Male Body Mass Index Research Articles

P-399 Effect of male body mass index on miscarriage rate following fertility treatment, a systematic review and meta-analysis

Abstract Study question Is raised paternal body mass index (BMI) important for the miscarriage rate following assisted reproductive technology (ART)? Summary answer Based on the available evidence, raised male BMI is not associated with higher risk of miscarriage following ART. What is known already More than half women and men of reproductive age worldwide are overweight or obese.There is extensive literature exploring the importance of normal female BMI for reproductive outcomes. However, little attention has been given to male BMI for couples seeking fertility treatment [1] .The adverse effect of male obesity on sperm parameters including DNA damage is well documented and there is evidence suggesting that raised male BMI results in significant decrease in live birth rate following ART [2] .Furthermore, emerging evidence from human and animal studies demonstrates that paternal obesity can affect the future health of the offspring through epigenetic pathways[3]. Study design, size, duration A computerized literature search was performed using EMBASE, MEDLINE, CINAHL and the Cochrane Central register of trials from database inception to November 2021. The aim was to explore the association between male BMI on miscarriage rate following ART. Reference lists of relevant studies were cross-checked. Only articles with full manuscripts available and published in English were included. Papers not relating to human subjects were excluded. All eligible studies were included (observational, prospective and retrospective studies). Participants/materials, setting, methods Included studies reported on couples undergoing ART for any indication using partner’s fresh sperm. Outcomes of interest were miscarriage rate and clinical pregnancy rate. Outcome data from each study were pooled and expressed as odds ratio (OR) with 95% confidence interval (CI) by using a random-effect model due to statistical heterogeneity in the outcome data[4]. Heterogeneity of treatment effects was evaluated using the I2 statistic to quantify the variation across studies caused by heterogeneity. Main results and the role of chance Abstract screening identified 197 relevant studies. After excluding duplicates, reviews and studies which did not fulfill the inclusion criteria, full manuscripts were accessed for 13 studies. Six studies were identified exploring the effect of male BMI on miscarriage following ART, two prospective and four retrospective. The quality of evidence was low using the GRADE framework. Meta-analysis was possible for three studies including 6793 couples undergoing ART. Outcomes were compared for male BMI < 25 kg/m2 versus BMI >/=25 kg/m2 . The pooled results did not show a statistically significant increase in miscarriage rate when the male partner was overweight or obese compare to normoweight (OR 1.32, 95% CI 0.82–2.1, P = 0.249). There was significant heterogeneity between the included studies (I 2 = 48.7%). There was no significant effect of male BMI on clinical pregnancy rate (OR 0.90, 95% CI 0.59–1.38, P = 0.637). For two of the remaining studies which could not be included in the meta-analysis due to missing data, the authors concluded that male BMI >25 was not associated with increased miscarriage risk whilst the most recent prospective study showed that high male BMI was associated with increased risk of chromosomal aberration-related miscarriages. Limitations, reasons for caution The number of the included studies and significant heterogeneity are the main limitations. It was not possible to account for important confounders such as age, subfertility diagnosis, type of stimulation and laboratory parameters including embryo grade. We grouped participants in two BMI categories therefore did not distinguish between overweight/obesity/morbid obesity. Wider implications of the findings Despite increasing evidence suggestive of adverse effect of raised male BMI on reproductive outcomes, there is limited literature exploring the impact on miscarriage rate following ART. More well-designed studies are needed for sound conclusions. Paternal characteristics, general health and preconception lifestyle should not be overlooked in the fertility consultation. Trial registration number not applicable

Postoperative IL-6 levels cannot predict early onset periprosthetic hip/knee infections: an analysis of 7,661 patients at a single institution.

Prior studies have outlined C-reactive protein (CRP) within the first 5 d following total hip arthroplasty (THA) as an inappropriate indicator of an early periprosthetic joint infection (PJI). Recently, interleukin-6 (IL-6), as a potential inflammatory marker following total joint arthroplasty (TJA), has gained increasing interest, particularly due to its considerably shorter half-life. The aim of the present study was to assess IL-6 measured on postoperative day 3 following TJA as a prediction marker of early onset PJI. 7,661 patients, who underwent total hip or knee arthroplasty (THA, TKA) at a single institution between 2016 and 2019, were evaluated. Serum IL-6 values were measured on postoperative day 3 and compared between patients, with and without early onset PJI in the postoperative follow-up, matched for age, gender, Surgical Site Infection Risk Score and Charlson comorbidity index. Overall (n = 7,661), there was no statistically significant difference in serum IL-6 levels comparing patients with and without early onset PJI following THA [38.9 pg/ mL vs. 32.0 pg/mL, p = 0.116] and TKA [30.6 pg/mL vs. 28.2 pg/mL, p = 0.718]. Male gender and high body mass index were associated with an increased risk of early onset PJI following THA (p = 0.027, p = 0.002). Matched cohort analysis (n = 86) showed no statistically significant difference in serum IL-6 levels between patients with and without early onset PJI following THA (p = 0.680) and TKA (p = 0.910). Serum IL-6 values on postoperative day 3 following THA or TKA could not predict early onset PJIs.

Üniversite Öğrencilerinin Beslenme Bilgi Düzeyi ve Obezite Durumunun Değerlendirilmesi

Giriş: Dünyada ve ülkemizde önemli bir sağlık sorunu olan obezitenin oluşumuna pek çok faktör katkıda bulunmaktadır. Sunulan çalışma beslenme bilgi düzeyinin üniversite öğrencilerindeki obezite üzerindeki etkisini araştırmak amacıyla yapılmıştır. Yöntem: Çalışma 252 üniversite öğrencisi ile yürütülmüştür. Antropometrik ölçümler (vücut ağırlığı, boy uzunluğu, bel, kalça çevresi) yapılmış ve beden kütle indeksi (BKİ) ve bel/kalça oranı (BKO) hesaplanmıştır. Vücut yağ analizi için biyoelektirik impedans yöntemi kullanılmıştır. Yetişkinler İçin Beslenme Bilgi Düzeyi Ölçeği (YETBİD) kullanılarak öğrencilerin beslenme bilgi düzeyleri değerlendirilmiştir. Bulgular: Kadınların vücut yağ oranı daha yüksektir (p<0,001). Erkeklerin %39,7’sinin kadın öğrencilerin ise 14,3’ünün şişman olduğu gözlenmiştir (p<0,001). Bel çevresi ölçümü ve BKO’ya göre cinsiyetler arasında anlamlı fark yoktur (p>0,001). Sigara ve alkol tüketimi erkeklerde daha fazladır (p<0,05). Kadınların temel beslenme ve besin tercihi bilgi düzeyleri erkeklerden daha yüksektir (p<0,05). Kadın ve erkek öğrencilerin BKİ, bel çevresi ölçümleri, vücut yağı oranı ve BKO’ları ile beslenme bilgi düzeyi ve besin tercihleri arasında anlamlı bir ilişki yoktur (p>0,05). Sonuç: Kadın öğrencilerin beslenme bilgi düzeyleri daha iyi olmasına karşın, beslenme bilgi düzeyi alt ölçekleri ile BKİ, BKO, bel çevresi ölçümü ve vücut yağ oranları erkek öğrencilerden farklılık göstermemektedir. Beslenme bilgi düzeyinin obezitenin önlenmesindeki etkisinin ortaya çıkarılması için daha çok araştırmaya gerek vardır.

Higher BMI and lower femoral neck strength in males with type 2 diabetes mellitus and normal bone mineral density

BackgroundType 2 diabetes mellitus (T2DM) and osteoporosis are two age-associated diseases. Body mass index (BMI) is positively associated with osteoporosis or osteopenia in T2DM population. Bone mineral density does not necessarily reflect the alterations in bone microarchitecture. Our aims were to investigate the relationship between BMI and femoral neck strength in males with T2DM and normal range of bone mineral density (BMD). MethodsThis study enrolled 115 males (median age 53.3 years) with T2DM and normal BMD. Femoral neck strength indexes, including compression strength index (CSI), bending strength index (BSI), impact strength index (ISI), were calculated by parameters generated from Dual-energy X-ray absorptiometry software. Pearson correlation analysis was performed to evaluate the relationships between BMI and femoral neck strength variables. ResultsCompared with T2DM-normal weight group, T2DM-overweight group and T2DM-obesity group had a higher femur neck and total femur BMDs. Cross sectional moment of inertia (CSMI), cross sectional area (CSA), section modulus (SM) were significantly higher (all p<0.05), and buckling ratio (BR) (6.35±2.08 vs 7.18±1.71) was lower in T2DM-obesity group than in T2DM-normal weight group. Compared with T2DM-normal weight group, CSI (all p<0.001), BSI (all p<0.001), ISI (all p<0.001) were significantly reduced in T2DM-obesity and T2DM-overweight groups. Pearson correlation analysis indicated that BMI was negatively correlated with CSI (r= − 0.457, p<0.001), BSI(r = −0.397, p<0.001), ISI (r = − 0.414, p<0.001). ConclusionsHigher BMI is associated with lower femoral neck strength in males with T2DM and normal BMD. It implies that femoral neck fracture risk increases in obese and diabetic males, despite their high bone density.

Influence of risk factors for the development of cardiovascular diseases on the parameters of arterial stiffness in patients with arterial hypertension and atherosclerosis of different degrees of severity

BACKGROUND: Arterial hypertension is widespread in the population, leads to the development of arteriosclerosis and increase of arterial stiffness, and is the main non-lipid risk factor of atherosclerosis development. Multiple studies have shown that increase of arterial stiffness is an independent risk factor for the development of cardiovascular events. However, the influence of traditional cardiovascular risk factors on arterial stiffness in arterial hypertension and atherosclerotic process of different degrees of severity has not been sufficiently studied.&#x0D; AIM: To assess the influence of traditional risk factors on the parameters of arterial stiffness in patients with arterial hypertension (AH) and atherosclerotic process of varying degrees of severity.&#x0D; MATERIALS AND METHODS: 133 subjects with AH have been divided into 3 groups depending on the severity of the atherosclerotic process. The control group included 33 individuals without known cardiovascular diseases. All the participants have undergone a standard clinical and laboratory examination, 24hr blood pressure monitoring with assessment of arterial stiffness (AS) parameters. The influence of risk factors on AS parameters has been analyzed for all the participants and separately by groups.&#x0D; RESULTS: In the AH patients, an increase in the arterial stiffness index (ASI) is associated with an older age and an increase in systolic blood pressure (SBP); an increase in the augmentation index (AIx75) is associated with age; SBP in higher in women. Pulse wave velocity in the aorta (PWVao) is most associated with age, smoking, and family history in patients with hypertension and subclinical atherosclerosis. An increase in AIx75 is associated with an older age and is higher in women, while ASI has a positive relationship with age and SBP. In patients with hypertension and coronary artery disease, there is a positive correlation between male body mass index and PWVao. The increase in ASI in this group is associated with female gender, SBP and age. In individuals without hypertension and signs of atherosclerosis with a family history of CVD, PWVao values are higher than in similar individuals without a family history of CVD.&#x0D; CONCLUSIONS: In the group of all the participants, female gender, smoking, an older age, SBP, and body mass index are associated with increased AS parameters. The association between risk factors and parameters of arterial stiffness has peculiarities in patients with hypertension with varying degrees of severity of the atherosclerotic process.

Normative Spirometric Values in Adult Kashmiri Population

Background. Normative values of pulmonary functions of healthy population are affected by different geographic, ethnic, climatic and demographic factors. Objective. Present study was designed to derive normative spirometric values, prediction equations for future reference in adult Kashmiri population. Methods. Pulmonary function testing was carried out on 3080 normal healthy non-smoking individuals (1974 males; age 18-65 years) of Kashmir valley. Multiple regression analysis was used to develop prediction equations for use in this population. Results. Forced vital capacity (FVC, L/s) (4.3±0.8 versus 3.0±0.5; p<0.05), forced expiratory volume in the first second (FEV1, L/s) (3.9±0.7 versus 2.6±0.5; p<0.05) and peak expiratory flow rate (PEFR, L/s) (7.9±1.8 versus 5.3±1.2; p<0.05) were significantly higher in males in comparison with females. All the other parameters except FEV1/PEFR ratio were significantly higher among males (p<0.05). Irrespective of gender, all the parameters declined with increasing age. Females had higher FEV1/PEFR ratio (p<0.05) in age group of 15-30 years. Overall the inter-group difference across the districts studied was not significant. Spirometric parameters manifested an overall negative correlation with increasing body mass index (BMI), although FVC and FEV1 in males with low BMI were high (p<0.05). Conclusion. These prediction equations can be utilised as reference values for future use in adult Kashmiri population. [Indian J Chest Dis Allied Sci 2012;54:227-233]

Impact of paternal body mass index on assisted reproduction treatment outcomes: An updated systematic review and meta-analysis.

The aim was to provide updated evidence on the association of male body mass index (BMI) with outcomes of assisted reproduction technology (ART). PubMed, Embase, and Scopus databases were systematically searched. The review included observational studies in patients undergoing ART, that is, either in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and compared rate of clinical pregnancy and live birth based on different categories of male BMI. Quality of the pooled findings was assessed using the GRADE criteria. A total of 19 studies were included in the review. Among subjects undergoing IVF, there were no significant differences in the rates of clinical pregnancy among overweight (odds ratio [OR] 1.38, 95% confidence interval [CI]: 0.65, 2.96) and obese (OR 1.86, 95% CI: 0.75, 4.58) BMI, compared to normal male BMI. Similarly, there were no significant differences in the rates of live birth among overweight (OR 1.04, 95% CI: 0.97, 1.13) and obese BMI (OR 0.90, 95% CI: 0.69, 1.18) when compared to males with normal BMI. Further, among those undergoing ICSI, there were no significant differences in the odds of clinical pregnancy among overweight (OR 0.98, 95% CI: 0.73, 1.33) and obese (OR 0.89, 95% CI: 0.62, 1.29). The odds of live births among overweight (OR 0.97, 95% CI: 0.89, 1.05) and obese (OR 0.95, 95% CI: 0.84, 1.07) male BMI were statistically similar to males with normal BMI undergoing ICSI. The low to very low-quality findings suggest no significant association of overweight and obese BMI with clinical pregnancy and live birth rates among couples undergoing either IVF or ICSI.

Cannabidiol and Cannabidiol Metabolites: Pharmacokinetics, Interaction with Food, and Influence on Liver Function.

Cannabidiol (CBD) is widely available and marketed as having therapeutic properties. Over-the-counter CBD is unregulated, many of the therapeutic claims lack scientific support, and controversy exists as to the safety of CBD-liver interaction. The study aims were to compare the pharmacokinetics of commercial CBD and CBD metabolites following the ingestion of five different CBD formulations, determine the influence of CBD on food induced thermogenesis, determine the influence of food on CBD pharmacokinetics, and determine the influence of CBD on markers of liver function. Fourteen males (body mass index ≥ 25 kg/m2) were studied in a placebo-controlled, randomized, crossover design. On five occasions, different CBD formulations were ingested (one per visit). On two additional occasions, CBD or placebo was ingested following a meal. CBD servings were standardized to 30 mg. Considerable pharmacokinetic variability existed between formulations; this pharmacokinetic variability transferred to several of the metabolites. CBD did not influence food induced thermogenesis but did favorably modify early insulin and triglyceride responses. Food appreciably altered the pharmacokinetics of CBD. Finally, CBD did not evoke physiologically relevant changes in markers of liver function. Collectively, these data suggest that consumers should be aware of the appreciable pharmacokinetic differences between commercial CBD formulations, CBD is unlikely to influence the caloric cost of eating but may prove to be of some benefit to initial metabolic responses, consuming CBD with food alters the dynamics of CBD metabolism and increases systemic availability, and low-dose CBD probably does not represent a risk to normal liver function.

The impact of a structured polygraphy screening incorporated in a novel remote mobile health pathway on sleep apnoea prevalence in patients with atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: None. Background Untreated obstructive sleep apnoea (OSA) contributes to progression of atrial fibrillation (AF) and reduces the success rate of heart rhythm control strategies. OSA remains one of the most frequently underdiagnosed modifiable risk factors in AF patients due to a lack of standardized screening methods and low awareness. Purpose To assess the impact of implementation of a structured remote OSA screening and management pathway on the prevalence of OSA in AF patients scheduled for AF ablation procedures. Methods In October 2020, a novel remote OSA screening and management pathway (VIRTUAL-SAFARI) was introduced in two AF outpatient clinics in the Netherlands. Consecutive patients scheduled for AF ablation were offered OSA screening consisting of sending a portable home sleep test to patients’ homes to perform a remote sleep recording for one night, analysis by a sleep physician, discussion of results with the patient, and initiation of treatment (when applicable). The impact of this structural screening strategy was assessed by comparing the prevalence of concomitant OSA (defined as apnoea-hypopnoea index ≥5) for patients scheduled for AF ablation in the year before and after introduction of the OSA management pathway. Results A total of 733 patients was studied, 308 in the year before (Oct ’19 - Sep ’20) and 425 in the year after (Oct ’20 - Sep ’21) introduction of the VIRTUAL-SAFARI pathway. Median age was 65 [58-71], 64% was male and median body mass index (BMI) was 27 [25-30] kg/m2. Baseline characteristics were comparable for the groups before and after introduction of the pathway (Table 1). In the cohort before pathway introduction, OSA had been diagnosed in 26 patients (8%, Figure 1) and was treated with positive airway pressure in 10 cases (3%). In the cohort after pathway introduction, OSA had previously been diagnosed in 53 patients (12%). Eighty-eight percent of patients without previous OSA screening was referred via the remote pathway. Results of the sleep recordings were available for 213 (59%) at the time of this analysis. Previously unknown OSA was diagnosed in 184 patients (86% of available recordings), increasing the prevalence of confirmed OSA to 237 (55%). For 22% of patients, results of sleep recordings are pending. Absence of OSA was confirmed in 9%, and 13% of patients had not been screened (e.g. because of patient preference or logistical reasons). After pathway introduction, 82 patients (19%) were treated or received advice to start treatment with positive airway pressure. Treatment decisions are pending for 9% of the cohort. Conclusion After the implementation of structured remote OSA screening in a well characterized cohort of consecutive patients scheduled for AF ablation, the prevalence of diagnosed OSA increased from 8% to 55%. Whether appropriate risk factor management, including treatment of OSA identified by structured screening, will improve AF outcomes needs to be tested in future studies.

What factors drive gender differences in the body mass index? Evidence from Turkish adults.

In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.

MO907: Predictors of Negative Outcomes in HDF-OL Patients: A Cohort Study

BACKGROUND AND AIMSHaemodiafiltration on-line (HDF-ol), an effective mode of replacement therapy for stage 5 chronic kidney disease (CKD 5D), cannot be considered sufficiently studied in terms of its effect on the outcomes. Our main aim was to identify a possible association between individual anthropometric, laboratory data and parameters of the prescribed treatment regimen with the best survival rate when using the HDF-ol mode.METHODA retrospective1 year analysis of the EuCliD database of 9986 patients treated with HDF-ol in 27 Fresenius Medical Care centres in Russia was carried out. All patients got post-dilution HDF-ol procedures at least 3 times a week, for at least 12 h a week with Kt/V at least 1.4. Data on alive (9616) and deceased (370) patients were compared by gender, age, treatment experience, body weight (BW), body mass index (BMI), body surface area (BSA), total body water volume (TBW), volume of urea distribution (V Urea BCM), presence of diabetes mellitus (DM), ischemic heart disease (CHD), chronic heart failure (CHF), as well as parameters of the procedure: effective weekly dialysis time, Kt/V, effective infusion volume (EIV) and effective convection volume (ECV).RESULTSDifferences in groups were found only for a part of parameters (Table 1).Table 1.Group of patientsStatisticAliveDeceasedP-valueBasic demographic characteristicsSex: f n (%)4422 (46.0%)140 (37.8%).0024Sex: m n (%)5194 (54.0%)230 (62.2%).0024Age (years) N 9616370<.0001Mean (SD)53.4 (13.6)58.8 (12.1)Median5560Min–max17.0–86.030.0–83.095% CI53.1–53.757.5–60.0BW (kg) N 9616370<.0001Mean (SD)75.2 (17.5)71.7 (16.5)Median73.470Min–max30.6–194.635.3–133.295% CI74.8–75.570.0–73.4BMIMean (SD)26.7 (5.7)25.5 (5.7)<.0001Median2625Min–max14.1–53.213.4–47.295% CI26.6–26.924.9–26.1CHD: yes n (%)1565 (16.3%)98 (26.5%)<.0001CHD: no n (%)8051 (83.7%)272 (73.5%)<.0001HF: yes n (%)1878 (19.5%)94 (25.4%).0065HF: no n (%)7738 (80.5%)276 (74.6%).0065diabetes: yes n (%)1213 (12.6%)72 (19.5%).0002diabetes: no n (%)8403 (87.4%)298 (80.5%).0002Parameters of the HDF ol proceduresEffective week dialysis time (min)Mean (SD)784.2 (140.2)731.6 (372.2)<.0001Median790733,5Min–max150.0–4979.0197.0–4017.095% CI781.3–787.1689.6–773.6EIV (L)Mean (SD)24.6 (4.3)23.0 (4.7)<.0001Median23.722.4Min–max0.5–69.41.9–43.895% CI24.5–24.722.6–23.5ECV (L)Mean (SD)27.0 (4.4)25.3 (5.0)<.0001Median2624.7Min–max0.5–71.22.0–46.095% CI26.9–27.124.8–25.8OCM Kt/VMean (SD)1.7 (0.3)1.7 (0.3)<.0001Median1.71.6Min–max0.5–6.40.7–3.095% CI1.7–1.71.7–1.7The main laboratory parametersCalcium (mmol/L)Mean (SD)2.2 (0.2)2.3 (0.2)<.0001Median2.22.2Min–max1.0–3.71.5–3.095% CI2.2–2.22.2–2.3Albumin (g/L)Mean (SD)40.6 (3.2)38.7 (4.3)<.0001Median4139Min–max13.0–71.018.2–49.095% CI40.5–40.638.4–38.9b2-microglobulin (mg/L)Mean (SD)23.8 (7.0)25.2 (8.1)<.0001Median23.323.7Min–max1.5–80.05.4–85.195% CI23.8–23.924.7–25.7Haemoglobin (g/L)Mean (SD)110.4 (14.9)105.6 (17.9)<.0001Median111106Min–max12.0–176.034.0–167.095% CI110.2–110.5104.5-106.7CRP (mg/L)Mean (SD)7.8 (15.7)19.7 (43.3)<.0001Median3.46.6Min–max0.0–500.00.1–521.195% CI7.6–7.917.0–22.4Table 2.Hospitalization of ESKD patients before and after the onset of the COVID-19 pandemic in a tertiary University Hospital of Thessaloniki, GreeceBefore COVID-19 pandemicAfter COVID-19 pandemicP-valueTime period1 March 2019–29 February 20211 March 2020–28 February 2021-Hospitalizationsa (n)14990-Age (years)67.7 ± 13.665.3 ± 16.7247Gender (M/F)105/44 (70.5%/29.5%)62/28 (68.9%/31.1%)884Duration of hospitalization (days)7 (2–83)9 (2–67)0.423Outcome (n, %)0.837 Improvement127 (85.2%)76 (84.4%) Stable medical condition10 (6.7%)6 (6.7%) In-hospital death12 (8.1%)8 (8.9%) aHospitalizations due to SARS-CoV-2 infection over the pandemic period were not included in this comparative analysis.CONCLUSIONAssociation of risk of death in patients with CKD 5D treated with HDF-ol included male gender, older age, concomitant diseases (CHD, CHF, DM), lower BW and BMI, shorter effective weekly dialysis time, lower values of EIV and ECV, Kt/V, higher values of hypercalcemia, hypoalbuminemia, lower haemoglobin levels, higher levels of b2-microglobulin and CRP. Such indicators as TBW, VUrea BCM, BSA and the length of treatment on dialysis did not reached statistical significance when comparing alivе and deceased patients.

Excess calorie availability and adult BMI: A cohort analysis of patterns and trends for 156 countries from 1890 to 2015

Current trends in adult obesity threaten global health. Although the implications of changes in diets, lifestyles, and food environments have been examined, the specific role of excess calorie availability (ECA)—understood as calorie availability in excess of human requirements for a healthy life—and the cohort mechanisms that underlie trends in adult body mass index (BMI) are poorly understood. We examine these relationships for 156 countries over the past century using an age-, sex-, and cohort-specific approach. We measure the association between increases in food energy supply and changes in BMI across countries and time. We find positive and significant associations between ECA and adult BMI for both males and females, and between ECA during early childhood and BMI at adulthood for males. We also find a strengthening of these correlations over successive generations. These cohort mechanisms are boosted by age effects, leading individuals in each successive cohort to reach unhealthy BMI levels at younger ages. Individuals in more recent cohorts are overweight or obese earlier and for larger proportions of their lifespan than those in earlier cohorts. Even after controlling for development dynamics, the pattern is consistent across countries and appears to be driven, in part, by availability of calories in excess of underlying requirements. Our findings provide novel insights into the role of ECA, and potential unintended health consequences of agricultural and trade policies directed at increasing calorie supplies.

Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders in Patients with Chronic Hepatitis C Virus.

BACKGROUND: Patients with chronic hepatitis C virus (HCV) usually have different abdominal complaints without any organic lesions. The functional cause of these complaints is claimed in most patients. This study aimed to evaluate functional gastrointestinal disorders (FGIDs) in patients with chronic hepatitis C using Rome IV diagnostic criteria. METHODS: This study included 1506 participants (1006 patients with chronic HCV, and 500 controls). All individuals were subjected to taking thorough medical history, basic investigations (complete blood counts, liver and renal functions tests), international normalized ratio (INR), alpha-fetoprotein, HCV RNA PCR (polymerase chain reaction), abdominal ultrasonography, and upper gastrointestinal tract (GIT) endoscopy for patients only), and Rome IV diagnostic questionnaire. RESULTS: Patients with HCV had symptoms of FGIDs including functional dyspepsia (FD) (P=0.009), early satiety (P=0.002), postprandial distress (P=0.02), epigastric pain (P=0.03), Inflammatory bowel syndrome (IBS) (P<0.001), IBS predominant constipation (P<0.001), IBS predominant diarrhea (P<0.001), and IBS mixed (P<0.001). There were multiple factors for the prediction of FD in patients with HCV, including high body mass index (BMI), education level, positive polymerase chain reaction (PCR), and fibrosis stage. Also, there were multiple factors for the prediction of IBS in patients with HCV, including male gender, high BMI, urban residence, education level, positive PCR, and fibrosis stage. CONCLUSIONS: FD is a prevalent finding in obese patients with HCV and with higher fibrosis scores. IBS is also prevalent in male patients with HCV.

Relationship between the body mass index and the ponderal index with physical fitness in adolescent students

BackgroundThe relationship between the Body Mass Index (BMI) with physical fitness in children and adolescent populations from diverse regions are consistent. However, the relationship between the Ponderal Index (PI) with physical fitness, based on what is known to date, has not been examined in depth. The objective was to evaluate the relationships between BMI and PI with three physical fitness tests of students living at moderate altitudes in Peru.MethodsA descriptive correlational study was carried out with 385 adolescents, between the ages of 10.0 to 15.9 years old, from the province of Arequipa, Peru. Weight, height, and three physical fitness tests (horizontal jump, agility, and abdominal muscle resistance) were evaluated. BMI and PI were calculated, and they were, then, categorized into three strata (low, normal, and excessive weight). Specific regressions were calculated for sex, using a non-lineal quadratic model for each item adjusted for BMI and PI.ResultsThe relationship between BMI and PI with the physical tests reflected parabolic curves that varied in both sexes. The regression values for BMI in males oscillated between R2 = 0.029 and 0.073 and for females between R2 = 0.008 and 0.091. For PI, for males, it varied from R2 = 0.044 to 0.82 and for females, from R2 = 0.011 to 0.103. No differences occurred between the three nutritional categories for BMI as well as for PI for both sexes (p range between 0.18 to 0.38), as well as for low weight (BMI vs PI), normal weight (BMI vs PI), and excessive weight (BMI vs PI) (p range between 0.35 to 0.64).ConclusionsBMI showed inferior quadratic regressions with respect to the PI. In addition, physical performance was slightly unfavorable when it was analyzed by BMI. PI could be a useful tool for analyzing and predicting physical fitness for adolescents living at a moderate altitude since it corrects for the notable differences for weight between adolescents.

Prevalence, diagnosis, and surgical management of complex ileocolic-duodenal fistulas in Crohn's disease.

The aim of the present study was to review the prevalence and surgical management of patients with Crohn's disease (CD) complicated by ileocolic-duodenal fistulas (ICDF). We performed a retrospective chart review of CD patients who underwent surgical takedown and repair of ICDF during January 2011-December 2021 at two inflammatory bowel disease referral centers. We identified 17 patients with ICDF (1.3%) out of 1283 CD patients who underwent abdominal surgery. Median age was 42 (20-71) years, 13 patients were male (76%) and median body mass index was 22.7 (18.4-30.3) kg/m2. Four patients (24%) were diagnosed preoperatively and only 2 (12%) were operated on for ICDF-related symptoms. The most common procedure was ileocolic resection (13 patients, 76%) including 4 repeat ileocolic resections (24%). The duodenal defect was primarily repaired in all patients with no re-fistulization or duodenal stenosis, regardless of the repair technique. A laparoscopic approach was attempted in the majority of patients (14 patients, 82%); however, only 5 (30%) were laparoscopically completed. The overall postoperative complication rate was 65% including major complications in 3 patients (18%) and 2 patients (12%) who required surgical re-intervention for abdominal wall dehiscence and postoperative bleeding. Preoperative nutritional optimization was performed in 9 patients (53%) due to malnutrition. These patients had significantly less intra-operative blood loss (485 vs 183ml, p = 0.05), and a significantly reduced length of stay (18 vs 8days, p = 0.05). ICDF is a rare manifestation of CD which may go unrecognized despite the implementation of a comprehensive preoperative evaluation. Although laparoscopic management of ICDF may be technically feasible, it is associated with a high conversion rate. Preoperative nutritional optimization may be beneficial in improving surgical outcomes in this select group of patients.

BLOOD PRESSURE MONITORING IN NORMOTENSIVE TYPE – 2 DIABETICS USING 24HR BLOOD PRESSURE MONITORING DEVICE AND ITS RELATIONSHIP WITH ANTHROPOMETRIC MEASUREMENTS: A ONE YEAR HOSPITAL BASED CROSS SECTIONAL STUDY

Systemic Hypertension (HTN) is one of the most common co-morbidities in Diabetes Mellitus (DM). Because of the drawbacks of office blood pressure monitoring, it has been suggested that ambulatory blood pressure monitoring (ABPM) be used for hypertension assessment. The sensitivity of Clinic/Office monitoring of BP to predict hypertension-associated organ damage is less. Hence the present study was carried out to estimate the prevalence of hypertension in normotensive type 2 diabetic patients by using a 24-hour ambulatory blood pressure machine and also to assess the relationship between blood pressure patterns and anthropometric measurements in overweight and obese type 2 diabetic patients.A 1 year cross-sectional hospital-based study was conducted on 162 people, attending a tertiary care institute over the age of 18, who had type 2 diabetes and a Body Mass Index (BMI) of 25 to 40 kg/m2 (Asian cut-off &gt; 23 kg/m2). All subjects underwent a standardized medical examination including anthropometric measurements, laboratory investigations and 24 hour ambulatory blood pressure monitoring. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency, and proportion for categorical variables. P value &lt;0.05 was considered statistically significant.The mean age was 60.65 ± 11.46 years. Majority were males (62.35%). The mean BMI was 28.31 ± 2.15 kg/m2. The mean all day SBP was 133.66 ± 13.53 mm/ hg while the mean all day DBP was 76.45 ± 10.99 mm/hg. The prevalence of HTN as measured by all day SBP was 77.78% while it was 42.59% for all day DBP. Systolic non dipping was seen in 93.39% of overweight and 90.24% of obese subjects as classified by BMI, respectively. Diastolic non-dipping was seen in 76.86% of overweight and 73.17% of obese subjects as classified by BMI, respectively. There was a statistically significant association between all-day SBP, all-day DBP, day SBP and day DBP with BMI (P Value&lt;0.05) in males. But in females, there was a statistically significant association between all day SBP, day SBP with BMI only (P Value&lt;0.05).The present study was one of the kinds in the study region as there was no report of ABPM parameters in the study population. Patients with T2DM can benefit from routine ABPM by early identification and management of Hypertension in Type 2 DM.

Predicting NAFLD prevalence in the United States using National Health and Nutrition Examination Survey 2017-2018 transient elastography data and application of machine learning.

This cohort analysis investigated the prevalence of nonalcoholic fatty liver disease (NAFLD) and NAFLD with fibrosis at different stages, associated clinical characteristics, and comorbidities in the general United States population and a subpopulation with type 2 diabetes mellitus (T2DM), using the National Health and Nutrition Examination Survey (NHANES) database (2017–2018). Machine learning was explored to predict NAFLD identified by transient elastography (FibroScan®). Adults ≥20 years of age with valid transient elastography measurements were included; those with high alcohol consumption, viral hepatitis, or human immunodeficiency virus were excluded. Controlled attenuation parameter ≥302 dB/m using Youden’s index defined NAFLD; vibration‐controlled transient elastography liver stiffness cutoffs were ≤8.2, ≤9.7, ≤13.6, and >13.6 kPa for F0–F1, F2, F3, and F4, respectively. Predictive modeling, using six different machine‐learning approaches with demographic and clinical data from NHANES, was applied. Age‐adjusted prevalence of NAFLD and of NAFLD with F0–F1 and F2–F4 fibrosis was 25.3%, 18.9%, and 4.4%, respectively, in the overall population and 54.6%, 32.6%, and 18.3% in those with T2DM. The highest prevalence was among Mexican American participants. Test performance for all six machine‐learning models was similar (area under the receiver operating characteristic curve, 0.79–0.84). Machine learning using logistic regression identified male sex, hemoglobin A1c, age, and body mass index among significant predictors of NAFLD (P ≤ 0.01). Conclusion: Data show a high prevalence of NAFLD with significant fibrosis (≥F2) in the general United States population, with greater prevalence in participants with T2DM. Using readily available, standard demographic and clinical data, machine‐learning models could identify subjects with NAFLD across large data sets.

Risk of Chronic Kidney Disease Associated With Orthostatic Hypotensive Stress: A Community-Based Korean Study.

The relationship between orthostatic blood pressure (BP) changes and incident chronic kidney disease (CKD) has not been explored in Asian populations. We reviewed the data of 7,039 participants from the Ansung-Ansan cohort study. BP was measured in the supine position and 2 minutes after standing. The change in BP from the supine to upright position was defined as orthostatic BP change. Orthostatic systolic BP (SBP) decline was defined as an orthostatic SBP change of <-2 mm Hg. The primary outcome was the development of CKD, defined as the first event of an estimated glomerular filtration rate <60 ml/min/1.73 m2 at least twice during the follow-up period. Of 7,039 participants, 949 (13.5 %) developed incident CKD over a mean of 11.9 years. Although orthostatic diastolic BP change was not associated with incident CKD, every 1 mm Hg increase in orthostatic SBP change was associated with a decreased risk of incident CKD (HR, 0.989; 95% CI, 0.982-0.995; P = 0.001). Orthostatic SBP decline was associated with an increased risk of incident CKD (HR, 1.337; 95% CI, 1.163-1.537; P < 0.001). Older age and diabetes were associated with increased odds of orthostatic SBP decline, whereas male sex and high body mass index were associated with decreased odds of orthostatic SBP decline. Subgroup analysis revealed that orthostatic SBP decline was associated with incident CKD only in non-diabetic participants. Orthostatic SBP decline was independently associated with an increased risk of future incident CKD, whereas orthostatic DBP decline was not.

Which factors influence the success rate of egg donation programmes with imported vitrified oocytes?

Research questionWhich factors influence the success rate of egg donation programmes with imported vitrified oocytes? DesignObservational longitudinal cohort study of 431 oocyte donation cycles conducted between January 2015 and February 2019. A total of 398 couples underwent an IVF cycle with imported donated vitrified eggs. All consecutive oocyte donation cycles conducted at the Centre for Reproductive Medicine of the European Hospital in Rome, Italy, were included. ResultsA univariable analysis was conducted. Among the demographic characteristics studied, body mass index (BMI) was significantly able to influence outcome. In 49% of unsuccessful cycles, men were overweight, compared with 39.4% in cycles with a positive beta-HCG test (P = 0.03). The relationship between female or donor BMI and treatment outcome, however, was not statistically significant. The day on which the embryo is transferred affects the outcome of the cycle: transferring on day 2 versus day 5 reduces the probability of clinical pregnancy. The relationship between male BMI classes and semen parameters was studied: obese men have a significantly lower sperm concentration than normal-weight men (P = 0.006 after Bonferroni correction). No statistically significant differences were found in semen volume (P = 0.722), sperm morphology (P = 0.100) and motility (P = 0.179) in obese men compared with normal weight men. ConclusionIn addition to the number of oocytes available after warming, male BMI, semen characteristics and blastocyst transfer are critical parameters able to influence the reproductive outcomes of egg donation programmes with imported vitrified oocytes.

Assessing the Adequacy of Obstructive Sleep Apnea Diagnosis for High-Risk Patients in Primary Care.

The exact prevalence of obstructive sleep apnea (OSA) is unknown, and primary care providers are left with conflicting guidance on screening criteria from various institutions. The purpose of this study was to identify health care gaps in OSA diagnosis for patients at high risk of OSA. A retrospective medical record review was performed assessing adult patients (≥ 18 years) who had outpatient visits in family medicine clinics, located in the cities of Detroit, Troy, and Commerce, Michigan in 2018. The primary outcome was the number of patients assessed for OSA. Patients determined as high risk for OSA had at least 3 of the following criteria: (1) hypertension, (2) age 50 years and older, (3) male gender, and (4) body mass index > 35 kg/m2. Statistical approach included univariate and logistic regression analysis. Manual chart review of 200 randomly selected records was performed to determine the most common reasons for OSA screening. Out of 30,022 patients, 4,911 (16.4%) were at high risk for OSA, of which 1,524 (31.0%) were assessed for OSA. Logistic regression analysis of high-risk patients revealed that male sex (odds ratio, 1.84; 95% CI, 1.51-2.26; P < .001) and body mass index > 35 kg/m2 (odds ratio, 4.96; 95% CI, 4.04-6.09; P < .001) were significantly associated with OSA evaluation. Race was not associated with OSA assessment. Because many individuals at high risk for OSA are not referred for evaluation, improved guidance on OSA screening based on objective risk factors is needed.