Impact Of Weight Research Articles

Health-Related Quality of Life Revealed Through Patient-Reported Outcomes

Background: The prevalence of being overweight and obesity is increasing at an alarming rate throughout the world. Health-related quality of life (HRQoL) is one of the most important issues to be investigated in obesity. The purpose of this study was to investigate the validity, reliability, and factorial structure of the Turkish version of the Patient Reported Outcomes in Obesity questionnaire (PROS). Methods: A total of 80 participants (40 overweight, 40 obese) were included in the study. The Impact of Weight on Quality of Life short version (IWQOL-lite) was used to determine validity. The PROS was readministered to 20 subjects after a 1-week interval for reliability analysis. Results: There was a high correlation between the PROS and IWQOL-lite mean scores (−0.855, p < 0.001). The test-retest reliability showed that the intraclass correlation coefficients (between 0.754 and 0.983) were significant for PROS. Factor analysis demonstrated a three-factor structure. Conclusions: PROS is a practical tool that is up-to-date, short, and easy to understand, implement, and calculate. The results of this study demonstrated that PROS is a valid and reliable questionnaire for measuring HRQoL in an overweight and obese Turkish population.

Impact of Normal and Overweight Pregnant Women upon Pregnancy Complications In Al-Nasiriya Hospitals: Comparative Study

Abstract: Maternal obesity is a major risk for both the mother and the fetus, and it is considered an obstetrical risk factor that leads to a high incidence of complications, as well as an increased risk of many adverse pregnancy outcomes. Objectives: To assess the impact of overweight pregnant women upon pregnancy complication at Al-Nasiriya city. Methodology: A descriptive analytic study was conducted from January11th, 2021 to march 18th, 2021 at Al-Nasiriya city Hospitals for Maternity and Children on (88) pregnant women who are attending Al-Nasiriya city Maternity Hospitals, (44) were overweight and (44) normal weight pregnant women. A non–probability (Purposive sample) was used to select the participants of study sample, a questionnaire was used as a tool to collect data content, validity was determined through reviewing it by (16) experts in different fields. Descriptive and inferential statistics were used to analyze the data. Results: The result of study revealed that (34.1%) (36.4%) of study sample aged (26-30) years in normal, and overweight pregnant respectively. The study results clarifies the previous and current body mass index among normal weight pregnant women (100% &amp; 95%) respectively, while in overweight (63.6%) overweight previously and (65.9%) obesity class (I) at current. the impact of weight upon pregnancy outcomes; the findings indicates that weight has significant impact up on outcomes related to pregnancy, at p-value= 0.007, while there is no impact has been reported among group of normal weight pregnant women. Conclusion: The study concluded that overweight impact upon outcomes related to pregnancy, while there is no impact has been reported among group of normal weight pregnant women. Recommendations: Increased physical activity and knowledge of healthy eating habits among pregnant women as part of primary health care center initiatives to reduce obesity in women.

Impact of fibre weight on the mechanical properties of chopped luffa cylindrica fibre reinforced polymer composites

ABSTRACT Due to its superior properties such as light weight, biodegradable, low density, readily accessible, low cost, high specific strength etc., natural fibre-reinforced polymer composites have been a wide field of research over the last few years. The effect of the fibre content on the mechanical property and water absorption behaviour of luffa cylindrica fibre-reinforced epoxy composite is studied in this research paper. The surface morphology of tensile fracture specimens is also analysed using FESEM analysis. Four different types of composites were prepared by using hand layup technique with varying fibre content such as 4%, 8%, 12% and 16 wt%. The mechanical behaviours of composites have been analysed, such as tensile strength, flexural strength, impact strength and water absorption properties, respectively. The experimental result shows that the water absorption increases with increase in fibre weight percentage. Similarly mechanical properties increase up to 12% luffa fibre content in a composite. Maximum tensile, flexural and impact strength obtained 19 MPa, 50.2 MPa and 2.3 joule, respectively, in 12 wt% luffa fibre composites. But maximum water absorption was obtained as 10.2% in 16 wt% of luffa fibre composites.

47-LB: Higher Weight Loss Is Associated with Improved Quality of Life in Patients with Type 2 Diabetes—SURPASS Program

In addition to glycemic control, the ADA recommends weight management for patients with type 2 diabetes (T2D) with overweight or obesity. This analysis explored the association between weight loss and patients’ quality of life using pooled data from the SURPASS clinical trials, regardless of treatment and dosing. SURPASS 1 to 5 participants achieving ≥5%, ≥10%, or ≥15% weight loss were assessed for patient-reported outcomes (PRO) at baseline and endpoint. Weight related PROs investigated were Ability to Perform Physical Activities of Daily Living (APPADL) , Impact of Weight on Quality of Life-Lite Clinical Trials (IWQOL-Lite-CT) , Impact of Weight on Self-Perceptions (IW-SP) , and other measures were the EQ-5D-5L and Diabetes Treatment Satisfaction Questionnaire change (DTSQc) . Higher PRO scores indicate better outcomes. At endpoint, improvements were observed from baseline in all assessed PRO measures across weight loss categories (Table) . As we narrow the groups to those with higher weight loss percentages, we observed greater improvements in APPADL, IWQOL-Lite-CT, IW-SP, and EQ VAS scores. EQ-5D-5L index score changes and the DTSQc scores also increased but to a lesser extent. Weight loss was associated with improved quality of life with greater improvement seen in higher percentages of weight loss in patients with T2D, regardless of therapy. Disclosure K. Boye: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. V. Thieu: None. M. Yu: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. H. Sapin: Employee; Eli Lilly and Company. Funding Eli Lilly and Company

A Scalable, Weight Management Program Tailored for Adults with Type 2 Diabetes: Effects on Glycemic Control, Weight, Hunger, and Quality of Life

ObjectivesOver 26 million people in the United States have type 2 diabetes (T2D) and 89% of those living with diabetes have overweight or obesity. Weight loss improves glycemic control and scalable weight management programs tailored for those living with diabetes are critically needed. The objective of this trial was to test the efficacy of a scalable and widely available diabetes-tailored weight management program (WW, formerly Weight Watchers) on glycemic control, weight, hunger, and quality of life (QOL) in adults with T2D and overweight/obesity.MethodsThis was a prospective 24-week single arm, three-site clinical trial. Participants (n = 136) had T2D, a baseline HbA1c between 7–11%, and a BMI between 27–50 kg/m2. All participants received the 24-wk WW intervention, tailored for people with T2D, that included weekly virtual workshops and use of the WW App. Assessments occurred at baseline, wk 12 (83.8% retention), and wk 24 (83.1%). Change in HbA1c at 24 weeks was the primary outcome. Secondary outcomes were changes in body weight, hunger (assessed with visual analog scale), and quality of life (assessed with Impact of Weight on QOL-Lite) at 24-weeks. All analyses adhered to the intent-to-treat principle with maximum likelihood estimation used for missing data. Generalized linear effects models were used to examine change over time for all outcome variables.ResultsParticipants were 56.8 ± 0.8 y (Mean ± SEM), 36.2 ± 0.6 kg/m2, 80.2% Female, and 62.2% non-Hispanic white. Baseline HbA1c, weight, hunger, and IWQOL-Lite were 7.9 ± 0.1%, 104.3 ± 1.8 kg, 55 ± 2 units, and 76 ± 2 points, respectively. At week 24, HbA1c decreased by 0.8 ± 0.1%.and body weight decreased by 5.7 ± 0.5% (both p < .0001). A majority of participants achieved clinically significant weight loss, with 59.3% losing ≥3%, 42.5% losing ≥ 5%, and 15.0% losing ≥10% at 24-weeks. At 24 weeks, hunger decreased by 13.2% (p = 0.0125) and QOL improved by 13.6% (p < .0001), with significant improvements in the domains of physical function, self-esteem, sexual life, public distress, and work (all p-values < .05).ConclusionsThe widely available and scalable WW program, modified for those with T2D, had favorable and clinically meaningful effects on glycemic control, body weight, hunger, and quality of life.Funding SourcesWW International, Inc.

¿Compulsion or perseveration? A case report

Introduction54-year-old female patient who came to hospital due to psychopathological decompensation of her Obsessive-Compulsive Disorder (OCD), after 35 years under follow-up. Parkinson´s disease. Psychopharmacological treatment: sertraline 100 mg (1-0-0); lorazepam 2 mg (1-1-1); Levodopa/carbidopa 100/25 mg (1-1-1). Distressed at first examination. She described increase in rituals, important intake restriction, weight impact and difficulties in home management with functional repercussions. Psychopathological exploration: conscious, oriented, and approachable. Circumstantial speech with no obsessive ideas. Increased frequency of repetitive behaviours led to a functional deterioration, becoming dependent for activities of daily living. Elevated anxiety. No major mood disorder. No psychotic symptoms. Bradykinesia. Hypophagia without anorexia. Admission is carried out. Good evolution: improvement in motor symptoms and intake restoration. No changes in repetitive behaviours.ObjectivesTo discuss the differential diagnosis between OCD and Frontotemporal Dementia.MethodsRepetitive behaviours were initially understood as rituals typical of OCD. However, the absence of both a fixed pattern of behaviour and a structured obsessive ideation, made us consider the possibility of frontal perseveration behaviours. For this reason, a neuropsychological evaluation and a functional neuroimaging test were performed: Test Mo-CA: 9/30 with striking failures in executive functions. SPECT: mild uptake defect in the left frontotemporal region.ResultsFinally, in view of the impairment in executive functions and the frontal defects in neuroimaging, we change the initial diagnosis of OCD towards a Neurocognitive Disorder of probable frontotemporal origin.ConclusionsThe presented case evidenced the importance of differentiating obsessive compulsions from frontal perseverance to guide the differential diagnosis, given the implications for therapeutic management and prognosis.DisclosureNo significant relationships.

227-OR: Disruption of Adipocyte YAP Improves Glucose Homeostasis in Mice and Decreases Adipose Tissue Fibrosis

Adipose tissue is a dynamic metabolic organ that is essential for the regulation of whole-body glucose homeostasis. Dysfunctional adipose tissue hypertrophy with obesity is associated with glucose intolerance and insulin resistance underlying type 2 diabetes. Yes-associated protein 1 (YAP) is a transcription cofactor important in the Hippo signaling pathway. However, the role of YAP in adipose tissue and glucose homeostasis is unknown. To understand the role of YAP in vivo under metabolic stress conditions, we assessed how increased weight and insulin resistance impact YAP protein levels. We found that YAP protein levels increase in adipose tissue in humans with type 2 diabetes and mouse models. This suggests that YAP signaling may contribute to adipocyte dysfunction and insulin resistance under metabolic stress conditions. To further investigate the role of YAP in adipose tissue and glucose homeostasis in vivo, we developed adipose tissue-specific YAP knockout (YAP-KO) mice and placed them on either chow or high fat diet (HFD) for 12-14 weeks. On an HFD, adipose tissue YAP-KO mice show improved glucose tolerance compared to controls. Perigonadal fat pad weight was also decreased in knockout animals, with smaller adipocyte size. Adipose tissue fibrosis and gene expression associated with fibrosis was decreased in vivo and in 3T3-L1 cells treated with a YAP inhibitor. Together, these data indicate that YAP is increased in adipose tissue with weight gain and insulin resistance. Disruption of YAP in adipocytes improves glucose tolerance and adipose tissue fibrosis; suggesting that YAP plays an important role in adipose tissue and modulating glucose homeostasis under metabolic stress conditions. Disclosure D.Han: None. R.Aslam: None. T.Ojha: n/a. D.Yuen: Consultant; Fibrocor Therapeutics. C.T.Luk: None. Funding NSERC Discovery Grant (RGPIN-2018-05671) BBDC Gales Family Charitable Foundation Pilot and Feasibility GrantCanadian Institutes of Health Research Project Grant (PJT 168996)

Prospective Multicenter Study of the Primary Obesity Surgery Endoluminal (POSE 2.0) Procedure for Treatment of Obesity

The Primary Obesity Surgery Endoluminal (POSE) 2.0 procedure involves a novel pattern of full-thickness gastric body plications to shorten and narrow the stomach using durable suture anchor pairs. Our prospective, multicenter trial examined the safety, efficacy, durability, and physiologic effects of POSE 2.0 in adults with obesity. Adults with obesity underwent POSE 2.0 at 3 centers. Primary outcomes were percent total body weight loss (%TBWL) and proportion of patients achieving >5% TBWL at 12 months. Secondary outcomes included change in obesity comorbidities, satiety, quality of life at 6 months, and durability of plications at 12 and 24 months. Subjects were followed for adverse events throughout the study duration. 44 patients (61% female; mean age, 45 ± 9.7 years; mean body mass index, 37 ± 2.1 kg/m2) were enrolled. This procedure used an average of 19 suture anchor pairs, with a mean duration of 37 ± 11 minutes, and was technically successful in all subjects. Mean %TBWL at 12 months was 15.7% ± 6.8%. At 12 months, %TBWL >5%, >10%, and >15% was achieved in 98%, 86%, and 58% of patients, respectively. Improvements in lipid profile, liver biochemistries, and hepatic steatosis were seen at 6 months. Improvements in hepatic steatosis persisted for 24 months in a subgroup of patients (P < .01). POSE 2.0 reduced maximum tolerated meal volume (P= .03) and was associated with increased fullness (P < .01) and improved eating behavior (P < .01) at 6 months. Impact of weight on quality-of-life questionnaire improved at 6 months (2.23 vs 1.23; P < .01). Repeat assessment at 24 months (n= 26) showed fully intact plications. No serious adverse events occurred. POSE 2.0 is an effective and durable endoscopic bariatric therapy which may influence physiologic pathways impacting satiety. Larger comparative studies are needed to further elucidate these initial findings. gov Identifier: NCT03721731.

The impact of non-response weighting in health surveys for estimates on primary health care utilization.

BackgroundLow response rates in health surveys may affect the representativeness and generalizability of results if non-response is systematically related to the indicator of interest. To account for such potential bias, weighting procedures are widely used with an overall aim to obtain less biased estimates. The aim of this study was to assess the impact of applying calibrated weights on prevalence estimates of primary health care utilization among respondents compared to the entire sample of a representative Danish survey of adults aged ≥16 years.MethodsRegistry-based 1-year prevalence data on health care utilization of chiropractor/physiotherapist, dentist and psychologist in 2016 were linked to the entire sample (n = 312 349), including respondents (n = 183 372), from the Danish National Health Survey in 2017. Calibrated weights, which applied information on e.g. sex, age, ethnic background, education and overall health service use were used to assess their impact on prevalence estimates among respondents.ResultsAcross all included types of health care, weighting for non-response decreased prevalence estimates among respondents, which resulted in less biased estimates. For example, the overall 1-year prevalence of chiropractor/physiotherapist, dentist and psychologist utilization decreased from 19.1% to 16.9%, 68.4% to 62.5% and 1.9% to 1.8%, respectively. The corresponding prevalence in the entire sample was 16.5%, 59.4% and 1.7%.ConclusionsApplying calibrated weights to survey data to account for non-response reduces bias in primary health care utilization estimates. Future studies are needed to explore the possible impact of weighting on other health estimates.

The impact of a school backpack's weight, which is carried on the back of a 7-year-old students of both sexes, on the features of body posture in the frontal plane

BackgroundThe lifestyle of children has a significant impact on the future health of the whole society. Therefore, health education, prevention and monitoring of health determinants is important at every stage of ontogenesis. This requires a thorough knowledge of the schoolchild's environment, perceived as a wide set of stressors, including not only genetic but also epigenetic factors. One of them is the issue of the correct and abnormal body posture at school and on the way there. The goal of the study was to show the influence of the weight of the back carried container with school supplies on body posture.MethodThe research was carried out as part of a project that examined the impact of carrying weights, which are school supplies, by children on their posture. The research material consisted of data obtained from a group of 65 students (35 girls, 30 boys) aged 7 years. Body posture tests were carried out, using the projection moiré method in 4 positions: 1-habitual posture, 2-posture after 10-min of asymmetric axial load, 3-a posture after 1 min of the load removal, 4-a posture after two minutes of the load removal. Physical fitness was measured with the Sekita test. The obtained data were statistically analyzed.ResultsThe significance of differences between the 1st and 2nd measurements was analyzed to determine the impact of the backpack load and the correlation with physical fitness, and to study its influence on the value of the differences in posture features. Considering the differences in the volume of posture features among boys between the 1st and 2nd measurement, the Wilcoxon’s rank test showed a statistically significant difference in the range of all analyzed variables, except for the torso bend angle to the right (KNT+), where no statistically significant change was noted. A statistically significant difference in the volume of all analyzed variables was observed among the girls.ConclusionsCarrying school supplies on the back induces significant changes in the value of the features describing the body posture in the frontal plane. The greater weight of the container and carrying time, and intensity of physical effort is the greater the changes will be. Physical fitness has a various and sex-dependent influence on the value of changes in body posture features because of carrying school supplies. Among boys it significantly affects the asymmetry of the torso bend, shoulder height, the waist triangles height and width, whereas among girls it affects the asymmetry of the shoulders and the distance of the angles of the lower shoulder blades from the line of the spinous processes of the spine. Among boys the changes in the value of posture features are mostly influenced by endurance and speed, but strength, power and agility are of lower influence, whereas among girls only agility matters.

IDF21-0036 Patient-Reported Outcomes in Patients with Type 2 Diabetes Treated with Tirzepatide or Insulin Degludec (SURPASS-3)

Background: Tirzepatide, a novel dual GIP and GLP-1 receptor agonist for treatment of type 2 diabetes, has shown clinically meaningful reductions in HbA1c and body weight that were significantly greater versus titrated insulin degludec. Aim: To evaluate the effect of tirzepatide versus insulin degludec in patient-reported outcomes (PROs) in the SURPASS-3 study. Method: Patients were randomized (1:1:1:1) to once-weekly tirzepatide 5, 10, 15mg or once-daily insulin degludec for 52-weeks. PRO instruments assessed at baseline and Week-52 were: EQ-5D-5L (measures general health-related quality-of-life), Impact of Weight on Self-Perceptions (IW-SP), Diabetes Treatment Satisfaction Questionnaire (DTSQ), and Ability to Perform Physical Activities of Daily Living (APPADL). Results: All tirzepatide doses significantly improved EQ-5D-5L index, EQ visual analog scale (EQ VAS), IW-SP, and APPADL scores from baseline to Week-52, indicating better outcomes, while insulin degludec significantly improved the EQ VAS only to Week-52. Changes in EQ VAS, IW-SP, and APPADL were significantly higher for all tirzepatide doses vs insulin degludec, indicating better patient-reported health-related quality of life, better weight-related self-perception, and better activities of daily living. Improvements in EQ-5D-5L index scores with tirzepatide did not differ vs insulin degludec. DTSQ change (DTSQc) total score was significantly higher for all tirzepatide doses vs insulin degludec, indicating greater improvement in treatment satisfaction. Self-reported DTSQc score for perceived hyperglycaemia was significantly lower with tirzepatide 15mg and DTSQc score for perceived hypoglycemia was significantly lower with tirzepatide 5mg vs insulin degludec. There were no other significant differences. Discussion: There was a positive treatment satisfaction, overall health, and weight-related quality of life trend with tirzepatide treatment versus insulin degludec. These data may provide useful information to clinicians regarding patient perspectives on quality of life.

Functional and Structural Findings in Infants Treated for Retinopathy of Prematurity Using Optical Coherence Tomography Angiography.

To assess the foveal microvascular structure of children with retinopathy of prematurity (ROP) treated with diode laser photocoagulation using optical coherence tomography angiography (OCTA). OCTA was performed at a tertiary medical center in 17 children (27 eyes) aged 4 to 16 years with a history of diode laser photocoagulation treated ROP. OCTA parameters were compared with those of 12 healthy age-matched controls (23 eyes) attending the orthoptics clinic and correlated with clinical factors. Compared with controls, the ROP group had a smaller foveal avascular zone area (P < .001), lower deep vascular plexus density (P < .001), lower flow density (P = .025), and greater central macular thickness (P < .001). High intraventricular hemorrhage grade correlated with smaller foveal avascular zone area (P = .008) and greater inner macular thickness (P = .047). There was no impact of gestational age, birth weight, or refractive status. OCTA can identify significant quantifiable long-term macular microvascular and structural changes in this patient population. [Ophthalmic Surg Lasers Imaging Retina. 2022;53(4):194-201.].

Effect of aerobic exercise intensity on health-related quality of life in severe obesity: a randomized controlled trial

BackgroundAerobic exercise is an important part of obesity treatment and may improve health-related quality of life (HRQOL). The objective of this study was to compare the effect of two different exercise programs on health-related quality of life in patients with severe obesity.MethodsThis was a single-center, open-label, randomized, parallel-group study comparing the effects of a 24-week moderate-intensity continuous training (MICT) program and a combined high-intensity interval training program with MICT (HIIT/MICT). The primary objective (specified secondary outcome) was to assess HRQOL by using the general health dimension of the Short Form Health Survey (SF-36). The secondary objectives were to assess other dimensional SF-36 scores, the impact of weight on the physical and psychosocial aspects of quality of life (IWQOL-Lite), and the burden of obesity-specific weight symptoms (WRSM).Results73 patients were enrolled and reported patient reported outcome measures, with 71 patients (55% females) allocated to either MICT (n = 34) or HIIT/MICT (n = 37). In the intention-to-treat analysis, general health scores increased between baseline and 24-week follow-up in both the HIIT/MICT group and the MICT group, with a mean change of 13 (95% CI 6–21) points and 11 (95% CI 5–17) points, respectively, with no difference between the groups. The effect sizes of these changes were moderate. The vitality and social functioning scores of SF-36, and the physical function and self-esteem scores of IWQOL-Lite increased moderately in both groups, with no difference between groups. The tiredness, back pain, and physical stamina scores based on WRSM showed moderate to strong changes in both the groups.ConclusionsPatients who had completed a combined HIIT/MICT program did not experience larger improvements in general health compared with those completing a clean 24-week MICT program. Exercise may confer general health benefits independent of intensity.Trials registrationRegional Committees for Medical and Health Research Ethics south east, Norway, October 23, 2013 (identifier: 2013/1849) and ClinicalTrials.gov December 8, 2014 (identifier: NCT02311738).

Pharmacokinetics and pharmacodynamics of MEDI0680, a fully human anti-PD-1 monoclonal antibody, in patients with advanced malignancies.

MEDI0680 is a humanized immunoglobulin monoclonal antibody that targets human programmed cell death protein 1 (PD-1) for the treatment of cancer. A population two-compartmental pharmacokinetic (PK) model and a sequential direct maximal effective drug concentration receptor occupancy (RO) model with baseline parameters were developed to quantify PK variability, identify significant covariates, and characterize the relationship between the PK and the RO of MEDI0680. A total of 58 patients with advanced malignancies received MEDI0680 by intravenous infusion at a dose of 0.1-20mg/kg in a phase 1 study. The clearance was 0.27L per day and the central volume of distribution (V1) was 3.14L, with a modest between-subject variability of 30 and 19%, respectively. None of the evaluated covariates showed any impact on PK parameters except for a nonclinically meaningful relevant impact of body weight on V1. The estimated half-maximal effective concentration for MEDI0680 binding to the PD-1 antigen was approximately 1.88µg/mL. Visual predictive check results demonstrated good predictability of the final population PK-RO model. PK-RO simulations demonstrated that > 90% RO could be maintained in all subjects after a 20-mg/kg dose every 2weeks (Q2W). Therefore, 20mg/kg Q2W and an equivalently fixed dose of 1500mg was recommended for phase 2 studies.

The Role of Resilience in Psychological Health Among Bariatric Surgery Patients.

Many individuals who undergo bariatric surgery have experienced repeated unsuccessful diet attempts and negative messages from healthcare providers, family, and others about their weight. Research pre- and post-operatively has taken a pathological or risk-based approach, investigating psychiatric problems and disordered eating. In contrast, the current study explores resilience in this population. Participants were 148 bariatric surgery patients. Participants completed measures pre-operatively and 1.5-3years post-operatively, including the Binge Eating Scale, Eating Disorder Examination Questionnaire, Patient Health Questionnaire, Generalized Anxiety Questionnaire, Impact of Weight on Quality of Life, Coping Responses Inventory, and Duke Social Support and Stress Scales. The Connor-Davidson Resilience Scale was measured post-operatively. Correlations demonstrated a significant association between post-operative resilience and lower symptoms of binge eating, disordered eating, depression, anxiety, and impact of weight on quality of life. Resilience was also associated with greater social support and less social stress, and greater use of approach coping strategies. Resilience was significantly associated with improvements in symptoms of binge eating, disordered eating, depression, anxiety, and impact of weight on quality of life from pre- to post-operative assessments. In regression models, associations remained significant after controlling for psychosocial variables at baseline (e.g., binge eating symptoms pre-operatively) and demographic covariates. Psychological resilience has been under-studied in the literature on obesity and bariatric surgery, with a primary focus on risk factors for poor outcomes. This study was among the first to investigate associations between resilience and post-operative psychological outcomes. Results suggest the field would benefit from consideration of patient resilience in psychological assessments and interventions.

Seven-year trajectories of body weight, quality of life and comorbidities following Roux-en-Y gastric bypass and sleeve gastrectomy

Background/objectivesThere is limited long-term data comparing the outcomes of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) for severe obesity, both with respect to body weight, quality of life (QOL) and comorbidities.We aimed to determine 7-year trajectories of body mass index (BMI), QOL, obesity-related comorbidities, biomarkers of glucose and lipid metabolism, and early major complications after SG and RYGB.Subjects/methodsPatients scheduled for bariatric surgery at two Norwegian hospitals, preferentially performing either SG or RYGB, were included consecutively from September 2011 to February 2015.Data was collected prospectively before and up to 7 years after surgery. Obesity-specific, generic and overall QOL were measured by the Impact of Weight on Quality of Life-Lite, Short-Form 36 and Cantril’s ladder, respectively. Comorbidities were assessed by clinical examination, registration of medication and analysis of glucose and lipid biomarkers. Outcomes were examined with linear mixed effect models and relative risk estimates.ResultsOf 580 included patients, 543 (75% women, mean age 42.3 years, mean baseline BMI 43.0 kg/m2) were operated (376 SG and 167 RYGB). With 84.2% of participants evaluable after 5–7 years, model-based percent total weight-loss (%TWL) at 7 years was 23.4 after SG versus 27.3 after RYGB (difference 3.9%, p = 0.001). All levels of QOL improved similarly after the two surgical procedures but remained below reference data from the general population at all timepoints. Remission rates for type 2 diabetes, dyslipidemia, obstructive sleep-apnea and gastroesophageal reflux disease (GERD) as well as the rate of de novo GERD significantly favored RYGB. SG had fewer major early complications, but more minor and major late complications combined over follow-up.ConclusionIn routine health care, both SG and RYGB are safe procedures with significant long-term weight-loss, improvement of QOL and amelioration of comorbidities. Long-term weight-loss and remission rates of main obesity-related comorbidities were higher after RYGB.

IMPACT OF LOCKDOWN DUE TO CORONAVIRUS DISEASE (COVID-19) ON THE WEIGHT RELATED QUALITY OF LIFE

Background: The current lockdown due to the COVID-19 pandemic has clearly led to changes in the lifestyles of people. This study aimed to determine the effects of this lockdown on the lifestyles of individuals and ultimately the overall changes in weight-based quality of life in the undergraduate students of Pakistan. Methods: This cross-sectional study was conducted on participants of ages 18–25 from different universities around Pakistan. The questionnaires were sent to participants via WhatsApp, posted online using Microsoft forms. A total of 157 responses were received. The questionnaires were adapted using Impact of Weight on Quality of Life (IWQOL). Chi-square test was used for comparison of categorical variables, and p&lt;0.05 was considered statistically significant. Results: Out of 157 responses, 109 were females and 48 males. The mean weight before and after the lockdown was 61.95 Kg and 64.97 Kg respectively. Significant changes in areas of physical function, self-esteem and work were attained with p&lt;0.001, 0.002, and 0.023 respectively. Conclusions: The lifestyle changed and as a result the weight of the undergraduate population of Pakistan generally increased during the lockdown due to the COVID-19 pandemic. Self-esteem decreased among the youth and they faced mental health issues including anxiety and distress due to direct effects of lockdown on lifestyle. Pak J Physiol 2021;17(4):63–6

Randomized Clinical Trial to Evaluate the Morphological Changes in the Adventitial Vasa Vasorum Density and Biological Markers of Endothelial Dysfunction in Subjects with Moderate Obesity Undergoing a Very Low-Calorie Ketogenic Diet.

Weight loss after bariatric surgery decreases the earlier expansion of the adventitial vasa vasorum (VV), a biomarker of early atheromatous disease. However, no data are available regarding weight loss achieved by very low calorie ketogenic diets (VLCKD) on VV and lipid-based atherogenic indices. A randomized clinical trial was performed to examine changes in adventitial VV density in 20 patients with moderate obesity who underwent a 6-month very low calorie ketogenic diet (VLCKD, 600–800 kcal/day), and 10 participants with hypocaloric diet based on the Mediterranean Diet (MedDiet, estimated reduction of 500 kcal on the usual intake). Contrast-enhanced carotid ultrasound was used to assess the VV. Body composition analysis was also used. The atherogenic index of plasma (log (triglycerides to high-density lipoprotein cholesterol ratio)) and the triglyceride-glucose index were calculated. Serum concentrations of soluble intercellular adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured. The impact of weight on quality of life-lite (IWQOL-Lite) questionnaire was administered. Participants of intervention groups displayed a similar VV values. Significant improvements of BMI (−5.3 [−6.9 to −3.6] kg/m2, p < 0.001), total body fat (−7.0 [−10.7 to −3.3] %, p = 0.003), and IWQOL-Lite score (−41.4 [−75.2 to −7.6], p = 0.027) were observed in VLCKD group in comparison with MedDiet group. Although after a 6-months follow-up period VV density (mean, right and left sides) did not change significantly in any group, participants in the VLCKD exhibited a significantly decrease both in their atherogenic index of plasma and serum concentration of sICAM-1. A 6-month intervention with VLCKD do not impact in the density of the adventitial VV in subjects with moderate obesity, but induces significant changes in markers of endothelial dysfunction and CV risk.

Combination of preoperative CA19-9 levels, cell differentiation, and age predicts survival for patients with gastric cancer before surgery.

Gastric cancer (GC) is very common in China, posing a threat to public health, with high morbidity and mortality ranks. Tumor-node-metastasis (TNM) staging system is routinely used to predict prognosis for patients with GC but only available after surgery. Therefore, searching for markers that can predict prognosis of GC patients before surgery is desirable to assist management decisions preoperatively. Among 322 GC patients followed-up for 128 months, the tumor markers alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 and carbohydrate antigen 72-4 of 168 patients were detected before surgery, and their impact on survival was analyzed. Four major findings were revealed: (1) Preoperative examined CA19-9 levels and cell differentiation using endoscopic biopsies were positively correlated with lymphatic metastases and TNM stages obtained after surgery. (2) Kaplan-Meier analyses demonstrated that poor survival of patients with GC was associated with higher CA19-9 levels, poor cell differentiation, and older age. (3) Cox multi-factorial regression analyses indicated that, in terms of predicting overall survival for GC patients, preoperative CA19-9 level, cell differentiation and age were independent factors, respectively, comparable to postoperative TNM staging system. (4) Using receiver operating characteristic curve analysis, we first revealed that preoperative CA19-9 levels and cell differentiation had the impact weights (IW) on survival comparable to postoperative TNM components. These findings suggest that preoperative CA19-9 levels, cell differentiation and age are useful prognostic related markers for GC patients, superior to postoperative TNM system in terms of timing for management. We propose that, assisted by clinical imaging, a comprehensive utilization of these preoperative survival-predictors may help formulate individualized medical management for GC patients such as surgical strategy, optimal chemotherapy and radiotherapy, and appropriate follow-up intervals after surgery.

Abstract 10599: The Effects of Gestational Age and Size on Management Strategies and Outcomes in Neonatal Tetralogy of Fallot

Introduction: Data suggests there are benefits to both staged (SR) and complete repair (CR) for neonatal Tetralogy of Fallot (nTOF), though data is lacking on whether high-risk groups would benefit from one strategy over another. In a large state with variable practice patterns, we studied the impact of gestational age (GA) and weight by GA (birth weight z-score: BWz) at birth on surgical strategy and outcomes in nTOF, hypothesizing that GA and BWz would influence these outcomes. Methods: Population-based cohort study (2011-2017) of infants with nTOF (defined as catheter or surgical intervention prior to 44 weeks corrected GA) was performed. BWz was categorized as appropriate, small or large for GA. Surgical strategy and timing were compared by GA ( &lt; 36 weeks preterm (n= 96), 37-38 weeks early term (n= 97), &gt; 38 weeks full term (n= 152)) and BWz. Multivariable (MV) models were constructed to evaluate composite outcome of mortality or significant morbidity (BPD, IVH, NEC, PVL etc.) at 1 year and total number of hospital days in first year of life. Results: There were 345 patients included (SR= 194; CR= 151). Surgical strategy did not differ by GA or BWz. Within CR group, full term and early term neonates underwent surgery 20 (95%CI: -27.1, -14.1; p&lt;0.001) and 15 days (95%CI: -22.1, -8.2; p&lt;0.001) sooner than preterm neonates. BWz was not associated with surgical timing. A stratified analysis trended toward lower survival probability among preterm neonates undergoing CR vs. SR (p= 0.1). In a MV model including GA, BWz, surgical approach and DOL surgery, only GA was associated with the composite outcome. The odds of a poor outcome was 0.45 (95%CI:0.24,0.86) times lower in full term vs. preterm neonates, p= 0.02. The adjusted total burden of hospital days in the first year was 32 (95%CI: -47.7,-16.9; p&lt;0.001) and 22 (95%CI: -36.5,-7.7; p= 0.003) days less in early term and full term compared to preterm neonates. Conclusions: In nTOF, GA and BWz were not associated with surgical strategy though premature neonates were more likely to wait longer for their initial intervention. One-year outcomes appear to be strongly influenced by GA and not surgical strategy; however, there was a trend to suggest that SR may result in better survival probability among premature neonates.