Normal Body Mass Index Individuals Research Articles

Associations between Body Mass Index, Gait Mechanics and Trochlear Cartilage Thickness in Those with ACL Reconstruction.

High body mass index (BMI) is a strong predictor of posttraumatic osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR). Altered gait mechanics are independently affected by BMI and ACLR, and influence OA risk. Yet, evidence directly assessing the impact of high BMI on gait or cartilage characteristics after ACLR are limited. Here, we evaluated if high BMI moderates associations between gait and trochlear cartilage structure in individuals with ACLR. Treadmill walking biomechanics were evaluated in 40 normal BMI and 24 high BMI participants with ACLR at self-selected speeds. Normalized and absolute peak and cumulative loads (i.e., impulse) were extracted for peak knee flexion and adduction moments (KFM, KAM) and vertical ground reaction force (GRF). Medial and lateral femoral cartilage thickness and medial/lateral thickness ratios were assessed via ultrasound. Those with ACLR and high BMI walked with reduced normalized peak vertical GRFs, and greater absolute peak and cumulative loads compared with normal BMI individuals with ACLR. Those with ACLR and high BMI also exhibited thinner cartilage and greater medial/lateral ratios in ACLR limbs compared with contralateral limbs whereas normal BMI individuals with ACLR exhibited thicker ACLR limb cartilage. Lastly, greater peak KAM and KAM cumulative load were associated with thicker lateral cartilage and lesser medial/lateral thickness ratios, but only in the high BMI group. We observed those with high BMI after ACLR exhibited trochlear cartilage structural alterations not observed in normal BMI patients, whereas differential associations between loading outcomes and cartilage thickness in ACLR knees were observed between groups. Those with high BMI after ACLR may require different therapeutic strategies to optimize joint health in this subset of patients.

IMPACTS OF EXERCISE TRAINING ON THE VISCERAL ADIPOSE TISSUE AMONG INDIVIDUALS WITH NORMAL BODY MASS INDEX: A SYSTEMATIC REVIEW

https://youtu.be/617rv0W_7Kc BACKGROUND The thin outside fat inside (TOFI) phenotype, an obesity expression, is recognized by a high amount of visceral adipose tissue (VAT) despite average anthropometric measurements such as normal body mass index (BMI). High VAT is a considerable risk of metabolic syndrome. As a beneficial intervention, exercise training can decrease body fat amount. This review aimed to investigate exercise efficiency on VAT in individuals with normal BMI. METHODS Electronic databases were used to detect studies related to exercise training intervention on VAT in normal BMI individuals from 1999 to 2022. Inclusion criteria included acute, four weeks or more; duration intervention of aerobic training (AT), resistance training (RT) or combination training (COM) with adults. Participants BMIs were approximately 26 kg/m2 or less in studies investigating VAT differences between sedentary and active individuals. Acceptable body assessment measurements in the studies used computed tomography, magnetic resonance imaging, or dual-energy x-ray absorptiometry. RESULTS The primary search resulted in 217 original studies and 11 were included. The most common intervention was AT, using treadmill running, and the most common mode of RT was weight machines. Frequency of training averaged 3 days per week of 30- to- 90 minute sessions. AT intensity was demonstrated with the percentage of maximum oxygen consumption (VO2 max), peak rate of oxygen consumption (VO2peak), heart rate reserve (HRR), or maximal heart rate (MHR) in the range of 55% to 120%. The most common range was 60–70% MHR. The intensity of RT was determined as one-repetition maximum (1-RM), ranging between 60–80% 1RM. One study used interval modality intervention. Seven studies show a significant decrease in VAT values. The most impactful training was AT with two studies using COM also reported benefits. The most common unit of measurement used for VAT was cm2. Other studies used varying units such as 1) kg, 2) cm3, 3) liter, and 4) percentage of total body fat. The range of significant change in VAT scores was −2.5 ± 7.2 cm2 to −19.3 ± 12.7 cm2. Additionally, one study reported significant differences in VAT observed between active and sedentary individuals and one study reported no demonstrated differences using RT. CONCLUSIONS The systematic review suggests exercise training could be a beneficial intervention for improved VAT changes. However, exercise modality should be taken into account alongside acute variables such as volume, intensity, duration, and frequency. Based on findings, AT is the most effective modality and RT as another exercise option needs more investigation.

The influence of LPL S447X variants and obesity on lipid profile, oxidative stress, and the risk of T2DM: A case-control study.

The present study aimed to investigate the association between lipoprotein lipase (LPL) S447X polymorphism and type 2 diabetes mellitus (T2DM), obesity, lipid profile, and oxidative stress parameters in a population from the Kurdistan region of Iraq. We studied 250 adults (51% female and 49% male) aged 45-65 years in four groups, obese and normal body mass index (BMI) diabetic patients versus healthy normal BMI and obese individuals as controls. Lipid profile and oxidative stress parameters were analyzed by colorimetric assay. The LPL S447X genotypes were detected by polymerase chain reaction (PCR)-restriction fragment length polymorphism. We found that the obese diabetic group had higher levels of triglycerides (TG), cholesterol, and low-density lipoprotein-cholesterol, and lower level of high-density lipoprotein-cholesterol than other groups. Obese diabetic patients had higher anthropometric indices than nonobese diabetic patients, obese and normal BMI controls. The levels of TG and total oxidative status (TOS) were significantly lower and higher, respectively, in normal BMI controls than in obese controls. Obese diabetic patients had a lower level of total antioxidant capacity than nondiabetic obese controls. The level of TOS was lower in nondiabetic controls compared to the patient groups. Obese diabetic patients had the highest TOS and malondialdehyde levels. The LPL SX genotype was associated with decreased the risk of T2DM by 79% (odds ratio [OR] = 0.21; 95% confidence interval [CI]: 0.05-0.81, p = 0.03). Also, the presence of this genotype reduced the risk of obesity by 39% (OR = 0.61; 95% CI: 0.07-4.90, p = 0.6). In all individuals, the presence of the SX genotype was associated with significantly lower levels of fasting blood sugar (FBS) and TOS. We report the influence of obesity on lipid profile in diabetic and nondiabetic individuals and the effect of LPL SX genotype on decreased risk of T2DM and reduced levels of FBS and TOS.

The Role of Dietary Patterns and Dietary Quality on Body Composition of Adolescents in Chinese College.

There is limited evidence regarding the effects of dietary pattern and dietary quality on the risk of unhealthy weight status and related body composition in Chinese adolescence. In particular, studies using bioelectrical impedance analyzer (BIA) in these subjects are rare. The aim of this study was to evaluate the role of diet in body composition, to find a healthy dietary pattern for Chinese youth, and to promote the application of BIA among this population. A total of 498 participants aged from 18 to 22 years old were included. Dietary patterns were identified by principal components analysis. Energy-adjusted dietary inflammatory index (DII) and diet balance index (DBI) were calculated based on semi-quantitative food frequency questionnaire. Multivariate linear regression and logistic regression analysis were used to examine the relationship of dietary patterns, dietary quality with body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and the effect of dietary factors on BMI levels. The majority of participants with overweight and obesity had abdominal obesity, and there was 3.7% abdominal obesity in normal BMI individuals. Four dietary patterns were detected in the subjects. The pattern with the higher energy intake, which was close to the Western diet, was positively correlated with BMI (β = 0.326, p = 0.018) and FMI (β = 0.201, p = 0.043), while being negatively correlated with FFMI (β = −0.183, p = 0.021). Individuals who followed the pattern similar to the Mediterranean diet had a higher basal metabolic rate (BMR), and the highest fat free mass, soft lean mass, and skeletal muscle mass (p < 0.05) but the lowest FMI, visceral fat area (VFA), waist−hip ratio, and FMI/FFMI ratio (p < 0.05). Higher energy-adjusted DII was associated with high BMI. Higher bound score (HBS) (β = −0.018, p = 0.010) and diet quality distance (DQD) (β = −0.012, p = 0.015) were both negatively correlated with FFMI. In conclusion, fat or muscle indexes, such as BMR, FMI, and FFMI, had an important role in predicting overweight and obesity, which suggested the importance of applying BIA among Chinese college students. Students who followed healthful dietary patterns or the high-quality diet that is similar to the Mediterranean diet but not close to the Western diet were more likely to have a healthy BMI and normal body composition.

A Study of Social Health Status in the Population of the Prospective Epidemiological Shahrekord Cohort Study in Chaharmahal and Bakhtiari Province in 2019

Background and aims: Social health refers to the quantity and quality of interaction of an individual with society to promote the well-being of individuals in the society. This interaction promotes social capital and social security, and reduces poverty and injustice. So far, no study has been ever done on the social health situation in Chaharmahal and Bakhtiari province. This study aimed to investigate the social health status in Chaharmahal and Bakhtiari province in 2019. Methods: In this cross-sectional and descriptive-analytical study, the data from the prospective epidemiological study of Shahrekord cohort study in Chaharmahal and Bakhtiari province in 2019 were used. In order for measuring social health, a valid Iranian social health questionnaire with a score range of 33-165 was used. ANOVA and t test in SPSS version 22 were employed for analyzing the data in order to compare the mean values.Results: By way of explanation, 597 individuals out of 600 samples completed the social health questionnaire (99.5% response rate). The mean ± standard deviation age of participants was 48.54±9.33 years and the mean ± standard deviation score of their social health was 115.71±22.7. This score was higher in men than in women (P = 0.038). Social health score was significantly higher in urban areas than in rural areas (P = 0.001). Social health was highest in civil servants, and lowest in unemployed participants (P = 0.001). Social health score was lower in obese and high body mass index (BMI) individuals than in normal BMI individuals (P = 0.047).Conclusion: Social health in the studied population was moderate and, therefore, deserves the attention of health policy makers and planners. Social health can be improved by holding training classes for villagers and teaching them how to interact with each other – especially with family members, furthering participation of women in social affairs and increasing their social relationships, giving advice on diets and social health to people with non-normal BMI, as well as by holding post-retirement training classes for retirees.

Increased Sodium Consumption Is Associated With Abdominal Obesity in Older Adults

ObjectivesSodium intake has been widely studied for its role in cardiovascular disease (CVD) and blood pressure (BP) changes. Some studies have suggested that sodium intake is associated with an increased risk of obesity. Although BMI is a common measure of obesity, waist circumference (WC) may serve as a better predictor of increased obesity-related CVD risk. The objective of this study was to examine the association of measures of body fat distribution including body mass index (BMI), WC, waist to hip ratio (WHP), and waist to height ratio (WHT) with sodium intake and BP in older adults. MethodsOne hundred twenty-eight adults aged 65–80 were included in this cross-sectional study. Dietary data was collected through a food frequency questionnaire (110 food items). Anthropometric and BP measurements were also collected. Multiple linear regression analyses were conducted to examine the association of obesity measures with sodium intake and BP levels. One-way ANOVA was used to determine differences in sodium and BP readings between BMI categories (Normal: 18.5–24.9; Overweight: 25.0–29.9 and Obese: 30.0 and above). ResultsWC and WHT were both significantly associated with sodium intake after controlling for age, gender, physical activity, and total calorie intake. Obese individuals consumed significantly more sodium than individuals with normal weight (2834 ± 974 mg in obese individuals; 2172 ± 840 mg in normal weight individuals; P = 0.044). BMI, WC, WHP, and WHT were significantly associated with systolic and diastolic BP. Mean systolic BP was significantly different between individuals with normal BMI and obese BMI (126 ± 16.5 mmHg in normal BMI; 139.7 ± 22.9 mmHg in obese BMI; P = 0.047). The mean diastolic BP showed a statistically significant difference between the normal BMI and overweight individuals (70.9 ± 10.4 mmHg in normal BMI; 79.3 ± 15.2 mmHg in overweight; P = 0.036) but not in obese individuals. ConclusionsHigher sodium consumption was significantly related with higher abdominal body fat mass as measured by WC and WHT in older adults. Higher BMI, WC, WHP, and WHT were also associated with systolic and diastolic BP levels. Our findings suggest that excessive sodium intake is an independent risk factor for obesity in older adults. Funding SourcesNone.

Prevalence Rate and Correlation Between Triglyceride Level and Human Body Mass Index in Sulaimani Province, Iraq

The condition of elevated concentrations of ‎triglyceride in ‎the blood is called hypertriglyceridemia, which ‎triggers the onset of some physiological disorder. This study was carried out to find the ‎correlation between body weight and ‎hypertriglyceridemia. ‎Out of 518 cases, 342 individuals were underweight, with body ‎mass index (BMI) values of ≤18, while their mean ‎serum triglyceride level was 172.4 ± 25.2mg/dl. In addition, 99 cases had normal BMI of &gt;18, whereas 60 were overweight (‎BMI = 25-29), with mean serum triglyceride level of 182.3 ± 15.9. Also, 17 cases were obese (BMI &gt;30), where the ‎mean triglyceride level was 202 ± 25.6. The results showed no significant differences in terms of weight categories and triglyceride levels, whereas significant ‎effects of marital status, daily exercise, and diet on elevated triglyceride ‎levels were observed. These findings conclude that underweight and ‎normal BMI individuals were as much at risk of elevated level of triglyceride as overweight and obese ones, which are mostly at higher risk. Moreover, daily exercise and supplementary nutrient have significant effects on triglyceride level.

English

BACKGROUND Reaction time (RT) is a simple, non-invasive means of estimating sensorimotor coordination and monitoring performance of an individual. The effect of body mass index (BMI) on RT, suggests that underweight, overweight and obese have increased RT as compared to normal BMI individuals. We wanted to compare the effects of supine, sitting and standing postures on RT and determine the influence of BMI on the same. METHODS An observational cross-sectional study was carried out over 2 months in the Department of Physiology on 60 medical students (30 males and 30 females). Visual and auditory choice reaction times of subjects were measured in supine, sitting and standing postures for green, red and yellow colours and high, medium and low frequency sounds. RESULTS In sitting posture, significant and moderate negative correlation was observed between BMI and visual reaction time (VRT) while the correlation between auditory reaction time (ART) and BMI was weak negative but non-significant. In standing posture, non-significant and weak negative correlation was observed between BMI and VRT, also the correlation between ART and BMI was weak negative but not significant. In supine posture, significant and moderate negative correlation was observed between BMI and ART while the correlation between VRT and BMI was weak negative but not significant. CONCLUSIONS When compared with normal BMI group, higher BMI subjects had longer visual as well as auditory reaction times. The difference was not found to be statistically significant though. A weak or moderate negative correlation between BMI and reaction time (r value &lt; 0.4 in magnitude) was observed in three different postures. KEYWORDS Choice Reaction Time, Visual Reaction Time, Auditory Reaction Time, Posture, Body Mass Index

Cancer Risk in Normal Weight Individuals with Metabolic Obesity: A Narrative Review.

Obesity represents one of the most significant public health challenges worldwide. Current clinical practice relies on body mass index (BMI) to define the obesity status of an individual, even though the index has long been recognized for its limitations as a measure of body fat. In normal BMI individuals, increased central adiposity has been associated with worse health outcomes, including increased risks of cardiovascular disease and metabolic disorders. The condition leading to these outcomes has been described as metabolic obesity in the normal weight (MONW). More recent evidence suggests that MONW is associated with increased risk of several obesity-related malignancies, including postmenopausal breast, endometrial, colorectal, and liver cancers. In MONW patients, the false reassurance of a normal range BMI can lead to lost opportunities for implementing preventive interventions that may benefit a substantial number of people. A growing body of literature has documented the increased risk profile of MONW individuals and demonstrated practical uses for body composition and biochemical analyses to identify this at-risk population. In this review, we survey the current literature on MONW and cancer, summarize pathophysiology and oncogenic mechanisms, highlight potential strategies for diagnosis and treatment, and suggest directions for future research.

Impact of malnutrition on systemic immune and metabolic profiles in type 2 diabetes

BackgroundWhile obesity and overweight status are firmly established risk factors for Type 2 diabetes mellitus (T2DM), a substantial proportion of diabetic individuals, especially in Africa and Asia, are often underweight or normal weight. However, very little is known about the immunological and metabolic profiles of these individuals.MethodsThis study aimed to assess the relationship between malnutrition and Type 2 diabetes mellitus (T2DM). We examined a variety of analytes associated with the immunological and metabolic profiles of T2DM individuals with low (< 18.5 kg/m2) or normal (18.5–24.9 kg/m2) body mass index (BMI). To this end, we measured plasma levels of HbA1c, glucose, insulin, glucagon, adipocytokines and Type 1, Type 2, Type 17, pro-inflammatory and regulatory cytokines in T2DM individuals with low BMI (LBMI) or normal BMI (NBMI) with small sample size n = 44 in each group.ResultsLBMI individuals exhibited significantly higher levels of HbA1c, random blood glucose, insulin and glucagon compared to NBMI individuals. Similarly, LBMI individuals exhibited significantly higher levels of adiponectin and adipsin and significantly lower levels of leptin in comparison to NBMI individuals. LBMI individuals also exhibited significantly lower levels of the Type 1, Type 2, Type 17, pro-inflammatory and regulatory cytokines in comparison to NBMI individuals. Finally, while the metabolic parameters exhibited a significant negative correlation with BMI, the immunological parameters exhibited a significant positive correlation with BMI.ConclusionsMalnutrition is associated with a significant modulation of glycemic, hormonal and cytokine parameters in T2DM. Hence, the biochemical and immunological profiles of T2DM is significantly influenced by BMI.

Exploring functional and structural vascular changes in obesity: are metabolically healthy obese individuals really healthy?

Abstract Purpose Aim of the study is to compare vascular function and structure parameters among middle-aged men with differences in body mass index (BMI) and metabolic status and to investigate whether obese individuals with a normal metabolic profile have a unhealthy vascular profile. Methods We measured carotid-femoral pulse wave velocity (cfPWV), carotid intima media thickness (cIMT) and brachial flow-mediated dilation (bFMD) in 141 obese (BMI≥30 kg/m2) and in 176 aged-matched men with normal BMI (&amp;lt;25 kg/m2) individuals. All participants had no clinical manifestations or a history of atherosclerotic disease. High sensitivity C-reactive protein (hsCRP) and total testosterone (TT) were measured in all patients. Results The two BMI groups were subdivided into subgroups according to presence/absence of abnormal metabolic profile (presence of major cardiovascular risk factors): Metabolically unhealthy obese (MeUO, n=114), metabolically healthy obese (MeHO, n=27), metabolically unhealthy with normal BMI (MeUN, n=122) and metabolically healthy with normal BMI individuals (MeHN, n=54). The four subgroups had similar age. Figure 1 shows the mean cIMT (left plot), cfPWV (middle plot) and bFMD (right plot) of the four subgroups. Carotid IMT and cfPWV is higher and bFMD is lower in metabolically unhealthy compared to individuals with a normal metabolic profile in both patients with obesity and subjects with normal BMI. Interestingly, the MeNO patients had significantly lower cIMT (P&amp;lt;0.05) and cfPWV (P&amp;lt;0.01) and higher bFMD (P&amp;lt;0.01) level compared to MeUN individuals. However, as figure shows all measured vascular parameters were significantly impaired in MeNO patients compared to those of MeHN individuals. MeHO patients had comparable hsCRP and TT levels to those of MeUO and MeUN individuals denoting increased inflammatory activation and endogenous androgen deficiency. Conclusions MeHO which is a obesity phenotype that has created lot of debate is associated with a better vascular profile compared to MeUN status, however patients with MeHO have more impaired vascular function and structure parameters than MeHN individuals. This finding implies that even in the absence of overt metabolic aberrations, the MeHO profile may be associated with endothelial dysfunction, increased aortic stiffness and thickness of the carotid arterial wall. Figure 1. BMI, metabolic status and vascular changes Funding Acknowledgement Type of funding source: None

299 Obesity Is Risk Factor for Colorectal Cancer Recurrence: A Systematic Review and Meta-Analysis

INTRODUCTION: There is a wealth of epidemiologic evidence supporting the association between weight parameters and colorectal cancer incidence. However, how these variables affect colorectal cancer (CRC) recurrence is still a topic of debate. In our study, we hypothesized that there would be increased risk of recurrence of colorectal cancer with obesity and higher visceral fat. METHODS: A systematic review of electronic databases was performed through April 2019, including NCBI, Embase, Cochrane, and Web of Science. Screening was performed using Covidence and each article was screened independently by two authors. Included were retrospective and prospective studies reporting CRC outcomes of at least 2 months after cancer diagnosis. The primary outcome was CRC recurrence in obese compared to normal weight subjects, and high vs. normal visceral fat. Weight parameters tested were body mass index (BMI) categories of underweight, normal, overweight, and obese; visceral fat as measured by CT scan into categories of normal and high visceral fat. Odds ratios (OR), risk ratios (RR), and 95% confidence intervals (95% CI) are reported. Random effects analysis was performed for all outcomes, with heterogeneity assessed by the I2 statistic. RESULTS: 484 citations were reviewed of which 9 were included in the final analysis. In total, 7 studies analyzed CRC recurrence data in terms of BMI, and 2 in terms of visceral adiposity. Most were retrospective cohort studies. These studies comprised 5777 patients, with an average age of 61.4 years and with mean follow-up time of 58.4 months, range (52 months–77 months). Both overweight and obese BMI were associated with significantly increased risk of cancer recurrence compared to normal BMI individuals (Figure 1), OR 1.41 (95% CI 1.18–1.69), P = 0.00, I2 = 0%, N = 4295, and OR 1.47 (95% CI 1.02–2.12), P = 0.04, I2 = 45%, N = 3637, respectively. There was no association between being underweight and colorectal cancer recurrence compared to normal BMI or overweight BMI. High visceral adiposity was also not associated with increased CRC recurrence, although only two studies were included in our meta-analysis (Table 1). CONCLUSION: Obese and overweight BMI are both associated with increased risk of CRC recurrence compared to normal weight. However, being underweight was not associated with CRC recurrence compared to being normal weight. Patients with CRC would likely benefit from active interventions to prevent obesity.

Lower body mass index and higher height are correlated with increased varicocele risk.

To evaluate the anthropometric indexes in subjects with varicocele compared to controls and the incidence of varicocele in different body mass index (BMI) groups for the purpose of exploring the association between varicocele and anthropometric indexes. A comprehensive literature search was conducted by using PubMed, MEDLINE, EMBASE databases and Cochrane Library up to February 2019. A systematic review and meta-analysis was conducted by STATA, and Newcastle-Ottawa Scale was utilised for assessing risk of bias. Ultimately, 13 articles containing seven case-control studies and six cross-sectional studies with 1,385,630 subjects were involved in our study. Pooled results demonstrated that varicocele patients had a lower BMI (WMD=-0.77, 95% CI=-1.03 to -0.51) and a higher height than nonvaricocele participants, especially in grade 3 varicocele patients. Subgroup analyses showed that normal BMI individuals had a higher risk of varicocele than obese or overweight individuals and a lower risk than underweight individuals. In conclusion, this study indicates that varicocele patients have a lower BMI and a higher height than nonvaricocele participants. Moreover, men with excess bodyweight have a lower incidence of varicocele compared to normal weight or underweight people. That is to say, high BMI and adiposity protect against varicocele and high BMI is associated with a decreased risk of varicocele.

Obesity is Independently Associated With Increased Risk of Hepatocellular Cancer-related Mortality: A Systematic Review and Meta-Analysis.

Excess body weight is associated with increased risk of developing hepatocellular cancer (HCC), but its effect on HCC-related mortality remains unclear. We performed a systematic review and meta-analysis to assess the association between premorbid obesity and HCC-related mortality. Through a systematic literature search-up to March 2016, we identified 9 observational studies (1,599,453 individuals, 5705 HCC-related deaths) reporting the association between premorbid body mass index (BMI), and HCC-related mortality. We estimated summary adjusted hazard ratio (aHR) with 95% confidence intervals (CIs), comparing obese (BMI>30 kg/m(2)) and overweight (BMI, 25 to 29.9 kg/m(2)) individuals with normal BMI individuals using random-effects model. On meta-analysis, compared with individuals with normal BMI, obese (aHR, 1.95; 95% CI, 1.46-2.46), but not overweight individuals (aHR, 1.08; 95% CI, 0.97-1.21), had higher HCC-related mortality, with moderate heterogeneity. On subgroup analysis, magnitude of increased mortality was higher in obese men (aHR, 2.50; 95% CI, 2.02-3.09; 3 studies) as compared with obese women (aHR, 1.45; 95% CI, 1.08-1.97; 2 studies). The impact of premorbid obesity on HCC-related mortality was observed only in western populations (aHR, 2.10; 95% CI, 1.77-2.48; 4 studies), but not Asian populations (aHR, 1.10; 95% CI, 0.63-1.92; 1 study). There was limited assessment of competing risk because of advanced liver disease. On the basis of this meta-analysis, premorbid obesity may be independently associated with a 2-fold risk of HCC-related mortality. This association was more pronounced in men and western populations. Strategies targeting obesity-associated metabolic abnormalities may provide novel pathways for HCC therapy.

Time-Resolved Fluorescence Assays for Quantification of Insulin Precursors in Plasma and Serum.

In metabolic diseases such as obesity and type 2 diabetes mellitus, the conversion of proinsulin to mature insulin can be impaired. This could mean that insulin molecules with lower activity toward the insulin receptor can be released under conditions of high metabolic demand, resulting in an inadequate glucoregulatory response. The chapter describes a fluorescent monoclonal antibody-based protocol for measurement of human proinsulin and the proinsulin conversion intermediates (split proinsulins). An example assay is presented using serum from non-diabetic, normal body mass index individuals.

Abstract PD5-05: Metabolic obesity, adipose inflammation and aromatase: Potential drivers of breast cancer risk in women with normal body mass index

Abstract Background: Elevated body mass index (BMI) is associated with increased risk of postmenopausal breast cancer, which may be partly attributable to an inflammation-aromatase axis. Most individuals with elevated BMI harbor white adipose tissue inflammation (WATi), defined by the presence of crown-like structures in the breast (CLS-B). CLS-B are composed of a dead/dying adipocyte surrounded by CD68+ macrophages. This inflammation is associated with activation of NF-κB and elevated expression of aromatase, which could contribute to tumor development. Additionally, WATi correlates with several circulating changes, including hyperinsulinemia, which increase breast cancer risk. Although breast WATi correlates with rising BMI, it is also present in some normal BMI individuals. Beyond inherited germline syndromes, the etiology of breast cancer in individuals with normal BMI is not well understood. Here we examined the impact of breast WATi on breast aromatase expression and circulating factors in women with normal BMI. Methods: Non-tumorous breast tissue and fasting blood were collected from 72 women with BMI &amp;lt; 25 kg/m2 undergoing mastectomy at MSKCC. Breast inflammation was detected by the presence of CLS-B using CD68 immunohistochemistry. The primary objective was to determine if breast WATi in normal BMI individuals correlates with elevated aromatase levels in the breast, measured by qPCR, western blotting, immunofluorescence and enzyme activity. Secondary objectives included assessment of breast adipocyte size and circulating metabolic and inflammatory factors. Results: Breast inflammation was present in 39% of women. Median BMI was 23.0 (range 18.4 to 24.9) in women with breast WATi versus 21.8 (range 17.3 to 24.6) in those without inflammation (P=0.04). Aromatase mRNA expression was positively correlated with WATi (CLS-B/cm2; P=0.002). Those with severe WATi had highest aromatase mRNA levels, compared to those with no or mild WATi (P=0.005). Aromatase protein, assessed by measuring adipose stromal cell-specific immunofluorescence or western blotting, and activity were also higher in CLS-B+ cases compared to CLS-B- (P&amp;lt;0.001). Breast WATi correlated with larger adipocytes (P=0.01) and higher circulating levels of C-reactive protein, leptin, insulin, and triglycerides (P&amp;lt;0.05). Insulin resistance, characterized by the homeostasis model (HOMA2-IR), correlated with breast WATi (P=0.004). Finally, leptin, a known inducer of aromatase and driver of cancer growth, correlated with higher breast aromatase levels (P=0.02) and larger adipocytes (P&amp;lt;0.01). Conclusions: A metabolically unhealthy state occurs in women with inflamed breast adipose despite having a normal BMI. This subclinical inflammatory state is characterized by elevated aromatase in the breast, insulin resistance, and dysplipidemia. The presence of enlarged adipocytes in the breasts of normal BMI women with inflammation suggests a state of hyperadiposity which could not be predicted based on BMI alone. These findings indicate that normal BMI metabolic obesity may be associated with increased cancer risk. Our results suggest that objective measurements of adiposity rather than BMI may help to identify individuals at increased risk for disease. Citation Format: Iyengar NM, Brown KA, Zhou XK, Subbaramaiah K, Giri DD, Gucalp A, Howe LR, Zahid H, Bhardwaj P, Wendel NK, Falcone DJ, Morrow M, Wang H, Williams S, Pollak M, Hudis CA, Dannenberg AJ. Metabolic obesity, adipose inflammation and aromatase: Potential drivers of breast cancer risk in women with normal body mass index [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD5-05.

Effect of paternal overweight or obesity on IVF treatment outcomes and the possible mechanisms involved.

Leukocyte telomere lengths (LTLs) are shorter in obese compared with normal weight people. However, it is not known whether sperm telomere length (STL) is related to obesity. The aim of the study was to evaluate the impact of men’s body mass index (BMI) on STL, embryo quality, and clinical outcomes in couples undergoing IVF. In total, 651 couples were recruited, including 345 men with a normal BMI and 306 men with an overweight BMI (normal BMI group: 20–25 kg/m2; overweight BMI group: >28 kg/m2). We found that couples with male’s BMI over 28 kg/m2 exhibited a significantly lower fertilization rate, good-quality embryo rate and clinical pregnancy rate compared to their normal BMI counterparts. The mean STL in the overweight BMI group was also significantly shorter than that of the normal BMI group. The results also showed that individuals with higher BMI had higher ROS (Reactive oxygen species) content and sperm DNA fragmentation rate when compared with normal BMI individuals. Mitochondrial activity was also lower in the overweight BMI group than in the normal BMI group. This is the first report to find that STL is shorter in overweight/obese men, which may account for their poorer treatment outcomes in IVF cycles.

The effect of body mass index on pulmonary function

Objective: to characterize lung volumes, airway resistance (AWR), and carbon monoxide diffusion capacity (CMD) in individuals with normal, pre-obese, class I obesity, class II obesity, and class III obesity body mass index (BMI). Methodology: this was a retrospective, quantitative, and cross-sectional study. The sample consisted of 304 individuals of both genders with suspicion or clinical diagnosis of asthma, with BMI ≥ 25 kg/m, and without alterations in respiratory functional tests and 95 healthy and with normal BMI individuals of both genders.

Tobacco Smoking Cessation and Improved Gastroesophageal Reflux: A Prospective Population-Based Cohort Study: The HUNT Study

Tobacco smoking increases the risk of gastroesophageal reflux symptoms (GERS), but whether tobacco smoking cessation improves GERS is unclear. The aim of this study was to clarify if tobacco smoking cessation improves GERS. The study was based on the Nord-Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted from 1995-1997 to 2006-2009 in Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. The study included 29,610 individuals (61% response rate) who reported whether they had heartburn or acid regurgitation. The association between tobacco smoking cessation and improvement in GERS was assessed by logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). The analyses were stratified by antireflux medication, and the results were adjusted for sex, age, body mass index (BMI), alcohol consumption, education, and physical exercise. Subgroup analyses were also stratified by BMI. Among individuals using antireflux medication at least weekly, cessation of daily tobacco smoking was associated with improvement in GERS from severe to no or minor complaints (adjusted OR 1.78; 95% CI: 1.07-2.97), compared with persistent daily smoking. This association was present among individuals within the normal range of BMI (OR 5.67; 95% CI: 1.36-23.64), but not among overweight individuals. There was no association between tobacco smoking cessation and GERS status among individuals with minor GERS or individuals using antireflux medication less than weekly. Tobacco smoking cessation was associated with improvement in severe GERS only in individuals of normal BMI using antireflux medication at least weekly, but not in other individual with GERS.

Cardiovascular autonomic responses to hyperinsulinemia in young adult males of normal and low body mass index

Acute hyperinsulinemia increases sympathetic nervous system activity, it is unclear if individuals of low body mass index (BMI) have different responses from those of normal BMI. Approximately 30% of adults in India have a low BMI and are likely to become hyperinsulinemic as they transition to better nutritional planes. We evaluated whether individuals of low BMI had different autonomic nervous responses to acute hyperinsulinemia as compared with individuals of normal BMI. 51 young men were divided into 2 groups based on their BMI. All subjects underwent anthropometry, physical activity levels and a hyperinsulinemic euglycemic clamp (HEC). Lead II ECG and beat to beat blood pressure were recorded during the HEC. Basal insulin level and steady state plasma insulin values during HEC were significantly higher in the normal BMI. Insulin sensitivity and glucose disposal rates during the HEC were significantly higher in the low BMI group. LF-RR power (nu) increased and HF-RR power (nu) decreased with hyperinsulinemia, resulting in a significant increase in LF/HF ratio but with no between-group differences. There was a significant increase in low frequency systolic blood pressure variability and a significant reduction in baroreflex sensitivity in both the groups with hyperinsulinemia. However, there were no between-group differences in the magnitude of these responses. The present study indicates that insulin mediated activation of the autonomic nervous system was comparable between low and normal BMI groups in spite of differences in insulin sensitivity and body composition and suggests that insulin mediated autonomic nervous activation is affected by other factors.