Higher BMI Research Articles

Layering hyperintensity in T1-weighted magnetic resonance imaging predicts gallbladder sludge: a retrospective cohort and diagnostic accuracy study in patients with significant liver disease.

Layering hyperintensity in the gallbladder is frequently observed on T1-weighted (T1w) magnetic resonance imaging (MRI), but its association with hepatobiliary disorders is not well understood. This study aimed to evaluate the prevalence of T1w layering in the gallbladder and its correlation with ultrasound (US) findings and patient characteristics in a cohort with significant liver disease. A single-center study from 2015 to 2022 included patients who underwent MRI and abdominal US within one week. Exclusion criteria were poor imaging quality and prior cholecystectomy. MRI findings were correlated with US and analyzed against patient characteristics. Among 415 patients (mean age 58.3 ± 14.8 years; mean BMI 28.0 ± 4.5kg/m²), 67% had abnormal liver function tests, with high prevalences of cirrhosis (n = 260), transjugular intrahepatic portosystemic shunt (TIPS) (n = 233), and choledocholithiasis (n = 106). T1w layering was observed in 56% (n = 232) and associated with higher BMI (p = 0.001) and with cholecystolithiasis (p < 0.001), but not with age, sex, or liver disease indicators. T1w layering was predictive of gallbladder sludge on US (odds ratio 17.2, 95% confidence interval 9.87-31.44, p < 0.001), with a sensitivity of 92.7% but moderate specificity (57.9%). T1w layering on MRI strongly predicts gallbladder sludge detected on US and is associated with increased BMI in this cohort of patients with liver disease. However, the moderate specificity requires cautious interpretation, and our findings suggest that T1w layering may serve as a complementary diagnostic tool.

A noninvasive spinal device for measuring adolescent idiopathic scoliosis: validity, reliability, and factors influencing measurement difference.

Adolescent idiopathic scoliosis (AIS) is a common deformity, requiring regular screening and monitoring. While radiological measurements are considered the gold standard, X-ray exposure poses significant risks. A noninvasive spinal device offers a radiation-free alternative for measuring spinal curvature. This study evaluates the validity and reliability of its measurements and explores factors associated with measurement discrepancy. This study involved AIS patients in an outpatient setting from June to August 2023. Participants underwent device measurements to assess the scoliosis angle (SA) in the frontal plane, which were evaluated by two orthopedists and compared to radiological measurements (Cobb angle) from EOS images. A total of 112 patients were included in the study. The Cobb angle measured on EOS images was 30.3°± 12.4°. The SA measurements by observer 1, observer 2, and their average were 25.5° ± 10.9°, 25.4° ± 10.3°, and 25.4° ± 9.9°, respectively. The reliability analysis showed good agreement between observers (ICC = 0.77) and within observers (ICCs of 0.81 and 0.86). The validity analysis showed a very strong correlation between the SA and Cobb angle (r = 0.76). Logistic regression analysis indicated that high BMI, great scoliosis magnitude, and large maximal vertebral rotation (MVR) were associated with measurement discrepancy. Multivariate linear regression formula was: Cobb angle = 0.83×SA + 0.55×TRA + 0.21×BMI. This device measurement demonstrated good reliability and validity compared with radiological measurement, highlighting its safety and feasibility for screening and monitoring AIS progression. However, high BMI, great scoliosis magnitude, and large MVR were associated with measurement inaccuracy.

Health loss and economic burden of asthma in China: a qualitative review based on existing literature.

Asthma is a significant public health issue that cannot be ignored in China and around the world, bringing a huge social burden. To evaluate the disease burden of asthma in China, including health loss and cost of illness, and identify its influencing factors. A systematic literature review and qualitative descriptive analysis were conducted, Literature was accessed through PubMed, EMBASE, Web of Science, CNKI, Wangfang Data, and VIP databases, with a cutoff date of April 3, 2024. The analysis focused on two main aspects: health loss burden, measured by disability-adjusted life years (DALYs), including years of life lost (YLLs) and years lived with disability (YLDs); and economic burden, assessed through direct and indirect costs. The risk of bias in economic studies was assessed using an 11-item methodological checklist for cost of illness, while cross-sectional studies were evaluated using the Agency for Healthcare Research and Quality's recommendation rating tool. The analysis included 50 studies, with eight focused on health loss and 42 on economic burden. The health loss studies showed a 51% decrease in asthma's age-standardized DALYs rate over 30 years, from 209.24 to 102.81 per 100,000 person-years. The health loss burden is influenced by factors such as high BMI, smoking, and occupational exposure. Economic burden studies reported annual direct costs from $348 to $1187 per capita, indirect costs from $7 to $1195, and hospitalization costs from $177 to $1547, influenced by frequency and severity of acute exacerbation, comorbidities, and treatment adherence. Quality assessment revealed moderate overall quality, with gaps in sensitivity analyses and cost data transparency. The health loss burden of asthma in China has significantly decreased from 1990 to 2019, with males experiencing a higher burden. However, regional disparities in the economic burden persist, highlighting the need for improved management and adherence to standardized treatment protocols to address these disparities.

The Relationship and Mechanisms Between Body Mass Index and Autoimmune Hypothyroidism: Insights from Mendelian Randomization.

Obesity is increasingly prevalent worldwide and has been linked to various health conditions, including hypothyroidism. Summary-level GWAS data from the UK Biobank and the FinnGen Biobank were used for Mendelian randomization analysis. The impact of BMI on autoimmune hypothyroidism through putative mediators was assessed through a four-step analytical process. Statistical analyses, including the inverse-variance-weighted (IVW) method, weighted median (WM), and MR-Egger methods, were employed to evaluate causal relationships and detect horizontal pleiotropy. Mediation analysis was performed using a two-step method to assess the causal relationships between BMI, putative mediators, and autoimmune hypothyroidism. Higher BMI was associated with an increased risk of autoimmune hypothyroidism. Mean corpuscular volume, eosinophil count, and cystatin C levels were found to mediate this association. BMI positively correlates with autoimmune hypothyroidism, with mean corpuscular volume, eosinophil count, and cystatin C levels mediating this relationship. Further research is needed to confirm these findings and explore causal relationships across diverse populations.

Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021

BackgroundThe incidence and mortality rates of pancreatic cancer are rising globally. This study examines global and regional trends in pancreatic cancer incidence, Disability Adjusted Life Years (DALYs), and mortality from 1990 to 2021, utilizing data from the most recent Global Burden of Disease (GBD) 2021 database.MethodsData were sourced from the GBD database over the period from 1990 to 2021. Age-standardized rates for incidence, DALYs, and mortality were calculated per 100,000 population. We also calculated the proportion of DALYs and mortality attributable to risk factors. The Bayesian age-period-cohort model was applied to project future trends until 2050.ResultsBetween 1990 and 2021, the global incidence of pancreatic cancer increased significantly, with the number of cases rising from approximately 207,905 to 508,533 and the age-standardized incidence rate (ASIR) increasing from 5.47 to 5.96 per 100,000 population. The global burden of pancreatic cancer, measured in DALYs, rose from 5.21 million to 11.32 million. Mortality rates showed a similar upward trend, with the number of deaths increasing from around 211,613 to 505,752, and the age-standardized mortality rate (ASMR) rising from 5.655 to 5.948 per 100,000 population. Notable increases in ASIR and ASMR were observed in low-middle and low sociodemographic index regions with males experienced higher rates compared to females. Age-standardized DALYs rate (ASDR) and ASMR worldwide were attributable to tobacco smoking, high BMI, and high fasting plasma glucose. Furthermore, our projection model estimates that the ASIR and ASMR of pancreatic cancer will significantly decline, while the ASDR is anticipated to maintain a steady downward trend by 2050.ConclusionThis study offers a comprehensive analysis of pancreatic cancer trends, providing crucial insights for public health planning and policy-making. Addressing identified risk factors and targeting high-risk populations are essential for effective strategies to reduce the global burden of pancreatic cancer.

Investigating risk factors for migraine in Syrian women: a cross-sectional case-control study

This study aimed to investigate the relationship between potential risk factors and migraine among Syrian women through a cross-sectional case-control design. A total of 989 women were enrolled, including 519 migraine patients and 470 non-migraine controls. Data collection involved a comprehensive questionnaire covering demographic information, clinical features, and medical history. Statistical analysis was performed using descriptive statistics and Chi-Square tests. The findings revealed that migraineurs were more likely to smoke, have a higher BMI, have a family history of migraines (particularly in first-degree relatives), have a surgical history, and have undergone a cesarean delivery. No significant associations were found between migraine and allergies, anemia, contraceptive use, or menstrual cycle regularity. These results support existing literature on smoking, BMI, and family history as established risk factors for migraine, while also highlighting the novel associations between migraine and surgical history and delivery type. The study emphasizes the importance of addressing modifiable lifestyle factors and understanding familial predispositions in managing migraine in Syrian women. Further research in this region is crucial for a better understanding of the disease and effective management strategies.

Effect of atrial high-rate episodes (AHREs) on functional status and quality of life (QoL) in heart failure—cardiac resynchronization therapy population

BackgroundNew type of arrhythmia called atrial high-rate episodes (AHREs) has been discovered thanks to the ability of cardiac electronic implantable devices to track, record, and analyze complex arrhythmias. The aim is to determine factors associated with AHRE in HFrEF/CRT patients and the effect of AHRE on functional capacity and quality of life (QoL).ResultsWe interrogated 100 patients' devices to gauge the incidence and burden of AHRE, then assessed their functional capacity using the standard 6-min walk test (6MWT), and evaluated their QoL using the Minnesota Living with HF questionnaire (MLHFQ) score. 34% of patients had AHRE, and 91.2% of them had AF. By multivariate logistic regression analysis, smoking (OR 9.426, 95% CI [1.33, 66.65], P 0.025), higher BMI (OR 1.336, 95% CI [1.09, 1.635], P 0.005), and increased LAVI (OR 1.16, 95% CI [1.063, 1.262], P < 0.001) are independent predictors for AHRE. There was a significant correlation between AHRE and the distance walked during 6MWT when compared to the distance expected for an equivalent healthy individual (82.02 ± 17.22% in the non-AHRE group vs. 75.15 ± 15.78% in the AHRE group, P < 0.001). It was found that AHRE was statistically linked to a higher total MLHFQ score (46.76 ± 9.82 in the AHRE group vs. 36.97 ± 7.76 in the non-AHRE group, P 0.032), with higher physical scores in the AHRE group.ConclusionAHRE significantly reduces functional status and perceived quality of life in HFrEF patients receiving CRT. Longer than five minutes of AHRE was associated with a higher MLHFQ score and worse performance on the 6MWT. In that patient population, smoking, obesity, and elevated LAVI were independent predictors of AHRE.

Joint Associations of Moderate-to-Vigorous Physical Activity and Sedentary Time with Adiposity and Cardiometabolic Risk Factors in Adolescents.

This study aims to explore the joint associations of moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) with adiposity and cardiometabolic risk factors in adolescents. A cross-sectional study was conducted on 309 participants (10-16 years old). Measurements included accelerometer-measured MVPA and ST, anthropometrics, body composition, and cardiometabolic risk factors. MVPA and ST were categorized as high or low based on median values (MVPA 27.7 min/day, ST 597.7 min/day). General Linear Models assessed associations of MVPA and ST with adiposity and cardiometabolic risk factors, adjusted for covariates. We observed significant inverse associations between MVPA and adiposity measures. Thus, participants in the Low MVPA category, compared to those in the High category, had higher BMI (2.23 units), z-BMI (0.43 units), waist circumference (6.1 cm), fat mass (4.6 kg), body fat (3.9%) and visceral fat (0.13 L), indicating that higher MVPA is linked to healthier body composition. No significant associations were found between ST and adiposity. MVPA was also negatively associated with some cardiometabolic risk factors, whereas ST showed no significant associations. This study highlights the need to prioritize increasing MVPA among adolescents to support healthy body composition and improve cardiometabolic health. Although ST did not show significant associations, it remains important to limit sedentary behaviors due to their potential contribution to negative health outcomes later in life.

Transition of clinical biomarker status from childhood into adolescence-A prospective study in children from eight European countries.

Understanding factors influencing clinical biomarkers is important for the prevention of chronic disease. This study aimed to estimate transitions of biomarker status from childhood to adolescence and to identify determinants of biomarker status in early life in a prospective children cohort. Our sample comprised 1295 children participating in the baseline (2007/08) and second follow-up examination (2013/14) of the multi-center IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS)/I.Family study. Clinical blood biomarkers including glycated hemoglobin A1c (HbA1c), high-density lipoprotein cholesterol (HDL-cholesterol), triglycerides, C-reactive protein (CRP), interleukin 6, ferritin, leptin and insulin-like growth factor 1 (IGF-1) were repeatedly measured in 2007/2008 (age range: 3.0 to <10.0 years) and in 2013/2014. Latent transition analysis was used to estimate biomarker statuses and transition probabilities; determinants of biomarker status were estimated using mixed-effects models. Four distinct biomarker statuses were identified: (1) "normal" (all biomarkers low/medium; except HDL-cholesterol; reference), (2) "low leptin/IGF-1/HbA1c", (3) "dyslipidemia/high leptin" and (4) "inflammation". Children classified as "low leptin/IGF-1/HbA1c" at baseline were most likely to stay in this status (89.8%) or to change to the "normal" status (10%) during follow-up. Compared to "normal" children, children classified as "low leptin/IGF-1/HbA1c" were less likely to have a family history of diabetes (0.26 [0.08;0.86]; odds ratio (OR) and 95% confidence interval) or hypertension (0.53 [0.29;0.99]) and the children (0.32 [0.27;0.38]) as well as their mothers (0.93 [0.88;0.98]) had a lower BMI. Children from families with low/medium education had a 55% [9%-119%] higher risk of being in the "dyslipidemia/high leptin" and 49% [1%-121%] higher risk of being in the "inflammation" status as compared to children in the "normal" status. Membership in a sports club reduced the latter risks by 28% [2%-47%] and 40% [17%-56%], respectively. European children showed distinct phenotypes for the investigated biomarkers. Especially parental characteristics like a family history of diabetes or hypertension, a high maternal BMI, or low/medium education were associated with unfavorable biomarker status in children.

Comparison of risk factors, treatment strategy, and outcomes of early- vs. older-onset colorectal cancer within the prospective ColoCare study.

95 Background: The incidence of colorectal cancer among young adults aged 20-49 has continually increased in recent decades. Early-onset colorectal cancer (EOCRC) patients are more likely to be diagnosed at a more advanced stage of disease, have hereditary cancer syndromes, and have different molecular pathological features of disease than later-onset patients. Herein we compare the risk factors, treatment approaches, and responses to treatment of early-onset versus later-onset colorectal cancer within. Methods: The ColoCare Study is a prospective cohort enrolling individuals diagnosed with primary colorectal cancer at six different cancer centers in the United States and one in Germany. Serial questionnaires assess demographic characteristics and symptoms experienced prior to diagnosis, while clinical characteristics (including staging, pathology, treatments given) are abstracted from medical records. Restricting to patients with available age and stage, patients diagnosed &lt;50 years old were labeled as “early-onset” and ≥50yo as “later-onset.” Associations between patient age and characteristics of interest were tested using Fisher’s Exact Test for count data. Results: Of the3,173 patients included in this analysis, 78% were later-onset (mean: 65 years) and 22% were early-onset (mean: 42 years). Demographic data was comparable between the two groups, with 43% being female. Though similar rates of ever alcohol use were seen between the two groups, early-onset patients reported consuming fewer weekly alcoholic beverages than later-onset patients (mean (standard deviation) of 5.5 (6.6) vs. 8.4 (9.3)). Early-onset patients were less likely to have ever smoked tobacco (38% vs 51%, p&lt;0.001) and had lower rates of obesity (27% vs 31%) or overweight (34% vs 40%) than later-onset patients (p&lt;0.001). For stage II/III disease, early-onset patients were more likely to have received chemotherapy and/or radiation treatment compared to later-onset patients (87% vs 70%, p&lt;0.001), though both groups had similar rates of surgery. Despite this, younger patients did not appear to experience better outcomes, with 21% of younger patients experiencing a recurrence or new metastasis during follow-up versus 20% of later-onset patients. Conclusions: The risingincidence of colorectal cancer in early-onset patients does not appear to be explained by traditional risk factors such as alcohol use, tobacco use, or high BMI. Early-onset patients are more likely to receive chemotherapy or radiation, but observed outcomes are notably poorer compared to later-onset patients. Further statistical analysis on specifics of treatments by stage is ongoing.

Sudden cardiac death associated with fatty liver disease.

Fatty liver disease or steatotic liver disease (SLD) affects 25% of the global population and has been associated with heart disease. However, there is a lack of postmortem studies in the context of sudden cardiac death (SCD). To investigate the relationship between SLD and SCD. A post-mortem case-case study was conducted in victims of SCD from an ongoing community-based study in Southern California (Ventura, CA, 2015-2023). Diagnosis of SLD was determined from post-mortem liver histopathology reports. For each patient, demographic variables, laboratory values, and presence of co-morbidities were ascertained from medical records and were compared between patients with and without SLD. Of 162 individuals with SCD, there were 101 SLD cases and 61 without SLD. Individuals with SLD were found to have higher BMI (31.6±7.6 vs. 26.7±5.7, p<0.001), higher prevalence of heavy drinking (28% vs. 12%, p=0.008), heavier liver weights (2433.6g±940.6 vs 1934.7g±505.3, p<0.001), and were more often Hispanic (37 vs. 18%, p=0.01). Patients with SLD had lower prevalence of coronary artery disease (CAD) (49% vs. 70%). Multivariable logistic regression analysis showed that CAD was a negative predictor of SCD with SLD (OR = 0.35, 95% CI 0.14 - 0.83). Among adults with SCD, SLD was associated with higher prevalence of Hispanic ethnicity and lower prevalence of CAD. Given the major rise in SLD burden, these ethnicity-based differences as well as the specific nature of non-ischemic SCD etiologies warrant urgent further investigation.

Body Weight and Breast Cancer Treatment Experiences: Results From the Share Thoughts on a Breast Cancer Study.

Differences in breast cancer recurrence and survival occur by body size; the role of treatment differences in these disparities has been underexplored. Our objective was to evaluate differences in treatments received, patient experiences of care, and treatment decision-making processes among breast cancer survivors by body size. We used data from the Share Thoughts on Breast Cancer study. Participants (n = 1198) completed a survey that included information on demographics, treatments received, quality of care, and decision-making. We used descriptive statistics to evaluate differences in survey response by BMI category, and multivariable-adjusted multinomial and logistic regression to examine associations of BMI with treatments received. Those with higher BMI were more likely to be older, report fair/poor health, not have a college-level education, be non-white, not be insured, have an income under $50,000, be unemployed, and report a history of several chronic diseases. Although there were unadjusted associations, after adjustment, women with obesity were not significantly less likely to receive mastectomy [OR 0.79 (0.50, 1.26) and OR 0.66 (0.38, 1.16), for BMI 30-35 and 35+ kg/m2 respectively] or contralateral prophylactic mastectomy [OR 0.92 (0.59, 1.44) and OR 0.80 (0.46, 1.39)] than those without obesity. Similarly, we found no association of BMI with reconstructive surgery [OR 0.97 (0.58, 1.60) and OR 0.58 (0.30, 1.11)] after adjustment. Women with obesity were less likely to report that their breast cancer care was excellent or very good (p = 0.026). We observed no differences in breast cancer treatments received by BMI after adjustment for key covariates in this study sample. Further research is necessary to determine why quality of care may be perceived as lower among women with obesity.

Food choice motives mediate the relationship between delay discounting and binge eating: A structural equation modelling approach.

Binge eating (BE) is associated with psychological distress, functional impairment, and elevated risk of eating disorder diagnoses, and BE prevalence is increasing. Motivational and self-regulatory processes such as delay discounting may be important influences on BE; however, evidence is inconclusive, and lacks explanation of mechanisms. This study investigated how food choice motives mediate the pathway from delay discounting (DD) to BE symptomatology. Adult participants (N=391, 80% female, mean age 38.93) completed the Monetary Choice Questionnaire (DD), Food Choice Questionnaire (food choice motives), and Binge Eating Scale online. We used structural equation modelling (SEM) to analyse hypothesised partially-mediated pathways from DD to BE via Health, Mood, and Sensory Appeal food choice motives, incorporating participant age, sex, BMI, and Weight Control motives. The best fitting SEM indicated steeper DD was associated with greater BE, but this effect was fully mediated by lesser endorsement of Health motives. Greater endorsement of Mood and Weight Control motives, along with female sex and higher BMI, also accompanied greater BE symptomatology. Counter to hypotheses, Mood and Sensory Appeal did not mediate the relationship between DD and BE. The novel finding that Health motives mediated the effect of DD on BE suggests steeper discounting may hinder the longer-term perspective needed to value the health attributes of food, and thus promote food intake for immediate reinforcement. The significant effects of Weight Control and Mood motives independent of DD suggest support for overvaluation of weight and shape and negative reinforcement mechanisms in the etiology of BE. Our study highlights the influence of food choice motives and DD in BE, and supports the integration of individualised motivational and neurocognitive interventions in eating disorder treatment.

A comparative study of dosage strategies in HIPEC: BSA-based vs fixed dose methods.

832 Background: Peritoneal metastases commonly occur in ovarian, gastric, and colorectal cancers, significantly contributing to patient morbidity and mortality. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a promising approach for managing peritoneal surface cancers. This procedure involves cytoreductive surgery to remove visible tumors, followed by the perfusion of heated chemotherapy (41-42°C) directly into the peritoneal cavity. HIPEC addresses the limitation of systemic chemotherapy, which often fails to penetrate the peritoneal cavity effectively. HIPEC dosing may either be a flat-fixed dose or be calculated based on Body Surface Area (BSA). BSA can be determined using three methods: actual BSA (based on weight and height), ideal BSA (based on sex and height), and adjusted BSA (considering lean and fat mass). Methods: A retrospective chart review was conducted on 151 metastatic cancer patients at UVMMC. Patient BMI, weight, and height at diagnosis were collected to calculate BSA values (actual, adjusted, and ideal) for estimating a hypothetical chemotherapy dosage. Statistical analysis using SPSS involved linear mixed models and paired t-tests to compare Mitomycin-C dosages between a fixed dose (40 mg) and a BSA-derived dose (30 mg/m²). Results: The average dosage of Mitomycin-C differed significantly depending on whether the dose was calculated using actual, adjusted, or ideal BSA. The largest discrepancy in dosage was observed between the actual BSA method and the flat-fixed dose, with an average difference of 16 mg. The smallest difference in dose was between the adjusted and ideal BSA methods. When stratifying by BMI, the greatest variation in Mitomycin-C dosage was found among overweight and obese patients (BMI ≥ 25). For these patients, the average dosage difference between the flat fixed dose and the actual BSA dose was 20 mg. In comparison, in patients with a BMI under 18.5 (underweight) the actual BSA dose was comparable to the fixed dose. Conclusions: Different institutions utilize a variety of dosing strategies for the HIPEC procedure. Differences in BSA calculation methods and perfusate volumes (literature values of 2, 3 and 4 L is most common) contribute to the complexity of establishing standardized dosing. The significant dosing variations observed, especially in overweight and obese patients, are of concern, as 70% of the U.S. population has a BMI ≥ 25. Our study demonstrates significant variability in HIPEC chemotherapy dosing, especially among patients with higher BMI. The discrepancy between BSA-based methods and flat-fixed doses may impact treatment efficacy and toxicity. Standardizing dosing approaches is important to ensure consistent therapeutic outcomes and patient safety.

Potential mechanism associated with post-heart transplantation diabetes mellitus in Chinese patients.

Post-transplantation diabetes mellitus (PTDM) is a common metabolic complication following heart transplantation, which not only leads to elevated microvascular morbidity, but also seriously affects graft function and recipient survival. However, the specific metabolites and underlying mechanisms are not yet fully understood. A total of 106 adult heart transplant recipients (56 PTDM and 50 non-PTDM) who followed for more than one year were enrolled in the study. The untargeted metabolomics was performed by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The demographic, clinical data and drug information were collected at the time of sample collection. PTDM patients were older (p=0.003), with higher BMI (p=0.010), higher triglyceride levels (TG, p=0.007), and a higher prevalence of hypertension (p=0.001) than non-PTDM. A total of 1174 metabolites were detected, of which 99 metabolites showed significantly differentially abundant (VIP>1, p<0.05, FC>1.5 or <0.67). KEGG functional enrichment analysis showed these differently expressed metabolites could be further enriched in ABC transporter, carbon metabolism, retrograde endocannabinoid signaling, phospholipase D signaling pathway. Compared with non-PTDM group, glutamate, diacylglycerol (DAG) and D-sorbitol were significantly changed in PTDM through metabolomics. These findings may provide a novel understanding of the pathological mechanism of PTDM and could be utilized to predict the development and progression of PTDM.

Which factors influence emotional overeating among workers and students? Is online food delivery consumption involved? Results from the DELIvery Choice In OUr Society (DELICIOUS) cross-sectional study.

Emotional overeating (EO) is a complex behavior that involves consuming excessive food in response to emotions, presenting health risks due to poor dietary choices. Research indicates a notable prevalence of EO, especially among females, and its association with disordered eating behaviors like binge eating (BE). The rise of online food delivery (OFD) services has raised questions about their potential role in exacerbating EO. This study aimed to explore EO behaviors among Italian workers and students, assessing the influence of various personal, socio-demographic, and lifestyle factors, including OFD. This study is a secondary data analysis utilizing the DELICIOUS survey data, conducted nationwide through social media platforms from July 12, 2022, to February 1, 2023. Participants completed validated questionnaires, including the EO Questionnaire (EOQ-5). The sample was stratified according to worker/student status. Statistical analyses, including descriptive statistics (chi-squared tests, Mann-Whitney tests) and multivariable logistic regression, were performed to assess the influence of key variables on EO. The sample comprised 2853 workers and 898 students, with almost 75% exhibiting EO behavior above the threshold. Several factors were significantly related to a higher occurrence of EO. Positive associations included bad health literacy, female gender, occasional smoking, higher BMI, depression risk for students, and low work-life balance, job dissatisfaction, screen time while eating, and depression risk for workers. Surprisingly, OFD usage showed no relationship with EO. While some findings align with previous research, like the depression-EO link, others, such as the absence of a link between OFD and EO, were unexpected. The results suggest that personal, socio-demographic, and lifestyle factors significantly influence EO, with OFD serving more as a means of food access influenced by individual characteristics, rather than a direct EO risk factor.

Pain and Functional Outcome After Microsurgical Decompression of Lumbar Spinal Stenosis: Very Short- and Long-Term Postoperative Analysis.

Multicenter, prospective observational cohort study. 109 patients with lumbar spine stenosis (LSS) undergoing minimally invasive decompression in 6 different centers (Germany, Italy, USA). The demographic, surgical and clinical data was collected. Patients were examined preoperatively, immediately postoperatively, at 6 and 12 months after surgery with regard to pain (back and legs) and functional outcomes (ODI, SF-36, EQ5D). The mean age of the cohort was 67 ± 11 years, with a BMI of 31.8 ± 6.6kg/m². Most patients (93%) underwent single-level decompression, and postoperative adverse events occurred in 17% of cases. Significant initial reductions in back (6.0 ± 2.8 to 2.4 ± 2.1) and leg pain (6.4 ± 2.1 to 2.1 ± 2.5) were observed (P < 0.001). However, pain levels increased significantly by the 12-month period, reaching 3.9 ± 2.7 for back pain and 3.9 ± 2.4 for leg pain (P < 0.001). Functional scores (ODI) improved from 43 ± 18 at baseline to 36 ± 18 post-treatment but showed no further significant change (P = 0.509) by 12 months. Health status (EQ5D index) improved from 0.53 ± 0.33 to 0.82 ± 0.16 immediately post-treatment but declined to 0.75 ± 0.21 by 12 months (P = 0.011). SF36 physical scores also showed initial improvement but plateaued at follow-ups. Notably, high BMI and prior spine surgery were associated with worse outcomes. Although minimally invasive decompression without fusion initially led to a significant improvement in patients with LSS, the results deteriorated significantly over the course of the observation period. Future studies should focus on strategies to ensure sustained improvement in symptoms in patients with lumbar stenosis undergoing decompression procedure.

Robot-assisted versus conventional laparoscopic hysterectomy in endometrial cancer: an observational study in a French tertiary teaching hospital at the beginning of the learning curve.

The role of Robotic Assisted Laparoscopy (RAL) versus conventional laparoscopy (CL) in the surgical treatment of endometrial cancer remains a matter of debate. We aimed to compare RAL and CL in terms of clinical outcomes (hospital stay characteristics and 3-month complications) in patients undergoing hysterectomy for endometrial cancer. We conducted a single-center, retrospective study in a tertiary teaching hospital comparing two groups of women who underwent hysterectomy for endometrial carcinoma by RAL performed by a surgeon during the beginning of learning curve, or CL. Of the 110 patients included, 56 were in the RAL group and 54 in the CL group. The patients in the RAL group were significantly older (71.6±8.7 vs 67.8±9.7, p=0.031) and had a higher BMI (33.1±7.0 vs 29.8±6.1, p=0.030) than those in the CL group. Operating room occupancy time was higher with RAL (4.6 hours±1.3 vs 3.5±1.3, p<0.001). Although less spinal analgesia was used in the RAL group (35% vs 74%, p<0.001), the patients in this group consumed less postoperative paracetamol (9.4g±5.3 vs 13.0±9.9, p=0.032) meaning faster recovery. Conversely, there was a higher rate of unplanned consultations during the 3-month follow-up in the RAL vs CL group (18.5% vs 3.6%, p=0.012). RAL was associated with less postoperative pain even at the beginning of learning curve. Surgeons were more likely to perform RAL than CL for older and/or obese patients, suggesting they intuitively consider RAL of added benefit for these patients.

Prevalence and Determinants of Sarcopenia Among Older Adults in India: Insights From the Longitudinal Aging Study in India.

Sarcopenia, characterized by declining muscle mass and function, is a growing concern among India's aging population. This study investigates sarcopenia's prevalence and determinants using the nationally representative LASI dataset. This analysis included 26,780 community-dwelling adults aged 60 and above, with informed consent obtained from all participants. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Demographic, socioeconomic, health, and geriatric factors, including age, sex, living arrangements, economic status, comorbidities, and geriatric syndromes, were examined. Multinomial logistic regression was used to analyze associations with sarcopenia and severe sarcopenia, and results were expressed as relative risk ratios (RRR) with 95% confidence intervals (CI). The prevalence of sarcopenia was 43.6% (n = 11,665), and 19.4% (n = 5202) had severe sarcopenia. Sociodemographic factors significantly associated with sarcopenia and severe sarcopenia included being widowed (RRR: 1.24, 95% CI: 1.12-1.37 for sarcopenia; RRR: 1.82, 95% CI: 1.64-2.03 for severe sarcopenia) or divorced (RRR: 1.68, 95% CI: 1.12-2.54 for severe sarcopenia). Additionally, a higher BMI and higher education level were associated with a lower risk of sarcopenia. Among comorbidities, joint and bone diseases were linked to both sarcopenia (RRR: 1.21, 95% CI: 1.07-1.35) and severe sarcopenia (RRR: 1.4, 95% CI: 1.23-1.58), while hypertension (RRR: 1.22, 95% CI: 1.1-1.36), chronic lung disease (RRR: 1.22, 95% CI: 1.02-1.44), and cerebrovascular accident (RRR: 1.5, 95% CI: 1.09-2.08) were specifically associated with severe sarcopenia. Geriatric syndromes such as tooth loss, impaired vision and hearing, history of falls, and depression were significantly associated with increased risk of sarcopenia. This study reveals significant associations between sarcopenia and various sociodemographic factors, comorbidities, and geriatric syndromes in older adults in India, suggesting potential areas for targeted intervention. However, further longitudinal studies are needed to validate these findings and clarify the causal relationships of the observed associations.

Analgesic Protocols in Total Knee Replacement: Early Efficacy and Functional Outcomes

Abstract Objective Comparison of traditional opioid-based analgesic protocols with multimodal pain management strategies in terms of postoperative pain, opioid consumption, and knee range of motion (ROM). Materials and Methods The study included 397 patients (mean age 67.4 ± 8.6 years) undergoing unilateral TKA, divided according to the analgesic protocol: adductor canal block (ACB), periarticular local infiltration anesthesia (LIA), epidural analgesia, and traditional pharmacotherapy. Pain (VAS), opioid consumption (MME), and knee ROM were assessed over 4 postoperative days. Results Postoperative VAS scores differ significantly between cohorts at all time points (p &lt; 0.001). The ACB cohort had the lowest VAS scores on the day of surgery (3.30 ± 2.23) and on postoperative day 4 (2.10 ± 1.05), followed by the LIA cohort (2.30 ± 1.12). Epidural analgesia and traditional pharmacotherapy showed higher pain scores. Knee flexion on day 4 was highest in the ACB cohort (92.4° ± 7.2°), followed by the LIA cohort (88.5° ± 8.3°) (p &lt; 0.001). Opioid consumption was lowest in the ACB cohort (6.3 ± 5.8 MME) and highest in the traditional pharmacotherapy cohort (43.1 ± 12.8 MME) (p &lt; 0.001). BMI significantly influenced opioid consumption (p = 0.018), with higher BMI (&gt; 30 kg/m2) which was associated with higher doses. However, BMI, age, and gender had no effect on knee ROM (p &gt; 0.05). Conclusion Multimodal protocols, including ACB in particular, improve pain control, reduce opioid consumption, and support faster rehabilitation.