Male Obesity Research Articles

Causal Link of Human Papillomavirus in Barrett Esophagus and Adenocarcinoma: Are We There Yet?

Esophageal cancer is a relatively common malignancy worldwide with a high mortality (5-year survival of <15%). Despite screening, surveillance, improved imaging and treatment, the exponential rise in OAC continues. The strongest risk factors for OAC are chronic heartburn and metaplastic transformation of the lower third of the esophagus (Barrett's esophagus). The risk profile includes Caucasian race, male gender older age, obesity and smoking. Although the tumor risk in BO has been progressively revised downwards, the exponential rise in OAC remains unchecked. This paradox points to an unidentified missing link. Relatively recently, we provided the world's initial data for a strong association of biologically relevant hr-HPV with BD and OAC. Since then, systematic reviews and meta-analysis have documented HPV DNA prevalence rates in OAC of between 13 to 35%. In this review, we provide some evidence for a probable causal relationship between hr-HPV and OAC. This is challenging given the multifactorial etiology and long latency. Increasingly, high-risk HPV (hr-HPV) is regarded as a risk factor for OAC. This discovery will aid identification of a sub-group of high-risk progressors to esophageal cancer by surveillance and the development of effective preventive strategies including vaccination.

Malassezia Folliculitis in the Setting of COVID-19.

To review recent literature on Malassezia folliculitis and explore its association with COVID-19. Reports of Malassezia folliculitis in the setting of COVID-19 are scarce. Shared characteristics between affected individuals include male sex, obesity, intensive care, and administration of systemic antibiotics and systemic steroids. Dexamethasone can potentially stimulate sebum production and therefore lead to Malassezia proliferation. The clinical picture of Malassezia folliculitis accompanying COVID-19 is similar to classic descriptions but tends to spare the face and predominates in occlusion sites. Malassezia folliculitis is under-recognized. Fever, sweating, occlusion, immobility, antibiotics, and dexamethasone contribute to COVID-19 patients developing Malassezia folliculitis. Antifungal therapy, together with correcting predisposing factors, is the mainstay of management. Future research should explore the relationship between systemic steroids and other acneiform reactions.

The problem of hyperuricemia in the hypertensive population of the Nizhny Novgorod region

Objective. To assess the prevalence of hypertension (HTN) in the population of the Nizhny Novgorod region and its relationship with hyperuricemia (HU) and other cardiovascular risk factors. Design and methods. We examined 2501 people aged 35–74 in the population of the Nizhny Novgorod region, selected by the stratified multi-stage random sample. All respondents underwent a laboratory study of the following parameters: total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins, triglycerides (TG), fasting glucose, creatinine, uric acid, highly sensitive C-reactive protein (Hs-CRP) and fibrinogen. We also calculated body mass index (BMI), visceral obesity index with Amato formula and glomerular filtration rate with CKD-EPI formula. Binary logistic regression method was used to construct a predictive model for the risk of HTN. Statistical analysis was performed with IBM SPSS Statistics 26 software (USA). Results. HU was identified in 29,3 % of respondents with HTN. The mean uric acid level in this group was 345,1 [285,6; 410,55] µmol/l and significantly differed from the same indicator in residents without HTN — 297,5 [249,9; 351,1] µmol/L (p &lt; 0,001). In the multiple logistic regression model, the most significant factors associated with HTN were age over 53 years (odds ratio (OR) 2,954, 95 % confidence interval (CI) 2,456-3,554 p &lt; 0,001), abdominal obesity (OR 2,112, 95 % CI 1,663-2,730, p &lt; 0,001) and HU (OR 1,709, 95 % CI 1,341–2,177, p &lt; 0,001). A lesser contribution was made by such factors as the respondents’ BMI over 25 kg/m2 (OR 1,634, 95 % CI 1,262–2,117, p &lt; 0,001), elevated TG level (OR 1,567, 95 % CI 1,289–1,906, p &lt; 0,001), male gender (OR 1,553, 95 % CI 1,281–1,883, p &lt; 0,001), elevated Hs-CRP (OR 1,498, 95 % CI 1,242–1,806, p &lt; 0,001), elevated LDL (OR 1,277, 95 % CI 1,038–1,570, p = 0,020). Conclusions. The results of the study indicate the widespread prevalence of HU in residents of the Nizhny Novgorod region with HTN: almost every third (29,3 %) had this disorder. In a multiple logistic regression model, HU was found to be highly correlated with HTN (OR 1,709, 95 % CI 1,341–2,177, p &lt; 0,001), along with traditional cardiovascular risk factors such as male gender, age, overweight and obesity, lipid metabolism disorders. The high frequency of HU, its independent correlation with HTN, and the prospects for urate-lowering therapy in the prevention of cardiovascular diseases determine the need for further research.

Effect of Paternal Body Mass Index on In Vitro Fertilization and Neonatal Outcomes among Oligozoospermia and Asthenospermia Patients.

Male overweight and obesity could affect sperm quality and reproductive health. However, the impact of body mass index (BMI) on assisted reproductive technology (ART) outcomes in oligospermia and/or asthenospermia patients is yet lacking. This study aims to assess the impact of paternal BMI on ART and neonatal outcomes among oligozoospermia and/or asthenospermia patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). In this study, 2,075 couples undergoing their first fresh embryo transfer between January 2015 and June 2022 were recruited. Following the World Health Organization's (WHO's) categories, couples were stratified into three cohorts based on paternal BMI: normal weight (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²), and obese (≥30.0 kg/m²). Modified Poisson regression models were used to assess the associations of paternal BMI with fertilization, in vitro embryonic development, and pregnancy outcomes. Logistic regression models were performed to investigate the associations of paternal BMI with pregnancy loss and neonatal outcomes. Furthermore, stratified analyses were performed based on fertilization methods, male infertility cause, and maternal BMI. Higher paternal BMI is associated with a lower likelihood of achieving normal fertilized (p-trend=0.002), Day 3 transferable (p-trend=0.007), and high-quality embryos (p-trend=0.046) in IVF cycles, rather than in ICSI cycles. Paternal BMI of oligospermia or asthenospermia was negatively correlated with day 3 transferable (p-trend=0.013 and 0.030) and high-quality embryos (p-trend=0.024 and 0.027). Moreover, for neonatal outcomes, paternal BMI was positively associated with macrosomia (p-trend=0.019), large for gestational age (LGA) (p-trend=0.031), and very LGA (p-trend=0.045). Our data suggested that higher paternal BMI was associated with fetal overgrowth, reduced fertilization, and embryonic development potential. Among males with oligospermia and/or asthenospermia, the impact of overweight and obesity on the choice of fertilization method and the long-term effects on their offspring need to be further investigated.

Significant Systemic Insulin Resistance is Associated With Unique Glioblastoma Multiforme Phenotype.

Some glioblastoma multiforme (GBM) are characterized by the presence of gemistocytes (GCs), a unique phenotype of reactive astrocytes. Certain GCs can be identified as neoplastic cells but these cells were also found to be associated with diabetes in non-neoplastic lesions of the central nervous system. Our aim was to find a correlation between insulin - resistance metabolic features and the presence of GCs in patients with newly diagnosed GBM. Medical records from histologically confirmed GBM patients were retrospectively extracted for different systemic metabolic variables. A statistic-based comparison was made between GBM, diabetic patients with and without GC. Patients with poorly controlled diabetes (ie, hemoglobin A1C ⩾ 8.0) were also compared between the 2 groups. A total of 220 newly diagnosed GBM patients were included in our study. 58 (26.3%) patients had a history of diabetes mellitus type 2 (DM2) at the time of admission. The rate of poorly-controlled DM2 was nearly as twice in the GC-GBM group than in the non-GC GBM group (18.75% vs 9.5%; P = .130). In the DM2 cohort, the subgroup of GC-GBM was significantly associated with demographic and metabolic features related to insulin resistance such as male gender predominance (89% vs 50%, P = .073) and morbid obesity (weight ⩾85 kg: OR 6.16; P = .0019 and mean BMI: 34.1 ± 11.42 vs 28.7 ± 5.44; P = .034 for group with and without GCs, respectively). In the poorly-controlled DM2 group, none of the GC-GBM patients were using insulin prior to diagnosis, compared to 61.1% in the non-GC GBM patients (OR = 0.04, P = .045). Systemic metabolic factors related to marked insulin resistance (DM2, morbid obesity, male gender) are associated with a unique histologic phenotype of GBM, characterized by the presence of GCs. This feature is prominent in poorly-controlled DM2 GBM patients who are not using synthetic insulin. This novel finding may add to the growing data on the relevance of glucose metabolism in astrocytes and in astrocytes associated with high-grade gliomas. In GBM patients, a correlation between patients' metabolic status, tumor's histologic phenotype, tumor's molecular changes, use of anti-diabetic drugs and the respective impact of these factor on survival warrants further investigation.

Obesity: Impact and Outcome on Infertility—A Literature Review

Background: The health risks of obesity are a forever growing concern for societies worldwide. With the advent of Assisted reproductive technology more couples can achieve fertility which includes overweight and obese men and women. The review intends to explore the impact of overweight and obesity on human reproductive potential and explores ways of optimising outcome and minimising risk through development of sound recommendations. Aim: To determine the impact of obesity on infertility in men and women and recommendations to optimise reproductive outcome. Method: Relevant published reviews on the subject were searched on the PubMed, Google scholar, Medline, and Cochrane library within the past 10 years, from 2011 to 2021. Results: Thirty-six articles met the criteria. Twenty-six of these were qualitative studies and ten were quantitative. The main themes were increasing prevalence and burden of disease, impact on male and female obesity and assisted reproductive outcomes. Conclusion: Overall, it is evident that overweight and obesity negatively effects reproductive health of both men and women. It has numerous sequalae in men and women of reproductive age group with lasting impact on following progeny. These risks are minimised both in short and long term by weight loss strategies and there is need for more literature on the subject.

Male hypogonadism in overweight and obesity

Obesity-related gonadal dysfunction in males has been defined recently as male obesity secondary hypogonadism (MOSH). Affected individuals present with signs and symptoms related to the sex hormone imbalance but also with a burden of metabolic risk factors and occasionally compromised fertility. In pathophysiological terms, excess body fat is associated with leptin and insulin resistance. Accelerated synthesis of leptin and hyperinsulinemia downregulate the expression of kisspeptin receptors and, consequently, the action of kisspeptin. This critical neuropeptide is known to control gonadotropin secretion. In obese males, enhanced activity of the aromatase enzyme is associated with an increase in the conversion of circulating testosterone to estrogen, further promoting a state of hypogonadism. In addition, high fat and low fiber intake alter the intestinal microbiome and the dysfunction of the gut-brain axis. Weight loss appears to be the key to readjusting the function of the hypothalamus-pituitary-gonadal axis. It can be achieved with lifestyle measures in combination with weight loss medications or bariatric surgery. The degree of weight loss appears to resolve the symptoms related to hypogonadism and improve fertility chances. However, the role of hormone replacement is also important, as testosterone replacement has been shown to reduce fat mass and increase the amount of lean body mass while also contributing to weight loss and the regulation of body mass index and waist circumference. This narrative review analyzes the evidence on developing obesity-related endocrinopathies and the available management options. Further research is required to estimate the cut-off of body mass index associated with a higher risk for hypogonadism.

Reduced Fat Taste Sensitivity in Obese Japanese Patients and Its Recovery after a Short-Term Weight Loss Program.

Fat taste has recently attracted attention as the 'sixth taste.' However, the relationship between fat and sweet taste in Japanese obesity has not yet been examined, and no reports have ascertained whether improvement of fat taste can be obtained by weight loss. Patients were recruited into obesity group (BMI≥30 kg/m2; n=15) or control group (BMI<25 kg/m2; n=11). They answered a questionnaire on smoking, eating behavior, lifestyle, and food frequency, and their taste thresholds were measured (fat, umami, and sweet). The obesity group was tested twice (on admission and before discharge). They showed several eating behavior abnormalities, higher total energy intake, and less physical activity. There were some gender differences: physical inactivity was more prominent in females, and high total energy intake in males, which correlates with fat taste rank. Fat taste rank was significantly higher in obesity group, whereas taste rank of umami and sweet were not significantly different. Gender-specific analysis of fat taste rank revealed only male obesity showed significant difference. Reduced sensitivity of fat may be specific to male gender or obesity by overeating, but not by physical inactivity. Multiple logistic regression analysis revealed that fat taste was a factor relevant to obesity. Fat taste significantly improved after a weight loss program, with average duration of 11.3 d. Japanese obese people, especially males and those who are obese by overeating, have reduced sensitivity to fat taste. This can be recovered by even a short-term weight loss program.

Current status and treatment of obesity in Korea

Background: Over the last decade, the male obesity rate in Korea has surged from 36.3% in 2012 to 46.3% in 2021. The proportion of overweight and obese students among elementary, middle, and high school students increased from 22.9% in 2016 to 30.8% in 2021.Current Concepts: Various methods, such as body mass index, waist circumference measurement, and impedance body fat analysis, are used to diagnose obesity. Obesity treatment is needed to establish an individualized treatment plan based on the cause of obesity, and behavioral changes should be induced through dietary therapy and exercise. Drug therapy should be considered in patients who could not lose weight despite non-pharmacological therapies for over 3 months and have one or more cardiovascular risk factors. Behavioral therapy is the core of obesity treatment because of its application as a programmed treatment for weight control and an approach to changing behaviors related to food intake and physical activity. If non-drug treatment does not lead to weight loss, drug therapy should be considered. Along with drug treatment, dietary therapy, exercise, and behavioral therapy are essential. In severely obese patients, surgical intervention can be considered for weight loss, the maintenance of reduced weight, and improvement of obesity-related comorbidities, including type 2 diabetes.Discussion and Conclusion: To successfully treat obesity, a combination of dietary plans, exercise programs, and drug therapy are required according to an accurate assessment of the cause and degree of obesity.

Gender Dimorphism in Hepatic Carcinogenesis-Related Gene Expression Associated with Obesity as a Low-Grade Chronic Inflammatory Disease

Non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) show clear evidence of sexual dimorphism, with a significantly higher incidence in males. Among the determining factors that could explain this sex-based difference, the specific distribution of fat by sex has been suggested as a primary candidate, since obesity is a relevant risk factor. In this context, obesity, considered a low-grade chronic inflammatory pathology and responsible for the promotion of liver disease, could lead to sexual dimorphism in the expression profile of genes related to tumor development. When we compared the expression levels of genes associated with the early stages of carcinogenesis in the liver between male and female diet-induced obesity (DIO) rats, we observed that the expression pattern was similar in obese male and female animals. Interestingly, the SURVIVIN/BIRC5 oncogene showed a higher expression in male DIO rats than in female DIO and lean rats. This trend related to sexual dimorphism was observed in leukocytes from patients with obesity, although the difference was not statistically significant. In conclusion, this study evidenced a similar pattern in the expression of most carcinogenesis-related genes in the liver, except SUVIVIN/BIRC5, which could be a predictive biomarker of liver carcinogenesis predisposition in male patients with obesity.

Intergenerational Transmission of Obesity: Role of Education and Income

Based on the sixth round of the 2018 Chinese Household Income Project family income survey (CHIP) data, this study made use of the OLS estimation and transfer matrix method to measure and test the problem of obesity intergenerational transmission, analyze whether there is obesity intergenerational transmission as well as between urban and rural areas, gender, and the parental education level and income level on the suppression of the obesity intergenerational transmission effect. The empirical results draw the following main conclusions: obesity intergenerational transmission in Chinese families, the degree of parental obesity has a significant positive impact on the degree of offspring obesity; the higher the degree of parental obesity, the more it can promote the degree of obesity in the offspring. Moreover, the degree of obesity intergenerational transmission is heterogeneous in urban and rural areas and gender. At the same time, the degree of rural obesity intergenerational transmission is higher than that of urban areas, and the degree of male obesity intergenerational transmission is higher than that of women.

Liver test abnormalities in asymptomatic and mild COVID-19 patients and their association with viral shedding time.

Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant, and data on liver test abnormalities are rare. To evaluated the clinical characteristics of asymptomatic and mild coronavirus disease 2019 (COVID-19) patients with abnormal liver test results. This retrospective study included 661 laboratory-confirmed asymptomatic and mild COVID-19 patients who were treated in two makeshift hospitals in Ningbo from April 5, 2022 to April 29, 2022. Clinical information and viral shedding time were collected, and univariate and multivariate logistic regression models were performed in statistical analyses. Of the 661 patients, 83 (12.6%) had liver test abnormalities, and 6 (0.9%) had liver injuries. Abnormal liver tests revealed a reliable correlation with a history of liver disease (P < 0.001) and a potential correlation with male sex and obesity (P < 0.05). Elevated alanine aminotransferase was reliably associated with obesity (P < 0.05) and a history of liver disease (P < 0.001). Elevated aspartate transaminase (AST) was reliably correlated with a history of liver disease (P < 0.001), and potentially correlated with age over 30 years (P < 0.05). There was a reliable correlation between AST ≥ 2× the upper limit of normal and a longer viral shedding time, especially in mild cases. Obesity and a history of liver disease are risk factors for liver test abnormalities. Being male and an older age are potential risk factors. Attention should be given to liver tests in asymptomatic and mild COVID-19 patients, which has crucial clinical significance for evaluating the viral shedding time.

Semen Leucocytes Affect Sperm Quality of Infertility Patient

The association between the risk factors for male infertility including smoking, obesity, male age, and leukocyte count with sperm analysis, still shows mixed results. This study aims to determine the association between smoking, obesity, male age, and leukocytes count with sperm quality (sperm concentration, sperm motility, and sperm morphology) of infertility patients in Purwokerto. This study is an observational study with a cross-sectional design conducted in the medical records section of the Bunda Arif Hospital Purwokerto. The sample was taken by total sampling. The bivariate test of smoking and obesity behaviour variables with the results of sperm quality using the Chi-Square test and Fisher's exact test. Male age variables used the Kruskal-Wallis test and the Spearman correlation test. Variable leukocytes count using the Spearman test. The results showed no association between male age, obesity and smoking behaviour with sperm quality, sperm concentration, sperm motility, and sperm morphology (p&gt;0.05). There is a significant association (p&lt;0,05) between leukocyte semen count and spermatozoa concentration, sperm motility, and morphology of spermatozoa. It is concluded that there was a significant association between leukocyte count and sperm quality in infertility patients in Purwokerto. Research needs to be continued by examining the relationship between leukocytopenia and sperm DNA damage by looking at sperm DNA fragmentation.

Cardiovascular Disease and its Risk Factors: Frequency in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is one of the respiratory conditions which is indicated by persistent airflow obstruction. It is linked with various different comorbidities. Ischemic heart disease (IHD) is reported to be the most recurring in patients with COPD. Its impact in context of patient's exercise capacity, health status and manifestation of symptoms is poorly understood. The objective of my study is to ascertain the frequency of ischemic heart disease in patients with chronic obstructive pulmonary disease and to evaluate current magnitude of the problem in our local population. It a cross sectional study conducted in Department of Pulmonology, Nishtar Hospital Multan. Patients with COPD (as defined in Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria 2021) with duration of more than 3 months were taken in the study. Of these 212 study cases, 127 (59.9 %) were male patients while 85 (40.1 %) were female patients. Mean age of our study cases was 56.75 ± 6.78 years. Diabetes was present in 57 (26.9 %), Dyslipidemia in 43 (20.3%), hypertension in 98 (46.2%) our patients and 29 (13.7 %) were obese. Smoking was noted in 100 (47.2 %). Ischemic Heart disease was present in 57 (26.9%) of our study cases. High frequency of ischemic heart disease was noted in patients with chronic pulmonary obstructive disease in our study. Ischemic Heart Disease was significantly linked with male gender, increasing age, diabetes, hypertension, obesity, and family history for IHD and dyslipidemia.

Health Status and Self-Perception of Health in Czech Roma Community

Abstract Background The Roma population is reported to have a lower life expectancy in several European countries. The reasons for this are not well described, which limits the development of effective health promotion programs. This report investigates some possible reasons: self-perception of health risks and discrimination in a sample of Czech Roma. The study is a part of a complex health awareness program. Methods This is a pilot descriptive, cross-sectional survey conducted in Brno, Czech Republic in March 2022. Respondents were identified by community gatekeepers using quotas of gender and education. Data on disease incidence, lifestyle, attitudes to health care and risk perception were collected. Results In the sample of 30 participants, 60% were female, average age 42±5, 60% primary education. 57% daily smokers, with an average 17 cigarettes daily during 18 years. 35% had 1 chronic disease, another 38% had 2 and more. The most prevalent diseases were hypertension (43%) and obesity (41%). 60% of respondents with hypertension as compared to 23% without hypertension considered their stroke risk as medium. 43% smokers as compared to 21% non-smokers consider their risk of COPD as medium (for lung cancer 41% vs. 0%). Roma report not visiting a doctor due to a lack of time (33%), expecting the problem to resolve itself (33%), long waiting time (33%), but not discrimination (0%). Conclusions The Roma with risk factors correctly identify their risk of stroke, COPD, lung cancer as higher. None of them feel discriminated from physicians, but they limit contact with them due to other reasons. It appears that the prevalence of risk factors is higher in the Roma when compared to Caucasians based on the European Health Interview Survey (16% female, 31% male hypertension; 14% female, 29% male obesity). Self-perception of health and feeling of discrimination in Roma communities should be taken into account when designing health interventions. Key messages

Evaluating the Impact of Fetal Sex on Gestational Diabetes Mellitus Following Interaction with Maternal Characteristics.

Fetal-sex-specific changes to placental immunity and metabolism occur in response to obesity. Few studies have determined if fetal sex interacts with maternal characteristics to alter risk of gestational diabetes mellitus (GDM). Among 43,727 singleton pregnancies, we examined the association between male fetal sex and GDM using log-binomial logistic regression to calculate relative risks (RR) and 95% confidence intervals (CI). Interactions were examined between fetal sex and maternal characteristics on the risk of GDM by calculating relative excess risk due to interaction. After adjusting for body mass index, race/ethnicity, maternal age, education, and gravidity, male fetal sex was not associated with GDM (RRadj. 0.95, 95% CI 0.93, 1.04). We found a positive interaction between male fetal sex and obesity (p = 0.04). Nonobese women with male fetuses were less likely to develop GDM, but in the presence of obesity, an opposite trend was observed. There was a positive interaction between male fetal sex and GDM on the risk of preterm delivery < 37-weeks gestation (p = 0.0006). In response to underlying maternal obesity, fetal sex may modify the risk of GDM. In addition, male fetal sex may increase the occurrence of preterm birth among women with GDM.

Common Risk Factors Involved In The Development Of Myocardial Infarction In Adults Younger Than 45 Years Of Age.

Pakistan has got a very high prevalence of myocardial infarction (MI). MI presents at pretty young age in this country. The objective of present study was to determine the frequency of common risk factors associated with early development of MI in middle aged adults of less than 45 years. It was a cross sectional study conducted in the Cardiology department of Ayub Teaching Hospital (ATH) Abbottabad from 23rd June 2015 - 10th July 2016. A total of 255 consecutive patients diagnosed with MI admitted to the Cardiology Unit of ATH, Abbottabad. A detailed medical history and general physical examination of the patients was carried out with an emphasis on recording the presence or absence of common risk factors of MI in these patients. All routine investigations (Blood Complete Picture, Urea, Creatinine, Blood Sugar & Lipid Profile) were done. Mean age of the subjects was 39.98±4.61 SD. The frequency of risk factors in descending order was smoking in (38.8%), obesity in (29.4%) and essential hypertension in (21.6%) of the patients. Other risk factors of MI in this study were diabetes mellitus (19.2%), family history of ischemic heart disease (IHD) was (18.8%) and disproportionate dyslipidemias in (12.9%). Sex of patients (male predominance) was found to be significantly associated with diabetes, smoking and dyslipidemia (p<0.05). Male sex, smoking, hypertension and obesity confer an increased risk of myocardial infarction in patients younger than 45 years of age.

Quantification of sleep architecture in different grades of apnea hypopnea index in patients having obstructive sleep apnea

Background: Optimum sleep architecture is important from the point of view of optimum physiological functions. Sleep is qualitatively as well as quantitatively affected in patients of obstructive sleep apnea (OSA). Male gender and obesity are associated with increased risk of OSA. It is being increasingly recognized due to increased awareness not only among treating physicians but also in general population. We undertook this study to do quantification of sleep in individuals diagnosed with apnea/hypopnea syndrome and having different grades of apnea/hypopnea index (AHI). Aims and Objectives: The aims of this study were to analyze sleep pattern in individuals diagnosed with obstructive sleep apnea having different grades of AHI. Materials and Methods: This was a retrospective analytical study, in which data were collected from polysomnography reports of 92 patients having obstructive sleep apnea. The study was conducted in the Pulmonary Medicine, Seth GS Medical college and KEM Hospital Mumbai. Ninety-two patients diagnosed to be having OSA were included in this study on the basis of a predefined inclusion and exclusion criteria. The sleep parameters included in the study were total sleep time, percentage of time spent in rapid eye movement (REM), percentage of time spent in non-REM (NREM) Stage I, percentage of time spent in NREM Stage II, percentage of time spent in Stage III, percentage of time spent in stage NREM IV, N2 sleep, and wake after sleep onset (WASO) Index. P&lt;0.05 was taken as statistically significant. Results: Among the 92 studied cases, there were 66 (71.74%) males and 26 (28.26%) females with a M: F ratio of 1: 0.39. Most of the patients belonged to age group between 35–50 years (39.13%) and 51–70 years (42.39%). Most of the patients with obstructive sleep apnea were either obese (59.78%) or overweight (27.17%). AHI was found to be mild, moderate, and severe in 32 (34.78%), 15 (16.30%), and 16 (17.39%) patients, respectively. Percentage of NREM I, NREM II and NREM IV, and N3 SL was foundto be comparable across groups of different AHI (P&gt;0.05). The median AHI of the patients with underweight, healthy weight, overweight, and obese individuals was found to be 7.6, 5.5, 11.6, and 6.9, respectively, and it was found to be comparable with no statistically significant difference (P&gt;0.05). Conclusion: Obstructive sleep apnea affects sleep pattern qualitatively as well as quantitatively and is more likely to affect NREM I and WASO.

S182 Estimating the Prevalence and Characteristics of Colorectal Neoplastic Lesions in Young Patients Undergoing Colonoscopy

Introduction: Incidence of colorectal neoplasia (CRN) in patients < 50 years of age has been increasing. Although current guidelines recommend starting screening at age 45, data on the prevalence and characteristics of CRN in this cohort is sparse. We aim to determine the overall prevalence and characteristics of CRN lesions in patients < 50. Methods: All patients < 50 years who underwent colonoscopy for any indication between Jan 2012 and Dec 2018 were included. Data on demographics, comorbidities, risk factors and indications was obtained. Procedural data on number of polyps and polyp characteristics was collected. Patients with inadequate preparation, personal history of (h/o) colon polyps or cancer and inflammatory bowel disease were excluded. Logistic regression analysis was used to determine predictors of adenoma detection. Results: 4587 patients had diagnostic colonoscopy during the study period. Mean age was 38.1 years, with 61.2% females, 84% white. Abdominal pain (36%), family h/o CRC (29.5%), diarrhea (29.3%), hematochezia (25.7%) and constipation (21.2%) were the most common indications. Information on clinical characteristics based on age groups are shown in Table. 26.2% (n=1201) had at least one polyp; 14.8%, 31.9% and 39.4% were < 39, 40-44 and 45-49 years of age respectively. Overall adenoma prevalence was 15.8%; 7.81%, 19.9% and 24.9% were < 39, 40-44 and 45-49 respectively. ≥ 3 adenomas were observed in 6.9%; prevalence increased with age (Figure 1a). Majority of the polyps were tubular adenomas (45.6%), followed by sessile serrated adenomas (17.2%); tubulovillous adenomas were the least common (2.7%). High-grade dysplasia and carcinoma were observed in 0.4% and 0.8% (Figure 1b). On multivariate analysis of 1602 patients (801 with polyps and 801 age-sex matched controls), female sex (OR 0.79) and age < 39 (OR 0.63) were associated with lower odds, while family h/o polyps (OR 1.76) and BMI (1.04) were associated with higher odds of adenoma detection (Table). Conclusion: There was an increasing trend in the prevalence of polyps, adenomas, advanced adenomas and CRC with increasing age; our rates were similar to other published studies. Prevalence rates for all the above doubled between age groups < 39 and 40-44, but with a smaller proportion of increase between 40-44 and 45-49. Large population studies are needed to confirm this observation. Male gender, increasing age, obesity and family h/o colon polyps were independent predictors of adenoma detection in our cohort. Table 1. - Demographics, Clinical Characteristics and Logistic Regression Demographics Age < 39 Age 40-44 Age 45-49 All Age Groups p-value Total number of patients 2152 1036 1399 4587 Patients with ≥ 1 polyp, n 319 331 551 1201 Clinical Characteristics, Comorbidities and Risk Factors Mean BMI (+/-SD) 32 (10.1) 32.4 (9.5) 32.7 (9.4) 32.4 (9.6) 0.3128 Diabetes, n (%) 16 (5) 29 (8.8) 42 (7.6) 87 (7.3) 0.1591 Hypertension, n (%) 37 (11.6) 55 (16.7) 146 (26.6) 238 (19.9) < .0001 Tobacco use, n (%) 112 (35.2) 107 (32.4) 180 (32.9) 399 (33.4) 0.7137 NSAID use, n (%) 76 (23.9) 73 (22.3) 128 (23.3) 277 (23.2) 0.8904 Statin use, n (%) 7 (2.2) 20 (6.1) 67 (12.2) 94 (7.9) < .0001 Multivariate Analysis Predictor Reference OR 95% CI (UL, LL) p-value Age 40-44 ≤ 39 45-4945-49 0.490.63 0.75, 1.180.5, 0.79 0.59 < 0.001 Gender Male 0.79 0.65, 0.95 0.011 BMI Per each unit ↑ 1.04 1.03, 1.05 < 0.001 Diabetes No 0.81 0.56, 1.19 0.29 Hematochezia No 0.96 0.77, 1.19 0.71 Anemia No 1.22 0.87, 1.71 0.25 Family h/o colon polyps No 1.76 1.03, 1.05 < 0.01 Family h/o colon cancer No 1.18 0.94, 1.48 0.15 Figure 1.: Prevalence rates of polyps, adenomas and advanced adenomas (1a) and different types of adenomas, high grade dysplasia and carcinoma (1b)

Significantly different roles of economic affluence in sex-specific obesity prevalence rates: understanding more modifications within female body weight management

Socioeconomic status has been associated with obesity prevalence increase in both males and females worldwide. We examined the magnitude of the difference between the two relationships and explored the independence of both relationships. Country specific data on gross domestic product (GDP) per capita, sex-specific obesity prevalence rates, urbanisation, total calories availability and level of obesity, genetic background accumulation (measured by the Biological State Index, Ibs) were obtained for 191 countries. Curvilinear regressions, bivariate and partial correlations, linear mixed models and multivariate linear regression analyses were used to examine the relationship between GDP and obesity prevalence rates in males and females respectively. Fisher’s r-to-z transformation, F-test and R2 increment in multivariate regression were used to compare results for males and females. GDP significantly correlated with sex-specific obesity prevalence rates, but significantly more strongly with male obesity prevalence in bivariate correlation analyses. These relationships remained independent of calories availability, Ibs and urbanization in partial correlation model. Stepwise multiple regression identified that GDP was a significant predictor of obesity prevalence in both sexes. Multivariate stepwise regression showed that, when adding GDP as an obesity prevalence predictor, the absolute increment of R2 in male fit model (0.046) was almost four (4) times greater than the absolute increment in female model fit (0.012). The Stepwise analyses also revealed that 68.0% of male but only 37.4% of female obesity prevalence rates were explained by the total contributing effects of GDP, Ibs, urbanization and calories availability. In both Pearson’s r and nonparametric analyses, GDP contributes significantly more to male obesity than to female obesity in both developed and developing countries. GDP also determined the significant regional variation in male, but not female obesity prevalence. GDP may contribute to obesity prevalence significantly more in males than in females regardless of the confounding effects of Ibs, urbanization and calories. This may suggest that aetiologies for female obesity are much more complex than for males and more confounders should be included in the future studies when data are available.