Obesity Levels Research Articles

Unraveling the Connection: Visceral Adipose Tissue and Vitamin D Levels in Obesity.

Vitamin D deficiency and insufficiency are widespread on a global scale, with multiple factors playing a role in their development, such as limited exposure to sunlight, inadequate dietary consumption, as well as obesity and abdominal fat accumulation. Abdominal obesity, assessed with waist circumference (WC), is associated with metabolic syndrome and has been linked to low vitamin D levels. This study aimed to investigate the relationship between visceral adipose tissue (VAT) and vitamin D levels, particularly examining the potential threshold for vitamin D storage and sequestration using adipose tissue. The study was conducted between 2020 and 2022 with 58 patients from an internal medicine outpatient department. Patients with certain medical conditions and those taking medications affecting bone metabolism were excluded. Blood samples were collected at baseline and after 6 months of monthly cholecalciferol supplementation. Ultrasonography was used to evaluate adipose tissue measurements, including subcutaneous adipose tissue thickness, VAT, preperitoneal adipose tissue (PPAT), and prerenal adipose tissue (PRAT). Anthropometric measures such as the waist-to-hip ratio and waist-to-height ratio were also assessed. The results showed that all subjects had significant hypovitaminosis D at baseline. After 6 months of supplementation, the mean increase in vitamin D levels was 9.6 ng/mL, with 55.2% of subjects becoming deficient. The study revealed a significant correlation between follow-up vitamin D levels and waist circumference, hip circumference, and VAT. VAT exhibited a strong correlation not only with vitamin D levels but also with waist circumference. When analyzing gender differences, males showed a higher weight and waist-to-hip ratio, while females had higher body adiposity indexes and subcutaneous adipose tissue measurements. In conclusion, this study highlights the relationship between VAT and vitamin D levels, emphasizing the potential role of adipose tissue in vitamin D availability. Waist circumference was identified as a surrogate measure for VAT evaluation. Furthermore, the study showed variations in vitamin D response to supplementation between genders, with a higher percentage of males reaching normal vitamin D levels. Predictive factors for vitamin D levels differed between genders, with waist circumference being a significant predictor in males and body adiposity index in females.

OR24-04 High Prevalence Of Elevated ALT In Adolescent Females With Obesity And PCOS

Abstract Disclosure: S. Zhang: None. J.A. Darbinian: None. L.C. Greenspan: None. J.B. Schwimmer: Grant Recipient; Self; Intercept, Seraphina. J.C. Lo: None. Background: We recently observed that US Asian/Pacific Islander (PI) adolescents have two-fold higher odds of polycystic ovary syndrome (PCOS) compared to non-Hispanic White adolescents, with prevalence strongly associated with higher BMI. Moreover, similar to Hispanic/Latina adolescents, Asian/PI adolescents with obesity have much higher odds of elevated alanine aminotransferase (ALT), a biochemical marker for suspected non-alcoholic fatty liver disease (NAFLD). In a pilot study, we observed that PCOS was an independent predictor of elevated ALT in adolescent females with obesity. In this study, we characterized the association of PCOS and elevated ALT in a much larger population of adolescent females and further examined the burden of elevated ALT within the PCOS subset. Methods: We used data from 15,683 females aged 13-17 years who were members of a US integrated healthcare system, had a well-child visit in 2012-2018, met BMI criteria for obesity (BMI ≥95th percentile), and had ALT measured within 1 year of the visit. Elevated ALT was defined as ≥44 U/L (NASPHGAN criteria). PCOS was identified based on clinical diagnosis within 1 year of the visit. Class I, II, III obesity were defined by BMI percent of the 95th percentile from 100 to <120%, 120% to <140%, and ≥140%, respectively. Differences between PCOS and non-PCOS groups were compared using the Chi-square test. Multivariable logistic regression was used to examine the association of PCOS and elevated ALT. Results: Among 15,683 adolescent females with obesity and measured ALT (23.5% White, 14.1% Black, 11.0% Asian/PI, 46.8% Hispanic, and 4.7% other/unknown race and ethnicity), 5.5% had diagnosed PCOS and 39.5% had severe (class II-III) obesity. The prevalence of elevated ALT was 5.1% overall and was substantially higher among those with PCOS (10.6%) compared to those without PCOS (4.7%, p<0.001). In multivariable analyses, PCOS was associated with a 1.8-fold (CI 1.4-2.2) higher odds of elevated ALT, adjusting for age, race/ethnicity, and level of obesity. Similar to our prior report, greater obesity severity, Asian/PI race, and Hispanic ethnicity were significant predictors of elevated ALT. Among the subset of 865 adolescents with obesity and PCOS (40.9% class I, 34.9% class II, 24.2% class III obesity), the prevalence of elevated ALT varied by race and ethnicity, ranging from 15.8% among Asian/PI, 12.8% among Hispanic/Latina, 8.5% among White, and 2.0% among Black females. Conclusion: Our findings confirm a strong independent association of PCOS and elevated ALT among adolescent females with obesity. Among those with both obesity and PCOS, about 1 in 10 had elevated ALT, increasing to 1 in 8 among Hispanic/Latina females and nearly 1 in 6 among Asian/PI females. These findings support recommendations for NAFLD screening in adolescents with PCOS and consideration of screening in young adult women with PCOS, especially high-risk subsets. Presentation: Saturday, June 17, 2023

FRI004 Sex Differences In Oxytocin And Arginine-Vasopressin Levels Around A Standardized Meal In Adults With Obesity

Abstract Disclosure: M. Wronski: None. J.T. Sanislow: None. K. Holman: None. J. Gydus: None. M. Muhammed: None. S. Smith: None. E. Asanza: None. E.R. Golden: None. N. Hadaway: None. S. Ehrlich: None. A. Aulinas Maso: None. L. Kerem: None. J.M. Davis: None. H.P. Nazarloo: None. S. Carter: None. F. Plessow: None. E.A. Lawson: None. Objective: Oxytocin (OXT) and arginine-vasopressin (AVP) are neurohormones involved in metabolism that are regulated by gonadal steroid levels. OXT tends to be higher in healthy-weight females than males; levels decrease following a meal with an associated reduction in appetite. In contrast, AVP tends to be lower in healthy-weight females than males; post-prandial AVP response has not been examined. OXT and AVP levels in response to feeding and the impact of sex are important to study in individuals with obesity to improve our understanding of disease pathophysiology and advance treatment. We investigated peripheral OXT and AVP levels in female and male adults with obesity fasting and at three post-prandial time points (TP). Methods: The diverse study sample of 56 non-diabetic adults with obesity (35.71% non-White, 19.64% Hispanic) included 30 premenopausal females and 26 males (age: mean ± SEM = 33.73 ± 0.83 years, range = 18.60 - 45.71 years; BMI: 36.77 ± 0.66 kg/m2, 30.20 - 50.60 kg/m2). We tested sex differences in age and BMI using two-samples t-tests. Plasma samples were collected fasting and 30, 60, and 120 minutes (TP) after a standardized ∼500 kcal meal to measure OXT and AVP levels (using enzyme-linked immunosorbent assays). OXT and AVP levels deviating >3*SD from the hormone-, sex-, and TP-specific mean were excluded prior to log-transformation to approximate normality. Sex differences and meal-related dynamics in OXT and AVP levels were examined using two random-intercept linear mixed effects models with predictors sex, TP, and sex-x-TP interaction, covarying for BMI (false discovery rate across both models). Results: Age and BMI did not differ between sexes (ps ≥ 0.354). Across TPs, female sex significantly predicted lower OXT (F(1,53) = 4.90, FDR-q = 0.031, partial eta squared = 0.08, adjusted mean ± SEM females = 273.95 ± 1.12 pg/mL versus males = 397.61 ± 1.13 pg/mL) and lower AVP (F(1,52) = 5.04, FDR-q = 0.031, partial eta squared = 0.09, adjusted mean ± SEM females = 79.77 ± 1.21 pg/mL versus males = 149.39 ± 1.22 pg/mL). TP and sex-x-TP interaction effects were nonsignificant. Conclusion: In this first study to investigate sex differences and meal-dependent changes in OXT and AVP levels in adults with obesity, we found that levels of both neurohormones were lower in females than males. In contrast to our previous finding of a post-prandial decrease in OXT, associated with change in appetite in healthy-weight females, there was no impact of food intake on OXT or AVP levels in adults with obesity. Our data indicate that in obesity, OXT and AVP levels are sexually dimorphic and postprandial dynamics may be dysregulated. Presentation: Friday, June 16, 2023

Brain-derived neurotrophic factor knock-out mice develop non-alcoholic steatohepatitis.

While brain-derived neurotrophic factor (BDNF), which is a growth factor associated with cognitive improvement and the alleviation of depression symptoms, is known to regulate food intake and body weight, the role of BDNF in peripheral disease is not fully understood. Here, we show that reduced BDNF expression is associated with weight gain and the chronic liver disease non-alcoholic steatohepatitis (NASH). At 10 months of age, BDNF-heterozygous (BDNF+/- ) mice developed symptoms of NASH: centrilobular/perivenular steatosis, lobular inflammation with infiltration of neutrophils, ballooning hepatocytes, and fibrosis of the liver. Obesity and higher serum levels of glucose and insulin - major pathologic features in human NASH - were dramatic. Dying adipocytes were surrounded by macrophages in visceral fat, suggesting that chronic inflammation occurs in peripheral organs. RNA sequencing (RNA-seq) studies of the liver revealed that the most significantly enriched Gene Ontology term involved fatty acid metabolic processes and the modulation of neutrophil aggregation, pathologies that well characterise NASH. Gene expression analysis by RNA-seq also support the notion that BDNF+/- mice are under oxidative stress, as indicated by alterations in the expression of the cytochrome P450 family and a reduction in glutathione S-transferase p, an antioxidant enzyme. Histopathologic phenotypes of NASH were also observed in a knock-in mouse (BDNF+/pro ), in which the precursor BDNF is inefficiently converted into the mature form of BDNF. Lastly, as BDNF reduction causes overeating and subsequent obesity, a food restriction study was conducted in BDNF+/pro mice. Pair-fed BDNF+/pro mice developed hepatocellular damage and showed infiltration of inflammatory cells, including neutrophils in the liver, despite having body weights and blood parameters that were comparable to those of controls. This is the first report demonstrating that reduced BDNF expression plays a role in the pathogenic mechanism of NASH, which is a hepatic manifestation of metabolic syndrome. © 2023 The Pathological Society of Great Britain and Ireland.

Prevalence of hyperuricaemia among adults from Ningxia Hui Autonomous Region, China: a cross-sectional study

ObjectiveThis study aimed to estimate the prevalence of hyperuricaemia (HUA) and investigate its risk factors in the general adult population of Ningxia Hui Autonomous Region (NHAR), China.DesignCross-sectional study.SettingSurvey of cardiovascular...

Long-Term Exposure to Walkable Residential Neighborhoods and Risk of Obesity-Related Cancer in the New York University Women's Health Study (NYUWHS).

Living in neighborhoods with higher levels of walkability has been associated with a reduced risk of obesity and higher levels of physical activity. Obesity has been linked to increased risk of 13 cancers in women. However, long-term prospective studies of neighborhood walkability and risk for obesity-related cancer are scarce. We evaluated the association between long-term average neighborhood walkability and obesity-related cancer risk in women. The New York University Women's Health Study (NYUWHS) is a prospective cohort with 14,274 women recruited between 1985 and 1991 in New York City and followed over nearly three decades. We geocoded residential addresses for each participant throughout follow-up and calculated an average annual measure of neighborhood walkability across years of follow-up using data on population density and accessibility to destinations associated with geocoded residential addresses. We used ICD-9 codes to characterize first primary obesity-related cancers and employed Cox proportional hazards models to assess the association between average neighborhood walkability and risk of overall and site-specific obesity-related cancers. Residing in neighborhoods with a higher walkability level was associated with a reduced risk of overall and site-specific obesity-related cancers. The hazards ratios associated with a 1-standard deviation increase in average annual neighborhood walkability were 0.88 (95% CI: 0.85, 0.93) for overall obesity-related cancer, 0.89 (95% CI: 0.84, 0.95) for postmenopausal breast cancer, 0.82 (95% CI: 0.68, 0.99) for ovarian cancer, 0.87 (95% CI: 0.76, 0.99) for endometrial cancer, and 0.68 (95% CI: 0.49, 0.94) for multiple myeloma, adjusting for potential confounders at both the individual and neighborhood level. The association between neighborhood walkability and risk of overall obesity-related cancer was stronger among women living in neighborhoods with higher levels of poverty compared with women living in areas with lower poverty levels (). Our study highlights a potential protective role of neighborhood walkability in preventing obesity-related cancers in women. https://doi.org/10.1289/EHP11538.

The relationship between body dissatisfaction, lifestyle, and nutritional status among university students in Southern China

BackgroundIn recent years, obesity in early adulthood has become an urgent global public health concern. Body dissatisfaction may have adverse effects on lifestyle habits, leading to obesity. However, research on nutritional status and body dissatisfaction among Chinese young adults is still insufficient. Therefore, this study aimed to analyze the relationship between body dissatisfaction, dietary habits, physical activity, and nutritional status among university students. In addition, we explored the feasibility of improving university students’ nutritional status by improving the levels of body dissatisfaction.MethodsThis study was conducted in Ganzhou City, Jiangxi Province, China, at a randomly selected university. All 1900 undergraduate students volunteered to participate and signed the consent form. Students were required to completed anthropometric measurements and three questionnaires, which included the Physical Activity Rating Scale-3 (PARS-3), Chinese version of the Dutch Dietary Behavior Questionnaire (C-DEBQ), and Body Dissatisfaction. Of these, 1714 students (age: 18–24 years; men: 933, women: 781) with complete and valid data were included.ResultsHigher obesity levels were observed in men compared to women (p<0.01). Meanwhile, body dissatisfaction was higher in women compared to men (p<0.01). Overeating and insufficient physical activity were more problematic in women compared to in men (p<0.01). Multiple regression analyses were conducted separately, with BMI and body dissatisfaction as the dependent variables. Body dissatisfaction (β=0.72, p<0.01), muscle mass (β=0.33, p<0.01), emotional eating score (β=0.05, p<0.01), sex (β=-0.05, p<0.05) and physical activity (β=-0.04, p<0.05) score were significant predictors of obesity. Furthermore, Muscle mass (β=0.61, p<0.01), sex (β=0.54, p<0.01), restrained eating score (β=0.25, p<0.01), physical activity score (β=-0.20, p<0.01) and emotional eating score (β=0.08, p<0.01) were significant predictors of body dissatisfaction.ConclusionThe data presented in this study highlight the impact of university students’ body dissatisfaction in China on physical activity deficiency and overeating, discovering that reducing body dissatisfaction has great potential for preventing obesity.

Prostate Cancer in New York City: Impact of Neighborhood Level Social Determinants of Care

Social determinants of health may impact stage and aggressiveness of cancer presentation. As neighborhoods may influence adjacent neighborhoods across often porous and arbitrary borders, an analysis that measures the spatial impact of these social determinants provides a more holistic evaluation than an analysis that treats each neighborhood as independent and unrelated units. In this paper, we study the impact of sociodemographic and environmental characteristics of neighborhoods on cancer presentation in New York City, using both patient-level analysis and spatial autoregression on the New York State Public Access Cancer Epidemiology Data (NYSPACED) and the NYC Open neighborhood-level dataset. Two outcomes of interest were chosen: Presentation with high grade prostate cancer and presentation with distant disease. We performed logistic regression on individual patient level analysis. We created generalized cross sectional autoregressive spatial regression models to assess direct and indirect (via adjacent neighborhoods) impact of neighborhood level independent variables. We analyzed the following neighborhood level variables: 1) Percent population that was Black, 2) Percent population living in poverty, 3) Percent population obese based on self-reported height and weight, 4) Percent who report being current smokers, 5) Percent who report eating one or more servings of fruits and/or vegetables in the last day, and 6) annual average micrograms of fine particulate matter per cubic meter of air. We identified 95,749 patients diagnosed with prostate adenocarcinoma in New York City from 2001-2018. With reported Black race as the referent value, White patients were less likely to present with high grade disease (OR 0.92 [95% CI 0.89-0.95]). Similarly, self-identified White patients were also less likely to present with distant disease (vs. Black, OR 0.76 [95% CI 0.72-0.81]). Spatial autoregression models revealed no neighborhood level variables associated with direct or indirect impacts on presentation with high grade disease. However, there were several variables initially associated with distant disease presentation, including race, poverty, obesity, fruit and vegetable consumption, and air pollution. However, only neighborhood poverty and obesity levels continued to have significant direct impact on presentation with distant disease when included in the regression model with percent Black residents. In conclusion, we discovered a strong association between Race and poverty with the likelihood of presenting with advanced prostate cancer, at both the individual and neighborhood levels. Geographically targeted outreach to improve prostate cancer screening and access to care should be focused on Black men and neighborhoods with high levels of poverty.

Severity of adult-onset asthma - a matter of blood neutrophils and severe obesity

BackgroundAdult-onset asthma is associated with a poor treatment response. The aim was to study associations between clinical characteristics, asthma control and treatment in adult-onset asthma. MethodsPrevious participants within the population-based Obstructive Lung Disease in Northern Sweden studies (OLIN) were in 2019–2020 invited to clinical examinations including structured interviews, spirometry, fractional exhaled nitric oxide (FeNO), skin prick test and blood sampling. In total, n = 251 individuals with adult-onset asthma (debut >15 years of age) were identified. Uncontrolled asthma was defined according to ERS/ATS and treatment step according to GINA (2019). ResultsAmong individuals with uncontrolled asthma (34%), severe obesity (16.3% vs 7.9%, p = 0.041) and elevated levels of blood neutrophils, both regarding mean level of blood neutrophils (4.25*109/L vs 3.67*109/L, p = 0.003), and proportions with ≥4*109/L (49.4% vs 33.3%, p = 0.017) and ≥5*109/L (32.1% vs 13.7%, p < 0.001) were more common than among those with controlled asthma. Adding the dimension of GINA treatment step 1–5, individuals with uncontrolled asthma on step 4–5 treatment had the highest proportions of blood neutrophils ≥5*109/L (45.5%), severe obesity (BMI≥35, 26.1%), dyspnea (mMRC≥2) (34.8%), and most impaired lung function in terms of FEV1%<80% of predicted (42.9%), FEV1<LLN (47.6%), FVC<80% of predicted (42.9%) and FVC < LLN (38.1%). No associations between level of asthma control and treatment were found regarding blood eosinophils, FeNO or allergic sensitization. ConclusionThis study indicates that in adult-onset asthma, primarily non-type-2 characteristics such as obesity and blood neutrophils associate with poor asthma control and higher doses of inhaled corticosteroids.

A-035 Association between Obesity and Prostate Specific Antigen level in Diabetes Mellitus Type2

Abstract Background Body mass index (BMI) is a simple index commonly used to classify obesity. It is defined as a person’s weight(kg) divided by the square of his height (m). An inverse relationship between obesity and prostate-specific antigen (PSA) has been reported by previous studies with lower PSA levels found in groups with a higher body mass index (BMI). The main objective of this current study is to assess the association between body mass index (BMI) and PSA in male patients with diabetes mellitus. Methods This study uses a case-control experimental procedure to assess adult men between 40–75 years old, attending University of Nigeria Teaching Hospital, Enugu State, Nigeria. Eighty-six (86) of the volunteers recruited for this study were patients diagnosed with type II diabetes, and sixty (60) others were non-diabetic patients used as controls. Consent was sorted from these patients, and a questionnaire was given to the participants in which data about their age, family history of diabetes, and prostate condition was collected. Their hospital folders were used to confirm their diabetic status and prostate gland health. Body Mass Index (BMI) was calculated after measuring weight (kg) and height(m). Blood samples were assayed to determine the fasting blood sugar (FBS) using Glucose Oxidase enzymatic method, and total prostate-specific antigen (tPSA) concentration was determined using Enzyme-Linked Immunosorbent Assay (ELISA). The Body mass index (BMI), as a “gold standard” approach for obesity classification, was used to group the patients as; underweight (below 18.5), normal weight (18.5–24.9), pre-obesity (25.0–29.9), obesity class I (30–34.9), obesity class II (35.0–34.9), and obesity class III (40 and above). The Statistical Package for Social Sciences (SPSS) version 22.0 was used to analyze data generated and compared between groups using student T-test. Statistical difference was at a P value of 0.05 or higher. Results The result of this study demonstrated a significant difference in the BMI of diabetic men (test) and non-diabetic men (control). Moreso, lower tPSA was observed in obese men compared to normal BMI in both test and control. Hemodilution caused by elevated plasma volume, which may reduce serum concentration of soluble tumor markers, may be responsible for lower PSA levels in obese men. Conclusion Obesity may hinder the ability to detect prostate cancer at an earlier stage. Therefore, BMI should be considered while determining a PSA threshold for prostate disorders screening.

Impact of information and deliberation on the consistency of preferences for prioritization in health care – evidence from discrete choice experiments undertaken alongside citizens’ juries

BackgroundPublic preferences are an important consideration for priority-setting. Critics suggest preferences of the public who are potentially naïve to the issue under consideration may lead to sub-optimal decisions. We assessed the impact of information and deliberation via a Citizens’ Jury (CJ) or preference elicitation methods (Discrete Choice Experiment, DCE) on preferences for prioritizing access to bariatric surgery.MethodsPreferences for seven prioritization criteria (e.g. obesity level, obesity-related comorbidities) were elicited from three groups who completed a DCE: (i) participants from two CJs (n = 28); (ii) controls who did not participate in the jury (n = 21); (iii) population sample (n = 1,994). Participants in the jury and control groups completed the DCE pre- and post-jury. DCE data were analyzed using multinomial logit models to derive “priority weights” for criteria for access to surgery. The rank order of criteria was compared across groups, time points and CJ recommendations.ResultsThe extent to which the criteria were considered important were broadly consistent across groups and were similar to jury recommendations but with variation in the rank order. Preferences of jurors but not controls were more differentiated (that is, criteria were assigned a greater range of priority weights) after than before the jury. Juror preferences pre-jury were similar to that of the public but appeared to change during the course of the jury with greater priority given to a person with comorbidity. Conversely, controls appeared to give a lower priority to those with comorbidity and higher priority to treating very severe obesity after than before the jury.ConclusionBeing informed and undertaking deliberation had little impact on the criteria that were considered to be relevant for prioritizing access to bariatric surgery but may have a small impact on the relative importance of criteria. CJs may clarify underlying rationale but may not provide substantially different prioritization recommendations compared to a DCE.

Temporal optimization of exercise to lower fasting glucose levels.

Exercise stimulates glucose uptake and increases insulin sensitivity acutely. Temporally optimizing exercise timing may minimize the nocturnal rise in glucose levels. This study examined the effect of exercise timing on evening and overnight glucose concentrations in individuals who were non-obese with normal fasting glucose levels (Non-Ob; n=18) and individuals with obesity (OB) with impaired fasting glucose levels (OB+IFG) and without (n=16 and n=18, respectively). Subjects were studied on three occasions (no exercise (NOEX)), morning exercise (AMEX; 0700h) and evening exercise (PMEX; 2000h). The evening meal was provided (1800h) and blood samples were taken from 1740 to 0700h and morning endogenous glucose production (EGP) was measured. Glucose and insulin concentrations increased with the dinner meal with peak concentrations being higher in OB+IFG than in OB and Non-Ob (P=0.04). In OB+IFG, evening glucose concentrations rose above baseline levels at about 2300h, with the glucose concentrations staying somewhat lower with AMEX and PMEX until ∼0500h than with NOEX. In OB+IFG, insulin concentrations decreased following the dinner meal and waned throughout the night, despite the rising glucose concentrations. In the OB and Non-Ob individuals following the dinner meal, no increase in glucose concentrations occurred in the evening period and insulin levels mirrored this. No difference was observed in the morning fasting glucose levels between study days or between groups. Regardless of time of day, exercise delays the evening rise in glucose concentrations in adults with OB+IFG but does not lower morning fasting glucose levels or improve the synchrony between glucose and insulin concentrations. KEY POINTS: Insulin resistance and type 2 diabetes have been linked to disturbances of the core clock, and glucose tolerance demonstrates a diurnal rhythm in healthy humans with better glucose tolerance in the morning than in the afternoon and evening. Skeletal muscle is a primary site for insulin resistance in people with impaired glucose tolerance. In individuals with obesity and impaired fasting glucose levels (OB+IFG), following a dinner meal, glucose concentrations started to rise and continues throughout the night, resulting in elevated glucose levels, while concomitantly, insulin levels are waning. Exercise, regardless of the time of day, suppressed the rise in glucose levels in OB+IFG for many hours during the night but did not lower morning fasting glucose levels. Morning exercise was not quite as effective as evening exercise.

Impact of clinico-biochemical and inflammatory biomarkers on the immunogenicity and efficacy of SARS-CoV-2 adenoviral vaccine: a longitudinal study.

Due to a lack of effective antiviral treatment, several vaccines have been put forth to curb SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection and to reduce the mortality and morbidity rate by eliciting a protective immune response, primarily through virus-neutralizing antibodies specific for SARS-CoV-2 spike protein. This longitudinal study was designed to evaluate the vaccine effectiveness and immune response following the administration of adenoviral vaccine, COVISHIELD, in Indian population who were previously uninfected with SARS-CoV-2 and to reveal the effect of various sociodemographic, inflammatory and biochemical factors on antibody response. Briefly, the total immunoglobulin G (IgG) against SARS-CoV-2 spike and nucleocapsid protein along with the immunological markers were estimated by chemiluminescent microparticle immunoassay (CMIA) technology. Biochemical parameters were estimated by spectrometry. A total of 348 subjects received two doses of COVISHIELD (224 males, 124 females). The mean age of the study subjects was 42.03 ± 13.54 years. Although both the doses of COVISHIELD against SARS-CoV-2 spike protein induced a robust immune response that lasted for months in all the subjects, the total IgG titer against SARS-CoV-2 spike protein was found significantly higher in subjects ≥50 years of age, and those with obesity, elevated triglycerides and elevated lactate dehydrogenase levels. There is a definite effect of age and biochemical factors on the immunogenicity of COVISHIELD. An understanding of these factors could not only impact the design of vaccines and help improve vaccine immunogenicity and efficacy but also assist in decisions on vaccination schedules, in order to combat this deadly pandemic.

La actividad de la artritis psoriásica con afectación axial se correlaciona con el PsAID12

ObjectiveTo determine the impact of the disease in patients with PsA in daily clinical practice and to evaluate its relationship with its axial activity. MethodsA cross-sectional study was conducted in consecutive patients attended from January 2021 to December 2021 who met the CASPAR criteria, with clinical of inflammatory back pain and positive axial imaging, with or without peripheral involvement. Demographic, clinical, analytical data, HAQ index, PsAID12 and activity index (BASDAI and ASDAS-PCR) were also collected. Patients were divided into two groups, those with high impact and those with low impact according to PsAID results. Continuous variables are shown as median (Q1-Q3) and categorical variables as percentages and frequencies. ResultsOf the 269 patients evaluated with PsA, 72 patients with axial involvement were included, 40 men (55.6%), with a median age of 54.1 years and disease duration of 7 years. 28.3% of the patients were obese and serum CRP level was 0.45mg/dl (0.08-1.10). BASDAI was 4.2 (2.0-6.2) and ASDAS-PCR was 2.4 (1.5-3.2), which translates into 39.6% of patients in low activity or remission. The median PsAID total score was 3.9 (1.6–5.4), evaluated in 61 patients. The patients who achieved a PsAID12≤4 were 63%, mostly men and with lower CRP levels than PsAID≥4 patients. In addition, low impact measured by the PsAID12 was associated with low results in BASDAI and ASDAS-PCR. ConclusionsAxial involvement reflected lower impact of the disease measured by PsAID12 and it is correlated with low activity measured by BASDAI and ASDAS-PCR.

Mendelian randomization analysis to analyze the genetic causality between different levels of obesity and different allergic diseases

BackgroundThe causal relationship between obesity and different allergic diseases remains controversial.MethodsThe Two Sample MR package and Phenoscanner database were used to obtain and filter Genome-Wide Association Study (GWAS) data from the Open GWAS database. Mendelian randomization (MR) analysis was used to study the causal relationship between different levels of obesity and different allergic diseases. The data sets related to obesity and asthma were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were screened by the limma package. Cluster Profiler and GO plot packages were used for enrichment analysis to verify the results of MR analysis.ResultsTwo-sample MR analysis showed a causal relationship between obesity and childhood allergy (age < 16), allergic asthma and atopic dermatitis (P < 0.05). In addition, there was also a causal relationship between allergic asthma and obesity (P < 0.05), while there was no genetic causal relationship between obesity and allergic rhinitis, eczema, lactose intolerance and so on (P > 0.05). Subgroup analysis revealed a causal relationship between both class 1 and class 2 obesity and childhood allergy (age < 16) (P < 0.05). Obesity class 1 was associated with allergic asthma, while obesity class 3 was associated with atopic dermatitis (P < 0.05). Bioinformatics analysis shows that there were common DEGs between obesity and allergic asthma.ConclusionObesity is a risk factor for childhood allergy (age < 16), allergic asthma and atopic dermatitis, while allergic asthma is also a risk factor for obesity. Class 1 and class 2 obesity are both causally associated with childhood allergy (age < 16). In addition, there is a causal relationship between milder obesity and allergic asthma, while heavier obesity is causally related to atopic dermatitis.

Identification of contributing factors, microorganisms and antimicrobial resistance involved in the complication of diabetic foot ulcer treatment

Diabetic foot ulcer (DFU) is a neurological and peripherical complication of diabetes with unknown etiology that is often associated with polymicrobial infections. The present study was conducted to investigate the contributing factors in 285 DFU patients, which included 200 patients with diabetic foot infections (DFI). Identification and characterization of infecting bacterial isolates were done followed by assessment of their pattern of susceptibility to commonly used antibiotics. Among the studied subjects, type 2 diabetes mellitus (T2DM), ulcer type, depth, grade, loss of sensation, infection type, affected foot, recurrence, smoking status, Body Mass Index (BMI), and obesity levels revealed significant disease risk association. Ulcer grades 1 and 2 were more common in males while grade 3 in females. Recurrent infections were significantly higher in females (P = 0.03). Diabetic duration, hyperglycemia, ulcer type, infection type and BMI were positively correlated with delayed wound healing. In DFI samples, 40.2% consisted of gram-negative bacteria, with Pseudomonas aeruginosa (37.5%) being the most common, while in the 60% gram-positive isolates Staphylococcus aureus (40.5%) was the predominant species. Staphylococcus epidermidis was found more frequently in females (P = 0.05). The isolated bacterial strains presented higher resistance against the tested antibiotics; however, ceftriaxone was effective against most of the pathogens. In the current study T2DM along with diabetes duration, obesity, ulcer severity with polymicrobial infection was found to play a strong role in DFI development, where gender predisposition was also observed in ulcer grade and infection. DFI was correlated with loss of sensation, infection type, affected foot, smoking status, BMI and obesity levels.

Risks of metabolic syndrome in the ADVANCE and NAMSAL trials.

The ADVANCE and NAMSAL trials evaluating antiretroviral drugs have both reported substantial levels of clinical obesity in participants. As one of the main risk factors for metabolic syndrome, growing rates of obesity may drive metabolic syndrome development. This study aims to evaluate the risk of metabolic syndrome in the ADVANCE and NAMSAL trials. The number of participants with metabolic syndrome was calculated at baseline and week 192 as central obesity and any of the following two factors: raised triglycerides, reduced HDL-cholesterol, raised blood pressure and raised fasting glucose. Differences between the treatment arms were calculated using the χ2 test. Across all visits to week 192, treatment-emergent metabolic syndrome was 15% (TAF/FTC + DTG), 10% (TDF/FTC + DTG) and 7% (TDF/FTC/EFV) in ADVANCE. The results were significantly higher in the TAF/FTC + DTG arm compared to the TDF/FTC/EFV arm (p < 0.001), and the TDF/FTC + DTG vs. the TDF/FTC/EFV arms (p < 0.05) in all patients, and in females. In NAMSAL, the incidence of treatment-emergent metabolic syndrome at any time point was 14% (TDF/3TC + DTG) and 5% (TDF/3TC + EFV) (p < 0.001). This incidence was significantly greater in the TDF/3TC/DTG arm compared to the TDF/3TC/EFV arm in all patients (p < 0.001), and in males (p < 0.001). In this analysis, we highlight treatment-emergent metabolic syndrome associated with dolutegravir, likely driven by obesity. Clinicians initiating or monitoring patients on INSTI-based ART must counsel for lifestyle optimisation to prevent these effects.

Estimation of Obesity Levels through the Proposed Predictive Approach Based on Physical Activity and Nutritional Habits.

Obesity is the excessive accumulation of adipose tissue in the body that leads to health risks. The study aimed to classify obesity levels using a tree-based machine-learning approach considering physical activity and nutritional habits. Methods: The current study employed an observational design, collecting data from a public dataset via a web-based survey to assess eating habits and physical activity levels. The data included gender, age, height, weight, family history of being overweight, dietary patterns, physical activity frequency, and more. Data preprocessing involved addressing class imbalance using Synthetic Minority Over-sampling TEchnique-Nominal Continuous (SMOTE-NC) and feature selection using Recursive Feature Elimination (RFE). Three classification algorithms (logistic regression (LR), random forest (RF), and Extreme Gradient Boosting (XGBoost)) were used for obesity level prediction, and Bayesian optimization was employed for hyperparameter tuning. The performance of different models was evaluated using metrics such as accuracy, recall, precision, F1-score, area under the curve (AUC), and precision-recall curve. The LR model showed the best performance across most metrics, followed by RF and XGBoost. Feature selection improved the performance of LR and RF models, while XGBoost's performance was mixed. The study contributes to the understanding of obesity classification using machine-learning techniques based on physical activity and nutritional habits. The LR model demonstrated the most robust performance, and feature selection was shown to enhance model efficiency. The findings underscore the importance of considering both physical activity and nutritional habits in addressing the obesity epidemic.

Role of Ayurveda, Lifestyle Modification, and Panchakarma Therapy on Stabilization of Atherosclerotic Plaque in Known Coronary Artery Disease Patient

Atherosclerois is a major health concern in India and imposes a significant burden on the population. The prevalence of risk factors such as hypertension, obesity, smoking and high cholesterol levels contribute to the rising incidence of atherosclerosis in the country. A 57-year-old male presented with primary complaints of chest pain and heaviness, left arm pain, upper back pain, jaw pain, dyspnea on exertion grade I, flatulence, gaseous distension, cervical pain, scapular region pain, shoulder pain, constipation, and insomnia. He also complained of postprandial angina New York Heart Association (NYHA) Class III. The patient was a photographer by profession and had a history of hypertension, diabetes mellitus, and coronary artery disease. On 29th February 2020, he underwent computed tomography (CT) coronary angiography at another clinic which revealed stenosis of the 3 main coronary arteries – more than 90% stenosis in mid left anterior descending artery (LAD), 80–90% stenosis in proximal left circumflex artery (LCx), and 80–90% stenosis in proximal right coronary artery (RCA). The patient was advised an Ayurveda-based low-carbohydrate high antioxidant diet of 1,000 calories daily for the first 12 weeks. This case report supports the relationship between an Ayurveda-based low-carbohydrate high antioxidant diet and atheroma regression in a high-risk coronary artery disease patient.

The metabolic associated fatty liver disease responses of lifestyle changes using diet and exercise.

This review is aimed to study MAFLD responses of lifestyle modifications using Diet and Exercise. The sources for this MAFLD review following PRISMA protocol were PubMed, Google scholar, Scopus and Science Direct. Quality of evidence was assessed by consistent results with previous studies. Assessment of quality was done by Joanna Briggs Institute criteria. Quality of evidence was assessed by GRADE approach tool. This review included 12 studies, from which five were qualitative and seven quantitative. The later showed poor dietary habits and sedentary lifestyle exhibiting MAFLD which eventually affect their quality of life. Further studies suggested that by introducing healthy lifestyle in MAFLD group using diet and exercise caused reduction in BMI, obesity levels, improved glycemic control and reversal of liver fat content with improved liver enzymes. Subjects with MAFLD experienced poor quality of life. Altering lifestyle by diet and exercise can improve their physical wellbeing.