leukocytes, on PDAC risk. Our findings highlight the importance of understanding the mitochondrial biology in pancreatic cancer.

The Incidence and Risk Factors of Non-Alcoholic Fatty Liver Disease: A Cohort Study from Iran

Background: Non-alcoholic fatty liver disease (NAFLD) is a condition with a global prevalence of 24%. A broad spectrum of liver complications has been attributed to this condition. Objectives: This study was conducted to determine the incidence of NAFLD and its potential risk factors in a seven-year follow-up study in Iran. Methods: This is a prospective cohort population-based study conducted in the northern region of Iran. In phase I of the cohort study, 2,461 participants were selected, between 2009 and 2010, using the stratified randomization method based on the sex and age of individuals. Ultrasonographic examination was performed again after a seven-year follow-up between 2016 and 2017. The multiple binary regression analysis was applied to evaluate the association between the development of NAFLD and potential risk factors. Results: The incidence of NAFLD was 27.88% (95% CI: 25.41% - 30.35%) in men and 30.17% (95% CI: 27.40% - 32.94%) in women (P = 0.226) in a seven-year follow-up period. Based on the multiple binary logistic regression analysis, body mass index (BMI) [OR = 1.219 (95% CI: 1.162 - 1.278) P < 0.001], triglyceride (TG) [OR = 1.003 (95% CI: 1.001 - 1.005); P = 0.005] and high-density lipoprotein (HDL) [OR = 0.986 (95% CI: 0.972 - 0.999); P = 0.046] showed a significant association with the incidence of NAFLD in men. In contrast, the marital status [OR = 2.141 (95% CI: 1.286 - 3.565); P = 0.003], BMI [OR = 1.165 (95% CI: 1.121 - 1.211); P < 0.001] and homeostatic model assessment for insulin resistance (HOMA-IR) [OR = 1.164 (95% CI: 1.041 - 1.301); P = 0.007] had a significant relationship with the incidence of NAFLD in women. Conclusions: It seems that NAFLD is markedly rising in the northern part of Iran. Higher levels of BMI, TG, and HDL are considered independent risk factors for the development of NAFLD in men, while the marital status, BMI, and HOMA-IR exhibited independent risk factors with the incidence of NAFLD in women.

A systematic review on influencing factors of nutritional status in patients with head and neck cancer

Objective To systematically review the influencing factors of nutritional status in patients with head and neck cancer (HNC) . Methods Researches on influencing factors of nutritional status in HNC patients were retrieved in databases, such as PubMed, EBSCO, Web of Science, CNKI, WanFang Data and Chinese Biological Medicine (CBM) by computer from January 2010 to July 2018. Quality assessment, content extract and analysis was carried out for literatures met inclusive criteria. Results Finally, a total of 19 researches were included.Qualitative analysis and simple correlation showed that those researches involved 47 factors, the influencing factors of nutritional status included the reduced ingestion, high levels of weight and body mass index (BMI) before treatment, low levels of hemoglobin and serum albumin, swallowing problem, thirst, sense problem, constipation and oral mucositis; 23 factors of them were with varying degrees of influence, such as the ages, males, education levels and drinking. Multivariate analysis showed that those researches involved 35 factors; the influencing factors of nutritional status of HNC patients included the radiotherapy types/technology and swallowing problem; 17 factors of them were with varying degrees of influence, such as the ages, habitation and smoking. In simple correlation and multivariate analysis, swallowing problem was the only factor with statistical differences in two kinds of analysis; the ages, tumor stage, tumor location/kinds of disease, grades of T and N, complications after radiotherapy and adverse reactions were only with statistical differences in simple correlation but without statistical differences in multivariate analysis. Conclusions Nutritional status of HNC patients is influenced by many factors and influence of most factors is uncertain with great individual differences. Influencing factors of nutritional status of HNC patients and mechanisms need to be explored and expounded respectively by further studies, especially pay attention to swallowing problem of HNC patients. Key words: Head and neck neoplasms; Nutrition; Influencing factors; Systematic review

Objectively Measured Physical Activity and Its Association with Functional Independence, Quality of Life and In-Hospital Course of Recovery in Elderly Patients with Proximal Femur Fractures: A Prospective Cohort Study.

Background Physical activity in elderly patients is crucial for recovery from proximal femoral fractures. Considering the limited possibilities for objective measurement, we aimed to evaluate the use of an accelerometer in this population to determine activity's association with functional independence, quality of life, and course of recovery. Methods 52 patients undergoing operative treatment for proximal femur fractures (81.3 ± 7.5 years) were included in a prospective cohort study. 12 patients with fall but without fracture of the lower extremities (80.8 ± 9.5 years) served as control. An Axivity AX3 tracker continuously recorded signal vector magnitudes during the hospital stay. Additionally, 2 ± 1 and 8 ± 3 days (time point 1 and 2) after operation EuroQol-5D and Barthel-20 indices were evaluated. Results Physical activity increased in all patients with time. Multiple regression analyses revealed that a high Barthel-20 before fracture, a low age, a high body mass index, high albumin, and low C-reactive protein levels were independent predictors for high physical activity at time point 1 (p < 0.05). Physical activity correlated significantly with EuroQol-5D and Barthel-20 at time point 1 and 2 (p < 0.02). Furthermore, physical activity at time point 1 predicted EuroQol-5D, physical activity, and Barthel-20 at time point 2 (p < 0.01). A multiple regression demonstrated equal physical activity in patients with or without a hip fracture. Conclusions Accelerometer signals correlate with postoperative physical activity, Barthel-20 and quality of life in elderly patients. Physical activity is thereby positively influenced by a high prefall functional independence and a good nutrition status. A timely and adequate operation provided, there is no difference between patients with or without a fracture. This trial is registered with DRKS 00011934 on 10th April 2017.

The impact of body mass index and number of antihypertensive medications on clinical management of hypertension in primary health care

Introduction: Hypertension (HTN) is an extremely common disease and its prevalence is increasing globally. The association between obesity and HTN is not yet fully understood, insulin resistance and renal dysfunction are said to be the main causes of obesity-related HTN. This study explored the effect of obesity and different number of medications on blood pressure (BP) control in patients with HTN. Methods: This was a retrospective study conducted in the outpatient primary care clinic at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Results: A total of 286 patients were included in the study with an average weight of 80.6 kg and an average body mass index (BMI) of 32.2. Only 63% of the participants had controlled BP. There was a trend toward better controlled BP levels among male participants (67.1%) compared with females (57.7%) and among those with higher BMI levels, P = 0.099 and 0.094, respectively. Patients receiving two antihypertensive medications were more likely to have their BP controlled compared to those receiving four medications (odds ratio [95% confidence interval] =2.62 [1.32, 5.20]; P = 0.006). Conclusion: Uncontrolled BP was not associated with BMI. Taking two antihypertensive medications was associated with more BP control than monotherapy or combination of therapy with three drugs or more.

Effect of Urbanization, Sedentary Lifestyle and Consumption Pattern on Obesity: An Evidence From India

Once associated with the high-income countries, overweight and obesity has now become an emerging problem among the low- and middle-income countries. Overweight and obesity prevalence in India has almost doubled during the last decade (2005-15). Amongst all the factors that may lead to overweight and obesity, calorie-intense food consumption and low physical activity levels are major two factors which are associated with the rise in overnutrition problem. The consumption patterns and sedentary lifestyle among the urban areas make the urban population more susceptible to overweight and obesity. Present study estimates the causal impact of urbanization on the Body Mass Index (BMI) of the population in India. Living in urban areas is likely to be correlated with the omitted or unobserved lifestyle related factors that determine BMI of individuals. This may lead to potential endogeneity in the relationship between the BMI of individuals and their place of residence in the form of Omitted Variable Bias. To examine the effect of living in urban areas on the BMI levels of individuals, we estimate a Two-Stage Least Squares (2SLS) model with instrument variable. A measure of road connectivity is used as an instrument for the place of residence. Further, to understand other potential factors that may govern the overweight and obesity status of individuals, we examine the effects of sedentary lifestyle and consumption pattern on the overweight and obesity status of the individuals by estimating a logistic regression model. The study considers individual level data from National Family Health Survey (NFHS) for the year 2015-16. The results suggest that living in urban areas is associated with higher levels of BMI. The coefficient estimate of the urban residence for the IV-model is considerably higher as compared to the corresponding OLS estimate indicating that time variant omitted variables downwardly biased OLS estimates. Average BMI is found to be 1.7 kg/m2 units higher for the individuals living in the urban areas as compared to those living in the rural areas. Results obtained from estimation of a logistic regression model suggest that sedentary lifestyle increases the likelihood of being overweight or obese. More frequent television watching is associated with higher odds for being overweight or obese. The study has implications in the policy framing especially in the context of urban planning. To put a restrain on the increasing overnutrition prevalence, it is important to have sufficient evidence on what factors affect overweight and obesity in India, and which section of the population is at a higher risk from overweight and obesity. Our study provides an evidence for such effects. It also has important implications for the health and nutrition policies. Future studies may investigate the effect of improved transportation and easy access of ready-to-eat food on the BMI levels for the urban population of India.

SERUM LIPID PROFILE IN MIDDLE AGED FEMALE PATIENTS WITH CARPAL TUNNEL SYNDROME

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. It is a combination of symptoms and signs caused by the compression of the median nerve as it passes in the carpal tunnel at the wrist. It is an important cause of functional disability, and is the commonest cause of referral to the Electro diagnostic laboratory. CTS is studied extensively. However, its pathophysiology still unclear and most of the cases still idiopathic especially in middle aged women. Objective: To correlate between severity of CTS and abnormality of lipid profile, and to establish the relationship between severity of CTS and age, Body mass index (BMI), in Egyptian middle aged women. Patients and Methods: This study included 155 female cases and controls recruited from the Neurology outpatient clinics of Al-Hussein University Hospital and Al Sahel Teaching Hospital during the period from November 2018 to September 2019, 103 cases with the clinical and neurophysiological diagnosis of idiopathic carpal tunnel syndrome. The study demonstrated the relation between age, lipid profile, BMI and severity of carpal tunnel syndrome in this group of females in comparison to the 52 females as a controls. Results: Age, high BMI, higher cholesterol and LDL levels, were correlated with severity of CTS, while Cholesterol and LDL were much higher among the cases compared to controls. HDL was less in the patients. Conclusion: Abnormal lipid profile, higher BMI, obesity and poor living circumstances could influence the incidence and severity of CTS among middle aged Egyptian women.

SERUM LIPID PROFILE IN MIDDLE AGED FEMALE PATIENTS WITH CARPAL TUNNEL SYNDROME

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. It is a combination of symptoms and signs caused by the compression of the median nerve as it passes in the carpal tunnel at the wrist. It is an important cause of functional disability, and is the commonest cause of referral to the Electro diagnostic laboratory. CTS is studied extensively. However, its pathophysiology still unclear and most of the cases still idiopathic especially in middle aged women. Objective: To correlate between severity of CTS and abnormality of lipid profile, and to establish the relationship between severity of CTS and age, Body mass index (BMI), in Egyptian middle aged women. Patients and Methods: This study included 155 female cases and controls recruited from the Neurology outpatient clinics of Al-Hussein University Hospital and Al Sahel Teaching Hospital during the period from November 2018 to September 2019, 103 cases with the clinical and neurophysiological diagnosis of idiopathic carpal tunnel syndrome. The study demonstrated the relation between age, lipid profile, BMI and severity of carpal tunnel syndrome in this group of females in comparison to the 52 females as a controls. Results: Age, high BMI, higher cholesterol and LDL levels, were correlated with severity of CTS, while Cholesterol and LDL were much higher among the cases compared to controls. HDL was less in the patients. Conclusion: Abnormal lipid profile, higher BMI, obesity and poor living circumstances could influence the incidence and severity of CTS among middle aged Egyptian women.

CLINICAL FEATURES OF TYPE 2 DIABETES DIFFERENT PHENOTYPES

Objective of the study was to investigate clinical features of phenotypic variants of type 2 diabetes mellitus (T2DM) for personalization of hypoglycemic therapy. Material and methods. 2085 patients with T2DM (637 men and 1148 women), mean age 58.7 ± 6.9 years, duration of diabetes 7.8 ± 6.5 years; level of glycated hemoglobin (HbA1c), creatinine, urea, total cholesterol, triglycerides, low (LDL) and high density lipoprotein, uric acid, ALT, AST, insulin, C-peptide, microalbuminuria were examined. Depending on the level of C-peptide and the index of HOMA-IR, patients were divided into 3 groups: group of insulinopenic phenotype ( n = 250, 12 %), group of classical phenotype ( n = 1605, 77 %) and group of hyperinsulinemic phenotype ( n = 230, 11 %). Results . Patients with hyperinsulinemic phenotype differed from patients with classical and insulinopenic phenotype by later age of onset of diabetes (52.3 ± 8.1 years), high body mass index (BMI; 37.2 ± 7.4 kg/m 2 ), blood LDL (3.38 ± 1.08 mmol/l) and creatinine level and frequency of chronic kidney disease (39.1 %). Patients with the insulinopenic phenotype had less diabetes duration (48.3 ± 7.9 years), a lower BMI (31.1 ± 6.3 kg/m 2 ), higher blood glucose and HbA1c level and the frequency of diabetic polyneuropathy. Patients with the classic phenotype had a higher frequency coronary artery disease (20.8 %) compared to other phenotypes. Patients with insulinopenic phenotype on hypoglycemic tablets and patients with hyperinsulinemic phenotype on insulin therapy did not have HbA1c less than 7 %. Conclusions. To personalize therapy, the phenotypic variant of type 2 diabetes should be considered, with a study of the level of C-peptide, insulin and the calculation of the HOMA-IR insulin resistance index to determine the phenotype.

Time spent watching television impacts on body mass index in youth with obesity, but only in those with shortest sleep duration.

To determine the interplay between sleep and sedentary behaviours on body mass index (BMI) in children with obesity. Cross-sectional study of 343 children with obesity aged 4-17 years, from a tertiary care weight management clinic in Melbourne, Victoria, Australia. Multifaceted data relating to activity and sleep from child and parent questionnaires analysed with anthropometric data collected during routine clinical care. Associations between sleep duration and activity measures were examined via regression models with adjustment for potential confounders. Higher BMI was associated with more hours spent watching television (P = 0.04), as well as less reported enjoyment of physical activity (P = 0.005) and less time spent in organised sport activity (P = 0.005). Higher BMI was also associated with higher levels of obstructive sleep apnoea (P = 0.002). Less time in bed was associated with higher levels of BMI (P = 0.03) but analysis by sex revealed this association to only hold for males. In the whole group, a significant television and sleep interaction was seen, such that increasing television watching was associated with higher BMI, but only in those with shortest sleep duration. Both poor sleep and increasing screen time (including television viewing, smart-phone use, internet use or video-gaming) appear to impact BMI in children with obesity, with a particular detrimental effect of television viewing in those who sleep less. Efforts to improve sleep time and quality in children may minimise negative effects of screen time on increasing BMI and should be included in public health strategies to combat obesity in childhood.

Factors Associated With Underestimation of Weight Among Adults Living in Puerto Rico.

The aim of this cross-sectional study was to examine the associations between underestimation of weight and sociodemographic, health, and dietary factors among adults living in a rural community in Puerto Rico. For data collection, a researcher-designed questionnaire was distributed to each household in the area. A multivariable logistic regression was conducted for data analysis. Results revealed that the prevalence of overweight and obesity was 34.4% and 38.7%, respectively. A total of 53.4% of the participants underestimated their weight, most of whom were either overweight or obese. Weight underestimation was associated with being male, age ≥35 years, living below the poverty level estimate, perceiving diet quality as excellent/very good, and consuming fast food ≥1 times/week. In conclusion, overweight/obesity rates were high in this sample, and underestimation of weight was common among people with higher body mass index levels. Future public health interventions targeting obesity in this population should consider self-perception of body weight.

P4537Impact of body composition analysis on prediction of short-term readmission events in heart failure: muscle wasting vs. obesity

Abstract Background Obesity, defined as higher body mass index (BMI), is associated with better prognosis in patients with chronic heart failure (CHF), though the presence of obesity is a risk factor of development of CHF (Obesity paradox). On the other hand, muscle wasting, i.e. reduction in skeletal muscle mass, is frequently observed in CHF, leading to lower exercise capacity and poor cardiovascular outcome. Purpose The aim of this study was to examine whether analysis of body composition improves prediction of short-term readmission rates in patients with CHF. Methods We retrospectively analyzed data for 167 consecutive HF patients who were admitted to our institute for management of HF and received a Dual-energy X-ray absorptiometry (DEXA) scan. Muscle wasting was defined as DEXA-measured appendicular skeletal muscle mass index &lt;7.0 kg/m2 in male and &lt;5.4 kg/m2 in female according to the Asian Working Group for Sarcopenia criteria. Obesity was defined according to the criteria by the use of DEXA-measured percent body fat mass: &gt;25% in male, &gt;30% in female. The primary endpoint was readmission due to cardiac events including worsening heart failure, arrhythmia, and cardiopulmonary arrest during a 180-days follow-up period after discharge. Results The mean age of the patients was 74±13 years and 46% of them were male. The mean BMI was 21.8±3.8 kg/m2. Forty-seven percent of the patients were classified as NYHA functional class III. The most frequent etiology of HF was cardiomyopathy (30%), followed by ischemic heart disease (27%) and valvular heart disease (27%). The prevalence of muscle wasting and that of obesity were 69% and 59%, respectively. Patients with muscle wasting had lower BMI level, higher prevalence of NYHA functional class III and diabetes mellitus compared with those without muscle wasting. On the other hand, patients with obesity had higher prevalence of hypertension and dyslipidemia, higher level of BMI, fasting plasma insulin and triglyceride, and lower level of HDL-cholesterol compared with those without obesity. During the follow-up period, 34 patients (19%) were re-hospitalized due to cardiac events. Kaplan-Meier survival curves showed that patients with obesity had a significantly lower readmission rate during a 180-days follow-up period than did the patients without obesity (14.3% vs. 29.0%, Log-Rank test, p&lt;0.01). There was no difference in readmission rates between patients with and without muscle wasting (20.0% vs. 21.2%, p=0.88). In multivariate Cox regression analyses adjusted for age, sex, diabetes, and renal function, obesity was independently associated with lower readmission rates (hazard ratio 0.45, 95% confidence interval 0.22–0.93). However, the association between obesity and readmission rate was lost after the adjustment for NT-proBNP levels. Conclusion Body composition analysis by DEXA enables to find CHF patients with increased fat mass who have lower risk of short-term readmission.

The different influence of high levels of physical activity on the incidence of knee OA in overweight and obese men and women-a gender specific analysis

To investigate the influence of physical activity on incidence of knee osteoarthritis (OA) in overweight and obese men and women. Data were extracted from the Osteoarthritis Initiative cohort on 1,667 participants without symptomatic knee OA at baseline. We used logistic regression and marginal effect models to estimate the effect of body mass index (BMI) and reported physical activity score, together with the interaction between them, on the development of radiographic knee OA, symptomatic knee OA and joint space narrowing (JSN) after 96-months. Men in the most active quartile had almost double the likelihood of knee OA, independent of OA definition [e.g., odds ratio (OR) 2.4 (95%CI: 1.2-4.5) for radiographic knee OA]. Interaction analyses showed statistically significant interactions between physical activity and BMI on developing knee OA (i) radiographic OA interaction(P=0.039), (ii) symptomatic OA interaction(P=0.022), (iii) JSN interactionP=0.012). The margin plots in men also demonstrated that the effect of physical activity on different measures of knee OA were modified by high levels of BMI. These effects were not mirrored in women where at all BMI levels, the level of reported physical activity did not influence likelihood of knee OA independent of OA definition. In overweight and obese men, there appears to be a threshold above which increasing levels of physical activity are associated with higher risk of knee OA. This is absent in women.

Impact of unhealthy childhood and unfavorable parents' characteristics on adiposity in schoolchildren.

Childhood obesity is encouraged by low physical activity (PA), time spent using screens (screen time, ST), and by sugar-sweetened beverage consumption (SSBc). It is also influenced by unfavorable parents' characteristics, such as a high body mass index (BMI) and low education level (EL). Our aim was to evaluate the overall and specific influence of these factors on childhood adiposity. Anthropometric parameters including BMI z-score, waist circumference (WC), waist to height ratio (WtHR), and fat mass were measured in a cohort of 1702 schoolchildren (6.0-14.5years, mean 10.7±1.8) and questionnaires concerning children's PA, ST, and SSBc, and parent's BMI and EL were administered to parents. Overweight/obesity prevalence was higher (P<.0001) in males (57%) than in females (43%). Less physically active children (28.9%) had a higher prevalence of overweight/obesity and higher BMI z-score, WC, WtHR, and fat mass relative to more physically active children (P<.05). PA was negatively associated with the BMI z-score (r=0.18, P<.0001) and fat mass percentage (r=0.18, P<.0001). Children with more ST had higher WC and WtHR than non-ST viewers (P<.05) but not BMI. Moreover, SSBc did not influence the anthropometric parameters. At multivariate analysis, male gender, less PA, and parental risk factors (parent's overweight/obesity and low/medium EL) were independently associated with overweight and obesity among childhood with a progressively increasing odds ratio (1.65, 1.40, and 1.80, respectively). Male gender, behavioral risk factors (particularly low PA), and parent's characteristics are important correlates of obesity in children.

Associations between serum lipophilic antioxidants levels and non-alcoholic fatty liver disease are moderated by adiposity.

We aimed to evaluate the association between serum lipophilic antioxidants and liver function and prevalent non-alcoholic fatty liver disease (NAFLD). The Nutrition and Health Examination Surveys data were used (randomly selected population, 2001 and 2006). A total of 9658 participants were included, of whom 44.6% had prevalent NAFLD. In adjusted logistic regression models, participants in the top quarter of vitamin A and E had 56% (95% confidence interval (95%CI): 45-68) and 34% (95%CI: 29-57) lower odds of NAFLD compared with participants in the bottom quarter. When levels of vitamin A changed from low (1.53) to high (1.95), the fatty liver index (FLI) in the low body mass index (BMI) category changed from 36.1 to 24.3. However, at the high BMI level, FLI changed from 84.3 to 65.1 suggesting that obesity modulates the effects of vitamin A on FLI. This study suggests a protective effect of antioxidants against NAFLD occurrence, which is likely modulated by adiposity. Given the cross-sectional design, our results need to be validated in prospective studies.

Correlation between the distribution of intracranial and extracranial aterial lesions and risk factors in Chinese patients with ischemic stroke: a multicenter registry study

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke. Methods In this multi-center study, 2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to May 2016 were enrolled. Carotid ultrasonography and transcranial color-coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion. According to the distribution of lesions, the subjects were divided into 2 groups: the simple intracranial artery stenosis group and the simple extracranial artery stenosis group. The difference of risk factors between the two groups was compared. Results Of the 2 310 patients with ischemic stroke, 1 516 (65.6%) had simple intracranial artery stenosis and 794 (34.4%) had simple extracranial artery stenosis. The incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group (68.1% vs 48.7%, P<0.001). Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group (36.4% vs 22.1%, 14.9% vs 9.8%; all P<0.001). Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension, diabetes, obesity, and family history of stroke, and their systolic blood pressure, diastolic blood pressure, body mass index (BMI), fasting blood-glucose, glycosylated hemoglobin, triacylglycerol, total cholesterol, and low-density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group (all P<0.05). The proportion of elderly (≥65 years old), male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group (all P<0.05). Multivariate logistic regression analysis showed that elderly (≥65 years old), male, and smoking history were independent risk factors for extracranial arterial stenosis (OR=2.012, 1.637, 1.325, respectively; all P<0.05). While hypertension, diabetes, less physical activity, and high BMI levels were independent risk factors for simple intracranial arterial disease (OR=1.301, 1.252, 1.248, 1.030, respectively; all P<0.05). Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China. Key words: Ultrasonography; Ischemic stroke; Atherosclerosis; Distribution; Risk factor

Serum irisin level in myocardial infarction patients with or without heart failure.

This study aimed to assess serum irisin level in myocardial infarction (MI) with or without heart failure (HF) and the possible relation between irisin and cardiac markers, tumor necrosis factor-α (TNF-α) and lipid profile. Eighty-six subjects were included (33 patients had MI, 33 patients had MI with HF, and 20 controls). Body mass index (BMI), waist/hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP), heart rate, and left ventricular ejection fraction (LVEF) were measured. Blood samples were withdrawn on admission for measuring irisin, cardiac markers, TNF-α, total cholesterol (TC), triglycerides (TGs), low-density lipoprotein-cholesterol concentration (LDL-C), and high-density lipoprotein-cholesterol concentration (HDL-C). Patients with MI and HF had reduced serum irisin, LVEF, and HDL-C and higher levels of BMI, WHR, SBP, DBP, troponin-I, creatine kinase-MB (CK-MB), TNF-α, TC, TGs, and LDL-C compared with control. Negative correlations were observed between irisin and BMI, WHR, SBP, DBP, troponin-I, CK-MB, TNF-α, TC, TGs, and LDL-C. However, positive association was noticed between irisin and LVEF and HDL-C. Irisin might be a useful biomarker in diagnosis of MI with or without HF. It could have anti-inflammatory and hypolipidemic effects. Further studies are needed to elucidate the role of irisin as a promising prophylactic or therapeutic agent in cardiovascular diseases.

Effects of obesity on sperm retrieval, early embryo quality and clinical outcomes in men with nonobstructive azoospermia undergoing testicular sperm aspiration-intracytoplasmic sperm injection cycles.

The objective of this study was to assess the effects of body mass index (BMI) on sperm retrieval, early embryo quality and clinical outcomes in patients with nonobstructive azoospermia (NOA) undergoing testicular sperm aspiration-intracytoplasmic sperm injection (TESA-ICSI). A total of 3,005 infertile couples were evaluated between January 2010 and June 2017, including 1585 normal-weight (BMI<25kg/m2 ), 847 overweight (BMI 25-29.99kg/m2 ) and 573 obese (BMI≥30kg/m2 ) patients. We found no significant relationship between BMI and sperm retrieval rate (22.4%, 24.3% and 25.1%, p=0.327) or sperm motility. Among the 705 patients with NOA who underwent TESA-ICSI cycles, obese individuals had lower T levels and higher E2 levels than normal-weight and overweight individuals. However, there were no significant differences in other male hormones (follicle stimulating hormone [FSH], luteinizing hormone [LH], or prolactin [PRL]) among the groups. We also found that the sperm parameters, embryo quality and clinical outcomes of patients with NOA undergoing TESA-ICSI were not influenced by high BMI levels. In conclusion, this study demonstrated a lack of obvious effects of obesity on sperm retrieval, early embryo quality and clinical outcomes in infertile men undergoing TESA-ICSI cycles, although T and E2 levels were affected.