Non-obese Cases Research Articles

Comparison between Obese and Non-obese Cases after Total Knee Arthroplasty Regarding Their Short Term Functional Outcome.

Comparison between Obese and Non-obese Cases after Total Knee Arthroplasty Regarding Their Short Term Functional Outcome.

Impact of obesity on admissions for COVID-19 with concurrent prostate cancer.

e17110 Background: Obesity is a significant risk factor for prostate cancer and its associated mortality. Recent studies have shown that a five-point rise in BMI can lead to a 10% rise in death among these patients. Since the pandemic of COVID-19, obesity has also been associated with poorer outcomes among the general population. As there is a paucity of data on the impact of obesity among prostate cancer admissions with COVID-19, we conducted a retrospective study to provide a novel perspective. Methods: Patients with a diagnosis of COVID-19 were used for our study from the 2020 National Inpatient Sample. We included cases between April 2020 to December 2020. Hospitalization records with prostate cancer and obesity were also identified via their respective ICD-10 codes. The differences in outcomes, including non-invasive ventilation, use of mechanical ventilation, pulmonary embolism, events of Acute Kidney Injury(AKI) and in-hospital mortality were compared between obese and non-obese patients with a history of prostate cancer, admitted for COVID-19. We also compared the mean lengths of stay, mean ages between the two groups, and their overall mean hospitalization charge. Results: A total of 7165 prostate cancer patients were hospitalized with COVID-19 between 1st April 2020 to 31st December 2020 in the United States. 1065 (14.9%) were obese. Prostate cancer patients admitted with COVID-19 who were obese were also younger (mean age 71.75 years) than those who were not obese (77.50 years) and recorded a more extended stay (mean LOS 9.68 days vs. 7.93 days). Obese patients also recorded a higher adjusted odds ratio for needing non-invasive ventilation (aOR 1.736, 95% CI 1.331-2.263, p < 0.01), mechanical ventilation (aOR 1.894, 95% CI 1.533-2.340, p < 0.01), events of acute kidney injury (aOR 1.328, 95% CI 1.137-1.550, p < 0.01), and in-hospital mortality (aOR 1.246, 95% CI 1.033-1.502, p = 0.021). While more patients with obesity developed pulmonary embolism (4.2% vs. 3.6%) after adjusting for confounders, the result was not statistically significant (aOR 1.258, 95% CI 0.879-1.800, p = 0.209). Obese patients also recorded a higher mean hospital charge compared to non-obese cases ($117200.50 vs. $81028.15). Conclusions: Obesity in prostate cancer patients admitted with COVID-19 is linked with several poor outcomes and complications, including AKI, mechanical ventilation, non-invasive ventilation, and mortality. Thus, physicians must identify such cases as higher-risk and encourage closer monitoring during their hospitalizations.

Comparative Outcome of Obesity in Ischemic Heart Disease a Clinical Study

Objective: The purpose of this study is to determine the comparative outcome of obesity in ischemic heart disease. Duration of Study: July, 2021 to Dec, 2021 Place and Duration: CCU department D.G. Khan Medical College and Teaching Hospital Dera Ghazi Khan Methods: This research included 180 participants of both sexes. Patients were between the ages of 22 and 80 years old, according to the study. As part of their informed written permission, researchers collected demographic information such as age, sex and BMI. Patients were divided in two groups, group I had 90 obese patients and group II had non obese 90 patients. Follow up among patients were taken in duration of 12 months. Both groups' outcomes were evaluated and compared in terms of increase in risk factor of IHD, myocardial infarction and mortality because of these factors. SPSS 22.0 was used to analyze complete data. Results: There were 55 (61.1%) males and 35 (38.9%) females in group I and in group II 46 (51.1%) males and 44 (48.9%) females in group II. The mean age of the patients in group I was 41.4±11.62 years and had mean BMI 32.14±21.86 kg/m2 while in group II mean age was 38.41±12.42 years with mean BMI 25.2±11.34 kg/m2. 40 (44.4%) patients in group I and 45 (50%) patients in group II was educated. In group I 25 (27.8%) patients were smokers, 19 (21.1%) patients had DM and in group II 27 (30%) were smokers and 5 (5.6%) cases had DM. We found increase in Ischemic heart disease in 65 (72.2%) cases of group I and in group II IHD was found in 11 (12.2%) cases. Frequency of Myocardial Infarction was also higher in obese patients than non-obese cases. Systolic and diastolic blood pressure was also higher in obese patients. HDL was lower in obese patients while cholesterol, LDL, triglycerides and CRP was found higher in obese patients. Mortality in obese patients with IHD was 12 (13.3%) but no any mortality found in non-obese cases. Conclusion: In this study we found that obesity and increase in weight is a significant risk factor for ischemic heart disease and myocardial infarction and because of these diseases patients had poor outcomes with increase in rate of deaths. Keywords: MI, IHD, Mortality, Obese, Smoking

Effects of ambulatory blood pressure monitoring parameters on left ventricular mass index in hypertensive children.

We aimed to evaluate the effects of blood pressure (BP) values obtained by 24-h ambulatory BP monitoring (ABPM) of hypertensive children and adolescents on left ventricular mass index (LVMI). Patients diagnosed with HT with BP measurements confirmed with ABPM and evaluated with echocardiography for LVMI were included. The patients were divided into two groups according to their BMI as obese and nonobese. SDSs of ABPM parameters were compared between the groups. A total of 158 children with HT were included in the study. Ninety of these patients were obese. In obese and nonobese cases, mean SDS levels were similar in ABPM parameters, whereas LVMI was significantly higher in obese patients ( P = 0.049). There was a significant correlation between LVMI and 24-h SBP SDS, daytime SBP SDS, 24-h SBP load and daytime BP load. In obese cases, there was a statistically significant correlation between LVMI and 24-h SBP SDS, daytime SBP SDS, 24-h SBP load, daytime SBP load as well as nighttime SBP SDS and nighttime SBP load. When the whole group was evaluated, 24-h SBP SDS was the most effective parameter influencing LVMI ( P = 0.001). Similarly, the most effective ABPM parameter on LVMI in obese patients was 24-h SBP SDS ( P = 0.001). A significantly higher rate of LVMI in obese patients suggests that obesity itself is an effective factor on LVMI. In addition, systolic hypertension is more effective on cardiac functions compared with DBP measurements and systolic-DBP dipping ratios.

Comparison of Recurrence Rate of Breast Carcinoma between MRM and B. Conservative Surgery in Patients of Breast Cancer

Objective: To compare the recurrence rate of breast carcinoma between modified radical mastectomy and breast conservative surgery in patients of breast cancer. Material and methods: This randomized controlled was conducted at Department of Surgery, Akhtar Saeed Medical and Dental College Lahore from September 2020 to June 2021. Total 70 females with breast cancer from last 3 years (any stage), age between 30-60 years with ASA grade I, II and III were selected. In group A MRM was performed while in group B, conservative surgery was performed. Recurrence of breast cancer between the both groups was compared. Results: Mean age of patients was 44.47 ± 9.41 years with age range 30-60 years. Mean age of patients of study group A and B was 43.57 ± 9.89 years and 45.37 ± 8.95 years respectively. In study group A (MRM group), recurrence of breast cancer was found in 6 (17.14%) patients while in study group B (Conservative surgery group), recurrence of breast cancer was noted in 15 (42.86%) patients. Difference of recurrence of breast cancer between the both groups was significant with p value 0.019. Conclusion: Findings of this study showed higher frequency of recurrence of breast cancer in cases managed with conservative surgery as compared to MRM. Most of the cases belonged to 3rd decade of life. Among non-obese cases, significant difference of recurrence was seen. Most of the cancer cases were multiparas but difference of recurrence was not significant. Higher number of married cases were reported with breast cancer and difference between conservative surgery group and MRM group was significant. Keywords: Breast cancer, recurrence, MRM, conservative surgery

Effectiveness of Valsartan in Obese Versus Non-Obese Type 2 Diabetic patients presented with microalbuminuria

Aim: To ascertain efficacy of Valsartan, an angiotensin receptor blocker (ARB) in reducing microalbuminuria in obese verses non obese patients. Methods: This comparative study was done in Department of Nephrology Pakistan Institute of Medical Sciences Islamabad from July 1, 2018 to December 31, 1018. Patients fulfilling selection criteria were enrolled and categorized as two groups obese & non-obese; both groups were given valsartan. Urine ACR and serum creatinine was followed every month for 6 months. Results: Average age of all cases as 52.06 ± 4.11 years while the mean age in obese and non-obese cases was 52.48 ± 4.25 years and 51.63 ± 3.95 years, respectively. The mean change in Urine ACR (from baseline to 6th months) in obese cases was 41.76 ± 25.81 and non-obese cases was 76.05 ± 7.63, p-value <0.001. In obese cases mean urine ACR at 1st and 2nd month was same from baseline, p-value > 0.05 while at 3rd, 4th month was statistically lower as compare to baseline urine ACR, p-value < 0.05. Moreover, in non-obese cases the mean urine ACR was statistically decreased at 1st, 2nd, 3rd, 4th, 5th and 6th month when compared with baseline, p-value < 0.001. At 4th month in obese cases none of the cases achieved ACR < 30 while in non-obese cases 4(7.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.05. At 4th month in obese cases 12(22.2%) cases achieved ACR < 30 while in non-obese cases 31(57.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. At 6th month in obese cases 20(37%) cases achieved ACR < 30 while in non-obese cases 41(75.9%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. Conclusion: Valsartan is more effective in reducing microalbuminuria in non-obese patients as compared to obese patients. Keywords: Diabetes mellitus, obesity, microalbuminuria, Valsartan

Relation of Lactobacilli acidophilus to Obesity in Egyptian Population

Abstract Background Current considerations are existed about the sharing role of gut microbiota in the enhancement of obesity and its allied comorbidities Objective The aim of this observational case-control study was to assess the possible relation of lactobacilli acidophilus to obesity in a sample of Egyptian population by realtime PCR of lactobacilli acidophilus in stool. Subjects and methods The present study enrolled 20 healthy slim subjects and 40 subjects who had BMI >25 kg/m2. Routine laboratory analysis and identification of stool Lactobacillus acidophilus by quantitative real time PCR technique was performed for all enrolled subjects. Results Lactobacillus acidophilus was expressed in 21 out of 40 (52.5%) faecal samples of obese cases and 16 out of 20 (80%) of faecal samples of non-obese cases. In rest of samples in both studied groups, the expression was below the detection limit. The results showed that the mean CT at which Lactobacilli were expressed in the obese cases was (38.89±2.57) compared to (36.08±4.63) in non-obese cases and this indicated that the expression of lactobacilli was statistically higher in non-obese subjects compared to obese cases (P = 0.04). Conclusion Lactobacillus acidophilus was significantly lowered in obese Egyptian patients. The argument about the significance of correlation between imbalance in gut microbiota and obesity is considered one of the hottest open topics in medicine.

Association of Genetic Polymorphism in Apolipoprotein A5 and Lipoprotein Lipase Genes with Type Ii Diabetes Mellitus Patients in Rural South Western Maharashtra

The most commonly found type of diabetes in India is type II diabetes mellitus (T2DM), which is characterized by decrease in insulin secretion and decrease in insulin sensitivity. Several environmental factors, genetic factors, socio-economic factors, life style, dietary habits have contributed to the surge of T2DM cases in India. Numerous genes involved in lipid metabolism are likely to be candidates as the markers for obesity and T2DM. In the present study, single nucleotide polymorphism (SNP) of two genes namely Apolipoprotein A5 (APOA5) and Lipoprotein lipase (LPL) involved in triglyceride metabolism were investigated using polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP). The control group comprised of non-obese, non-diabetic subjects (n=120) and T2DM cases were divided into obese (n=120), and non-obese (n=120) groups based on their body mass index (BMI). The demographic features between the control and cases were compared using Chi-square distribution. The genotype frequencies of control and cases were compared using analysis of variance (ANOVA) and binary logistic regression analysis (Odds’ ratio (OR) and adjusted Odds’ ratio). It was observed that APOA5 rs3135506 (OR = 0.46 (0.27-0.79); p = 0.007) was negatively associated, while APOA5 rs662799 (OR = 2.22 (1.28-3.84); p = 0.006) was significantly associated in non-obese diabetic patients. APOA5 rs3135506 (OR = 0.03 (0.01-0.06); p < 0.001) was negatively associated and rs662799 (OR = 4.68 (1.47-14.93); p = 0.01) was significantly associated in obese diabetic patients. Both LPL SNPs (rs285 and rs320) were found not to be associated with T2DM. The association of Apo A5 variants with T2DM may be because of post transcriptional inhibition leading to reduced Apo A5 expression or these alleles may be in linkage disequilibrium with alleles which directly affect the functioning of APOA5. The observations indicated that T2DM is a multi-factorial disease with a large number of gene-gene and gene-environment interactions.

ACANTHOSIS NIGRICANS IN OBESE VERSUS NON-OBESE IN A TERTIARY CARE HOSPITAL ASSOCIATION WITH BMI AND CENTRAL OBESITY

Background and objectives:Acanthosis nigricans (AN) is a major cosmetic and pathological condition associated with obesity,hirsutism, polycystic ovary, DM, metabolic syndrome and insulin resistance. This study was conducted to determine frequency of obesity in acanthosis nigricans and the association of BMI and central obesity with gender, age andtype of AN. Methodology: This hospital based observational study was conducted from1st March to 31st May 2021 at department of Medicine RIHS Islamabad after ethical approval. Sample size was calculated to be 221.Inclusion criteria: Adult cases of both the genders presenting with AN in medical OPD. Exclusion criteria:Diagnosed cases of malignancy, critically ill cases, endocrine disorders and pregnant women were excluded.After detailed history and examination, clinical diagnosis of Acanthosis nigricanswasmade. The weight in kg and height in meters measured and BMI calculatedby formula weigh in Kg/height (m2).Waist circumference measured in cm by flexible measuring tape from narrowest part of torso,midway between the lowest rib and iliac crest for central obesity and relevant investigations suggested. Data analyzed by SPSS version 21.Chi-square test was used to compare various variables between obese and non-obese AN cases with significant p<0.05. Results: Among 221 cases with acanthosis nigricans, there were152(68.8%)females and 69(31.2%) males . The mean age was 27 + 13.56 years with a range of 18-64 years. The mean BMI was 31.63 + 6.92 kg/m2.Obesity was observed in 144(65%).Mean waist circumference was 37.75 + 13.73 inches. Most frequent site involved was neck (98.6%), followed by groin (80.5%), knuckles (59.7%),sub-mammary (49%) and axilla (47%).The benign acanthosis nigricans was most frequent(98.6%) followed by HAIR AN Syndrome 46% cases, acral AN14%, Syndromic AN 1.7% and mixed 1.4%. No case had unilateral AN.The types of AN had no association with obesity (p>0.05).Diabetes mellitus observed in 47 (21%) AN cases.Polycystic ovaries (PCOs) in 111 out of 152 females with AN. Autoimmune conditions seen in 53(24%) AN cases. Conclusion: Benign and HAIR-AN were most frequent type in our study that was associated with raised BMI, waist circumference, PCOS and diabetes. It is recommended to screen acanthosis nigricans cases regardless of age or gender for obesity, PCOS, DM, hypertension and autoimmune conditions. Hence,early diagnosis may improve quality of life, prevent complications of systemic disease and improve outcome of diseases and quality of life of patients.

Distinct Genetic Susceptibility Patterns of the Obese and Non-obese South Indian Women with Polycystic Ovary Syndrome

The researchers studied association of 92 SNPs of the metabolic and reproductive pathways genes in the obesity related cohorts of obese PCOS cases and non-obese controls, and non-obese PCOS cases and non-obese controls and observed eleven SNPs to be significantly associated (p < 0.05). While eight of those SNPs, five from FTO and one each from MTCH2, DENNDIA and THADA genes, were found to be associated in the first set involving obese PCOS cases, only three SNPs (IRS2-intronic, LOC107984901-intergenic and SUMO1P1-regulatory variants) showed association in the 2nd set involving non-obese cases. The SNPs associated in the two cohorts were distinct and mutually exclusive. However, all the SNPs associated in either obese or non-obese PCOS cohorts were not only risk-prone but also broadly represented a metabolic pathway, involving mostly obesity and T2DM related genes, prompting one to surmise if the recent spurt in PCOS prevalence is not driven by changes in the lifestyles.

Distinct Genetic Susceptibility Patterns of the Obese and Nonobese South Indian Women with Polycystic Ovary Syndrome

ABSTRACT The researchers studied association of 92 SNPs of the metabolic and reproductive pathways genes in the obesity related cohorts of obese PCOS cases and non-obese controls, and non-obese PCOS cases and non-obese controls and observed eleven SNPs to be significantly associated (pd” 0.05). While eight of those SNPs, five from FTO and one each from MTCH2, DENNDIA and THADA genes, were found to be associated in the first set involving obese PCOS cases, only three SNPs (IRS2-intronic, LOC107984901-intergenic and SUMO1P1-regulatory variants) showed association in the 2nd set involving non-obese cases. The SNPs associated in the two cohorts were distinct and mutually exclusive. However, all the SNPs associated in either obese or non-obese PCOS cohorts were not only risk-prone but also broadly represented a metabolic pathway, involving mostly obesity and T2DM related genes, prompting one to surmise if the recent spurt in PCOS prevalence is not driven by changes in the lifestyles

RELATION OF LACTOBACILLI ACIDOPHILUS TO OBESITY IN EGYPTIAN POPULATION

Current considerations are existed about the sharing role of gut microbiota in the enhancementof obesity and allied comorbidities. This observational case-control study assessed the possiblerelation of Lactobacilli acidophilus to obesity in a sample of Egyptian population by real-timePCR in stool. The study enrolled 20 healthy slim subjects and 40 subjects who had BMI >25kg/m2. Routine laboratory analysis and identification of stool L. acidophilus by quantitative realtime PCR technique was performed for all enrolled subjects. Lactobacillus acidophilus was expressedin 21/40 (52.5%) fecal samples of obese cases and 16/20 (80%) of fecal samples of nonobeseones. In rest of samples in both groups, the expression was below the detection limit. Theresults showed that the mean lactobacilli CT was expressed in obese cases (38.89±2.57) comparedto (36.08±4.63) in non-obese cases, with high significant difference (P =0.04). Lactobacillusacidophilus was significantly lowered in obese Egyptian patients. The argument aboutsignificance correlation between imbalance in gut microbiota and obesity is one of the hot topicsin medicine.

Study of interleukin-18 ( IL18 ) and high sensitive C - reactive protein ( CRP ) in type 2 diabetes ( T2D ) with or without obesity

Abstract Background: Both diabetes and obesity are associated with chronic low-grade inflammation. IL-18 is a cytokine that stimulates various cell types and has pleiotropic functions. It is elevated in obesity, metabolic syndrome and type 2 diabetes (T2D). Aim of study: to test the hypothesis that serum level of IL-18 and high sensitive C-reactive protein can be used as markers for presence of chronic low-grade inflammation in type 2 diabetes more than in obesity per se. Subjects and methods: The study recruited 80 subjects. They comprised 20 diabetic obese cases (DM-OB group), 20 diabetic non-obese cases (DM-NOB group), : 20 non-diabetic obese cases (NDM-OB group) and 20 non-diabetic non-obese subjects (NDM-NOB group). All participants were submitted to careful history taking, through clinical investigations and laboratory assessment Results: hs-CRP was significantly highest in DMOB group (3.4±0.5 mg/dl) followed by NDM-OB group (2.9±0.4 mg/dl) followed by DM-NOB group (2.3±0.3 mg/dl) and least in NDM-NOB (0.8±0.3 mg/dl). Also, it was found that serum IL-18 was significantly highest in DMOB group (397.8±33.9 pg/mL) followed by NDM-OB (368.8±26.7 pg/mL) group followed by DM-NOB group (335.9±18.4 pg/mL) and least in NDM-NOB group (281.1±22.9 pg/mL). Serum IL-18 levels are directly correlated with BMI, waist circumference, hip circumference and waist/hip ratio in all the studied groups and with HbA1c in the diabetic groups. Conclusions: Serum IL-18 and hs-CRP are related to diabetes and obesity. They are associated with dyslipidemia, poor glycemic control, insulin resistance and impaired liver and renal functions.

The Impact of Body Mass Index on Perioperative Outcomes of Robotic Adrenalectomy: An Update.

Background. Robotic surgery has gained increasing popularity over the past 2 decades. However, factors including patient comorbidities and tumor characteristics are still crucial factors for outcomes of surgery. In this study, we evaluated the impact of body mass index (BMI) on perioperative outcomes in patients who underwent robotic adrenal surgery. Methods. Between May 2012 and November 2017, 66 consecutive patients who underwent robotic adrenalectomy were included in this study. Patients were divided into 2 groups based on their BMI: nonobese (<30 kg/m2) and obese (≥30 kg/m2). Additionally, patient demographics, tumor size, total operative time, docking time, console time, estimated blood loss, conversion to open, complications, additional analgesia requirement, length of hospital stay, and rough costs were evaluated. Results. Of the 66 patients, a total of 26 patients were obese (30%). Between study groups, the median BMI was calculated as 26 (18-29) and 33 (30-57). The groups were similar in terms of age, gender, American Society of Anesthesiologists scores, and previous history of abdominal surgery. Likewise, there were no significant differences between groups regarding total operative time (P = .085), docking time (P = .196), console time (P = .211), estimated blood loss (P = .180), complications (P = .991), length of hospital stay (P = .598), and rough costs (P = .468). Five cases were converted to open surgery. Nonobese cases required additional analgesia (P = .007). We had no unexpected hospitalizations in either group. Conclusion. Guidelines express the advantages of robotic surgery in obese patients. No statistically significant differences were detected between the 2 groups except for the additional analgesia required in nonobese patients.

Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study.

Purpose To investigate the association between obesity and breast cancer clinicopathologic characteristics at presentation along with prognostic impact among Jordanian breast cancer patients. Such data are lacking in Arabian countries. Methods In this retrospective study, 348 breast cancer patients were included. Analyses were conducted for associations between body mass index (BMI) and age at diagnosis, tumor clinicopathologic characteristics, and molecular subtypes. Eight prognostic factors were considered, and total prognostic scores were calculated. The analysis was stratified by menopausal status. Multivariate logistic stepwise regression analysis was conducted to identify predictors for breast cancer recurrence and death. Results Mean age at diagnosis was 50.98 ± 10.96 years. Mean BMI at diagnosis was 29.52 ± 5.32 kg/m2. Mean age at diagnosis was significantly higher for overweight and obese patients compared to underweight/normal patients (P < 0.001). A significant positive correlation was observed between patient age and BMI at diagnosis (r = 0.251, P < 0.001). Grade of carcinoma was significantly correlated with BMI in the whole population examined (P=0.003). Obese breast cancer patients had significantly higher prognostic scores compared to nonobese cases, indicating worse prognostic features at presentation (P=0.034). Stratification of data analysis based on menopausal status revealed significant associations between obesity and each of tumor stage and grade among postmenopausal but not premenopausal patients (P=0.019 and P=0.031, respectively). Similarly, postmenopausal obese patients had significantly higher prognostic scores compared to nonobese counterparts (P=0.007), indicating worse prognosis, a finding which was also absent among premenopausal breast cancer patients. No significant association between BMI with expression status of hormone receptors, HER2, lymphovascular invasion, and molecular subtypes was found among patients. BMI was a significant predictor for disease recurrence in which obese breast cancer patients had greater odds (2-fold) to develop locoregional and distant recurrence compared to nonobese cases (P=0.011). Conclusions Obesity was associated with advanced stage and grade of breast carcinoma at diagnosis. The impact of BMI on clinicopathologic characteristics and prognosis was confined to postmenopausal cases. Jordanian obese breast cancer patients are at greater risk of breast cancer recurrence and reduced survival compared to their nonobese counterparts.

Circulating neuregulin-1 levels in polycystic ovary syndrome

Neuregulin-1 (NRG1) has been shown to be associated with the regulation of inflammation and ovulation. The aim of this study was to investigate the relationship between serum NRG1 levels and various clinical and metabolic parameters in women with polycystic ovary syndrome (PCOS). This case-controlled study included 38 women with PCOS and 46 age and body mass index (BMI)-matched controls without PCOS. The serum NRG1 levels of the women with PCOS were found to be significantly lower compared to the control group. The high sensitivity C-reactive protein (hs-CRP) levels of the PCOS subjects were significantly higher than in the control group. The circulating NRG1 levels were negatively correlated with a homeostasis model assessment of insulin resistance (HOMA-IR) and the hs-CRP in the PCOS group. There is no significant correlation between the circulating NRG1 levels and the serum insulin in the PCOS group. There was a trend toward high NRG1 levels in the PCOS subjects with high BMI, but the difference failed to reach a statistical significance. Decreased NRG1 levels in PCOS subjects may be associated with insulin resistance and a low-grade chronic inflammation.Impact statementWhat is already known on this subject? Although there have been many studies related to NRG1, we could not find any study explaining the relationship between NRG1 and PCOS. This study provides first and novel insights into the relationship between serum NRG1 levels and the insulin resistance in women with PCOS.What do the results of this study add? A decline in the NRG1 levels in PCOS may be associated with insulin resistance and a low-grade chronic inflammation.What are the implications of these findings for clinical practice and/or further research? Decreased NRG1 levels may play an important role in the reproductive and endocrine properties of PCOS. We think that NRG1 research may be contribute to the clarification of PCOS pathophysiology. Future research investigating NRG1 levels in obese and non-obese cases, as well as in ovulatory and anovulatory PCOS patients, will make a significant contribution to the resolution of the mystery under PCOS aetiology.

Peroxisome Proliferator-Activated Receptor-γ Gene Polymorphism in Psoriasis and Its Relation to Obesity, Metabolic Syndrome, and Narrowband Ultraviolet B Response: A Case-Control Study in Egyptian Patients.

Background:Psoriasis is a common dermatologic disease with multifactorial etiology in which genetic factors play a major role. Peroxisome proliferator-activated receptor (PPAR)-γ is expressed in keratinocytes and is known to affect cell maturation and differentiation in addition to its role in inflammation.Aim:To study the association between PPAR-γ gene polymorphism and psoriasis vulgaris in Egyptian patients to explore if this polymorphism influenced disease risk or clinical presentation.Methods:Forty-five patients with psoriasis vulgaris and 45 age, sex and body mass index matched healthy volunteers who have no present, past or family history of psoriasis as a control group were enrolled. Selected cases included obese and nonobese participants. Detection of PPAR-γ gene polymorphism was done with restriction fragment length polymorphism polymerase chain reaction. Narrow-band ultraviolet B (NBUVB) was given for every case three times/week for 12 weeks.Results:Homopolymorphism, heteropolymorphism, and Ala allele were significantly associated with cases (P = 0.01, P = 0.01, and P = 0.004, respectively) and increased risk of occurrence of psoriasis by 5.25, 3.65, and 3.37 folds, respectively. Heteropolymorphism was significantly associated with nonobese cases compared to obese ones (P = 0.01). Ala allele was significantly associated with obese cases (P = 0.001) and increased risk of occurrence of psoriasis in obese participants by 1.14 folds. Homopolymorphism, heteropolymorphism, and Ala allele were more prevalent among obese cases without metabolic syndrome (MS) than obese cases with MS but without statistical significance. Percentage of decrease of mean Psoriasis Area and Severity Index score before and after 3 months of treatment with NBUVB was higher in cases with heteropolymorphism with no significant difference between homo- and heteropolymorphism.Conclusion:PPAR-γ gene polymorphism is associated with and increased the risk of psoriasis and its associated obesity in Egyptian patients. It has no role in NBUVB response in those patients. Future large-scale studies on different populations are recommended.

Neuro-cognitive Ramifications of Fasting and Feeding in Obese and Non-obese Cases.

Preliminary studies have claimed that short term fasting would negatively affect school performance and cognition. In contrast some other studies have reported not important decline in cognition and executive function as a result of fasting. Also limited attention was generally devoted to dietetic regimens, nutritional status and body weight. Yet neuroscience and neuro-cognitive aspects of acute hunger on the electroencephalogram and differences between obese and non-obese cases is not well understood. Hence, we decided to design and perform a case study in a more controlled situation similar to reality. Therefore, we performed several examinations including subjective tests (for eating status) and objective tests (cognitive tests such as Stroop effect and Sternberg search and electroencephalogram measures such as steady-state visual evoked potential and auditory steady-state responses) for an obese and a non-obese academic case before and after a simple breakfast. The results showed that the breakfast effects on the neuro-cognitive functions depend on either obesity status, nutritional status of the case or the type of cognitive task (visual or auditory). This paper would open a new insight to answer some important questions about the neuro-cognitive implications of fasting and feeding in obese and non-obese human cases.

Neuro-cognitive Ramifications of Fasting and Feeding in Obese and Non-obese Cases

Neuro-cognitive Ramifications of Fasting and Feeding in Obese and Non-obese Cases

The relationship between adiponectin gene polymorphism and occurrence of obesity at Zagazig University Hospitals

Background Obesity is considered a severe rapidly growing health problem all over the world. Adiponectin is an adipokine produced and secreted by adipose tissues and widely known as antidiabetic, anti-inflammatory, antiatherogenic, and cardioprotective factor. The adiponectin gene has various single nucleotide polymorphisms (SNPs). Objective Our aim of this study was to determine the genotype frequency of SNPs (276 G→T) in adiponectin gene and its relationship with the occurrence of obesity and to detect the association between adiponectin gene polymorphism and different degrees of obesity. Patients and methods A total of 96 volunteers were included and divided into the following: group I had 48 healthy nonobese control volunteers, and group II included 48 obese patients not having any disease. Anthropometric parameters were measured by standard procedures. Random blood sample was collected for routine and research investigations. PCR assay with restriction fragment length polymorphism was used to examine the adiponectin gene SNP276G>T polymorphism. Results Genotypes distributions of 276G>T polymorphisms were significantly different between obese and nonobese cases. T allele was significantly associated with obese individuals (P Conclusion The T allele and TT genotypes at the 276 locus of the ADIPOQ gene were associated with higher risk of obesity.