Normal Weight Group Research Articles

Evaluation of the Diagnostic Utility of Selected Serum Adipokines and Cytokines in Subjects with MASLD-A Pilot Study.

Excess adipose tissue, particularly of the visceral type, triggering chronic low-grade inflammation and altering its secretory profile, is a contributing factor to the initiation and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to compare the levels of selected adipokines and cytokines in individuals with normal weight and obesity, assessing their potential for diagnosing MASLD and establishing a cutoff point for body fat content associated with hepatic steatosis development. The research involved 99 participants categorized by body mass index and MASLD presence, undergoing body composition analysis, liver elastography, biochemical tests, and evaluation of adipokines and cytokines in serum. The results indicated elevated IL-6 (interleukin 6) serum levels in individuals with obesity with MASLD compared to the normal-weight group without MASLD. The multivariate regression analysis demonstrated a connection between hepatic steatosis and total adipose tissue content, VAT (visceral adipose tissue), VAT/SAT (subcutaneous adipose tissue) ratio, HOMA-IR (homeostasis model assessment of insulin resistance), IL-6, Il-1β (interleukin 1β), and MMP-2 (matrix metalloproteinase 2). Among the adipokines and cytokines examined in this study, interleukin 6 was the strongest predictor of MASLD regardless of gender. In addition, an association between the development of hepatic steatosis and higher serum IL-1β levels and higher adipose tissue was observed in women. However, further studies on a larger group of patients are needed to consider the use of these cytokines as markers of MASLD. The HOMA-IR index demonstrated potential diagnostic utility in identifying hepatic steatosis.

Outcomes of idiopathic pulmonary fibrosis patients with high body mass index undergoing extracorporeal membrane oxygenation support

To evaluate the extracorporeal membrane oxygenation (ECMO) related outcomes during hospitalization during the intensive care unit (ICU) in idiopathic pulmonary fibrosis (IPF) patients with high body mass index (BMI, > 25 kg/m2) undergoing lung transplantation with ECMO support. A retrospective observational study was conducted. IPF patients who received ECMO during lung transplantation admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University from 2019 to 2020 were enrolled. Preoperative indicators including, demographics, comorbidities, arterial blood gas, and laboratory indicators; intraoperative indicators, such as lung lobe volume reduction, surgical type, surgical time, cold ischemia time, blood loss and transfusion volume; immediate indicators upon admission to the ICU, such as blood gas analysis and laboratory indicators; ECMO related outcomes, such as ECMO mode, ECMO support time, ECMO related complications (bleeding at the catheterization site, intraductal thrombosis, lower limb ischemia), and the length of ICU stay, duration of mechanical ventilation, and 30-day survival rate were collected. According to BMI, patients were divided into three groups: light weight group (BMI < 18.5 kg/m2), normal weight group (BMI 18.5-24.9 kg/m2), and overweight group (BMI ≥ 25.0 kg/m2). Mainly to compare the relevant outcomes of ECMO among patients during ICU. A total of 114 IPF patients who received ECMO support during lung transplantation were collected, including 23 cases in the light weight group, 63 cases in the normal weight group, and 28 cases in the overweight group. Compared with patients with underweight and normal weight, overweight patients were more likely to have hypertension (46.4% vs. 8.7%, 23.8%, P < 0.01) and coronary heart disease (32.1% vs. 4.3%, 20.6%, P < 0.05) before surgery, which was consistent with international guidelines for obesity. Other clinical data (preoperative, intraoperative, ICU characteristics) showed no statistically significant differences and were comparable. There was no statistically significant difference in terms of ECMO related outcomes, such as ECMO related complications [veno-venous (V-V) mode: 78.3%, 77.8%, 78.6%, veno-arterial (V-A) mode: 21.7%, 22.2%, 21.4%], ECMO support time (hours: 61.70±20.03, 44.57±5.76, 41.77±7.26), ECMO related complications (bleeding at the catheterization site: 4.3%, 7.9%, 14.3%; intraductal thrombosis: 8.7%, 12.7%, 17.9%; lower limb ischemia: 8.7%, 12.7%, 14.3%), and the length of ICU stay (days: 11±3, 7±1, 9±1), duration of mechanical ventilation [days: 2 (2, 11), 2 (2, 6), 3 (2, 8)] among the light weight group, normal weight group, and overweight group (all P > 0.05). Kaplan-Meier survival curve analysis showed that there was no statistically significant difference in the 30-day cumulative survival rate among the three groups (Log-Rank test: χ 2 = 0.919, P = 0.632). High BMI does not worsen ECMO-related outcomes or adversely affect early prognosis in IPF patients undergoing lung transplantation. BMI as a single parameter should not be a contraindication for the use of ECMO in lung transplantation surgery for IPF patients.

Analysis of Body Mass Index and Clinicopathological Factors in Patients with Papillary Thyroid Carcinoma.

To analyze the correlation between body mass index (BMI) and clinicopathological factors of papillary thyroid cancer (PTC). The clinical data of patients with PCT who were hospitalized in the Department of Thyroid Surgery of the Affiliated Hospital of Guizhou Medical University from March 2023 to September 2023 were retrospectively collected, including age, gender, height, weight, BMI, v-raf murine sarcoma viral oncogene homolog B (BRAF) gene mutation, tumor size, multifocus, Hashimoto's thyroiditis, lymph node metastasis and other clinicopathological factors. According to the World Health Organization (WHO) definition for Asian population, BMI≥25kg/m2 was obese group, 23≤BMI≤24.9kg/m2 was overweight group, 18.5≤BMI≤22.9kg/m2 was normal weight group, and BMI≤18.5kg/m2 was low weight group. The clinicopathological factors of overweight and obese patients with PTC were analyzed. A total of 164 PTC patients were included, with an average BMI of (24.44±3.57) kg/m2. Age of overweight and obese PTC patients (Z=1.978, p=0.083); Gender of overweight and obese PTC patients (χ2 value: 11.570, p=0.004); Tumor size in overweight and obese PTC patients (Z=0.894, p=0.411); BRAF gene mutation in overweight and obese PTC patients (χ2 value: 1.452, p =0.623); Multifocal lesions were found in overweight and obese patients (χ2 value: 1.653, p =0.201). Hashimoto's thyroiditis was found in overweight and obese PTC patients (χ2 value: 1.147, p=0.298). Overweight and obese patients with PTC had lymph node metastasis (χ2 value: 1.690, p =0.251). Overweight and obesity in PTC patients are correlated with male, but not with age, tumor size, BRAF mutation, multifocality, Hashimoto's thyroiditis and lymph node metastasis.

Dynamics of Serum Inflammatory Markers and Adipokines in Patients: Implications for Monitoring Abnormal Body Weight: Preliminary Research.

This study aimed to investigate the influence of abnormal body weight on inflammatory markers and adipokine levels across varied body mass index (BMI) categories. The cohort included 46 participants categorized into normal BMI (group I; n = 19), overweight (group II; n = 14), and obesity (group III; n = 13). Inflammatory markers (hsCRP and IL-6) and adipokines (Adiponectin, Leptin, Nesfatin-1, and Zinc-α2-glycoprotein) were assessed to discern effective indicators of inflammation in individuals with abnormal body weight. Additionally, the full lipid profile was also assessed (total cholesterol, triglycerides, LDL-C, HDL-C). The results indicated significant biochemical changes, particularly in IL-6 and Leptin levels, in participants with a BMI over 25. The levels of ZAG protein were negatively correlated with the HDL-C and LDC-L levels with statistical significance (Pearson: -0.57, p = 0.001, and Pearson: -0.41, p = 0.029, for HDL-C and LDL-C, respectively), suggesting that the level of ZAG is also inversely proportional to the amount of cholesterol. Statistical analyses revealed decreased Zinc-α2-glycoprotein (ZAG) levels and increased Adiponectin, Leptin, and IL-6 levels in individuals with abnormal body weight. Correlation analyses demonstrated a statistically significant upward trend for IL-6 (p = 0.0008) and Leptin (p = 0.00001), with a similar trend observed for hsCRP without statistical significance (p = 0.113). IL-6 levels in the overweight group were 158.71% higher than in the normal-weight group, while the obese group exhibited a 229.55% increase compared to the normal-weight group. No notable changes have been recorded for the levels of Nesfatin-1. Based on our results, we propose IL-6, Leptin, and ZAG as potential biomarkers for monitoring interventions and assessing patient conditions in those with abnormal BMIs. Further research with a larger patient cohort is warranted to validate these correlations in overweight and obese individuals.

Assessing the impact of body mass index on insulin resistance and metabolic risk factors in pre-diabetic individuals: A comprehensive cross-sectional study

Background: Insulin resistance plays a crucial role in the onset of type 2 diabetes, with body mass index (BMI) being a significant determinant. Aims and Objectives: This study examines the link between BMI and insulin resistance in pre-diabetic individuals to inform strategies for early diabetes intervention. Materials and Methods: This cross-sectional study involved 100 pre-diabetic participants. Data on demographic characteristics, BMI, insulin resistance (measured by the Homeostatic Model Assessment for Insulin Resistance, HOMA-IR), lipid profiles, and blood pressure (BP) were collected. Participants were categorized into normal weight, overweight, and obese groups to explore the relationship between BMI and insulin resistance and its impact on metabolic and cardiovascular health. Results: The average participant age was 45.8 years (SD=12.3), with a slight majority being female (52%) and an average BMI of 28.4 kg/m² (SD=4.5). A significant positive correlation (r=0.64, P&lt;0.001) between BMI and the HOMA-IR index highlighted the association between increased BMI and insulin resistance. Obese individuals had a notably higher HOMA-IR index (3.5±1.3) compared to those overweight (2.5±1.0) and of normal weight (1.9±0.8). In addition, the study found worsening lipid profiles and increased BP with higher BMI categories. Gender did not significantly affect insulin resistance, whereas a slight increase in HOMA-IR with age was noted (r=0.23, P=0.02). Conclusion: The findings highlight the strong correlation between higher BMI and increased insulin resistance in pre-diabetics. They emphasize the importance of managing body weight to mitigate the risk of diabetes and cardiovascular diseases.

Relationships among Gonadotropins, Sex Hormones, and Vascular Function in Adolescents with Normal Weight or Obesity

Objective: Childhood obesity may lead to premature cardiovascular disease in adulthood. Excess adiposity suppresses gonadotropin [luteinizing hormone (LH), follicle-stimulating hormone (FSH)] production in both adolescent males and females, which act upon the gonads, leading to the release of the sex hormones (estrogen and testosterone). Both estrogen and testosterone have been linked to vascular function. Relationships among gonadotropins, sex hormones, and vascular function are not completely understood in male and female adolescents across the weight-status spectrum. We, therefore, sought to examine associations among gonadotropins, sex hormones, and vascular health in adolescents with normal weight or obesity. We hypothesized that increased levels of gonadotropins would be associated with worsened vascular function, and higher levels of estrogen would be associated with favorable vascular function. Methods and Data: Adolescents (n=58; 12– &lt;18-years of age) were stratified according to body mass index (BMI) percentile into normal weight (5th – &lt;85th BMI percentile; n=25) and obesity (³95th BMI percentile; n=33) categories. Fasting blood samples were collected to measure FSH, LH, testosterone, estradiol, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL), very-low-density lipoprotein cholesterol (VLDL), high-density lipoprotein cholesterol (HDL), glucose, and insulin. Insulin resistance was calculated using the homeostatic model assessment (HOMA-IR). Vascular function was measured via ultrasonography for measures of carotid artery compliance and distensibility [i.e., diameter compliance (cDC), incremental elastic modulus (cIEM)], and brachial artery flow mediated dilation (FMD). Results: Female adolescents with obesity had a significantly greater ( p=0.009) FMD compared to females with normal weight. Triglycerides, VLDL, total cholesterol-to-HDL ratio, HOMA-IR, and insulin were also significantly greater (all p&lt;0.05) in adolescents with obesity compared to those with normal weight, while HDL was significantly lower ( p&lt;0.0001). FSH, LH, testosterone, and estradiol did not statistically significantly differ between the normal weight and obesity groups in either sex. After adjusting for age, multiple comparisons, and stratifying by sex, higher testosterone was associated with decreased cDC (p=0.018) in females. Additionally in females, higher testosterone was associated with increased cIEM ( p=0.002). In adolescent males, higher estrogen was associated with decreased cDC ( p=0.006) and increased cIEM ( p=0.003). Conclusion: Adding to previous research showing relationships between sex hormones and vascular health in adults, the current study shows associations between sex hormones and cDC and cIEM in adolescents. That said, we found no associations between gonadotropins and measures of vascular function in adolescents with normal weight or obesity. Future studies are needed to confirm these results in a larger cohort and among those with BMI in the overweight (85th - &lt;95th BMI percentile) category and differentiating severe obesity (&gt;120% of the 95th percentile, or &gt;35 kg/m2). Dr. Kelly serves as an unpaid investigator, consultant, and educator for Eli Lilly, Novo Nordisk, and Vivus; an unpaid consultant for Boehringer Ingelheim; receives donated study medication from Novo Nordisk and Vivus for NIDDK-funded clinical trials. Dr. Bomberg has served as a site principal investigator and site co-investigator for Novo Nordisk. His research program is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) under award number K23DK125668. The content is solely the responsibility of the authors and does not necessarily represent the offcial views of the NIH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Diabetes and the social, biologic, and behavioral determinants of endometrial cancer in the United States

BackgroundEndometrial cancer is one of the most common types of cancer that affects women’s reproductive system. The risk of endometrial cancer is associated with biologic, behavioral and social determinants of health (SDOH). The focus of the work is to investigate the cumulative effect of this cluster of covariates on the odds of endometrial cancer that heretofore have only been considered individually.MethodsWe conducted a quantitative study using the Behavioral Risk Factor Surveillance System (BRFSS) national data collected in 2020. Data analysis using weighted Chi-square test and weighted logistic regression were carried out on 84,118 female study participants from the United States.ResultsWomen with diabetes mellitus were approximately twice as likely to have endometrial cancer compared to women without diabetes (OR 1.54; 95%CI: 1.01–2.34). Biologic factors that included obesity (OR 3.10; 95% CI: 1.96–4.90) and older age (with ORs ranging from 2.75 to 7.21) had a significant increase in the odds of endometrial cancer compared to women of normal weight and younger age group of 18 to 44. Among the SDOH, attending college (OR 1.83; 95% CI: 1.12-3.00) was associated with increased odds of endometrial cancer, while renting a home (OR 0.50; 95% CI: 0.28–0.88), having other arrangements (OR 0.05; 95% CI: 0.02–0.16), being divorced (OR 0.55; 95% CI: 0.30–0.99), and having higher incomes ranging from $35,000 to $50,000 (OR 0.35; 95% CI: 0.16–0.78), and above $50,000 (OR 0.29; 95% CI: 0.14–0.62), were all associated with decreased odds of endometrial cancer. As for race, Black women (OR 0.24; 95% CI: 0.07–0.84) and women of other races (OR 0.37; 95% CI: 0.15–0.88) were shown to have lower odds of endometrial cancer compared to White women.ConclusionOur results revealed the importance of adopting a comprehensive approach to the study of the associated factors of endometrial cancer by including social, biologic, and behavioral determinants of health. The observed social inequity in endometrial cancer among women needs to be addressed through effective policies and changes in social structures to advocate for a standardized healthcare system that ensures equitable access to preventive measures and quality of care.

Association of body mass index with clinical outcome of primary WHO grade 4 glioma.

The prognostic value of body mass index (BMI) in primary WHO grade 4 gliomas is not widely acknowledged. This study aims to assess the survival outcomes of patients with different BMIs. Real-world data of patients diagnosed with primary WHO grade 4 (2021 version) glioma was assessed. All 127 patients admitted in this study were administered with standard-of-care from September 2018 to September 2021. The outcomes of overall survival and progression-free survival were analyzed. The baseline characteristics of clinical features, molecular features, and secondary treatment in BMI subsets showed no significant difference. The survival analyses showed a significantly superior overall survival (OS) in the overweight group compared to the normal weight group. A trend of better OS in the overweight group compared to the obesity group was observed. The univariate Cox regression demonstrated patients of round-BMI 25 and 26 had superior OS outcomes. In this real-world setting, patients with a BMI between 24 and 28 have superior overall survival. Patients in the proper BMI range may acquire survival benefits undergoing standard-of-care of primary WHO grade 4 gliomas. The prospective studies on a larger scale on these subsets of patients are necessary to solve the paradox of BMI in glioma.

The Effect of Obesity in Individuals with Ankylosing Spondylitis: A Single Center Cohort Study

Aim: The aim of this study was to compare the disease activity and functional status of individuals with Ankylosing Spondylitis (AS) according to body mass index (BMI). Material and Methods: This study, which was planned as a single-center cohort study, included 437 individuals with AS. Disease activities were evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and functional levels with the Bath Ankylosing Spondylitis Functional Index (BASFI). Participants were categorized in 3 groups according to BMI data based on the criteria of the World Health Organization: normal weight:20-24.9; overweight: 25-29.9; obese:≥30. One Way Anova Test, Kruskal Wallis Test, Mann Whitney U test and Chi-Square Test were used to compare independent group differences. Linear regression models were used to describe the relationship between BASDAI, BASFI (dependent variables) and BMI categories (independent variables). Univariate regression analyses were performed (only one independent variable in the model). Results: Among 437 patients with AS, 30.2% are normal weight, 39.5% are overweight and 30.2% are obese. Analysis results of data between BMI groups; significant difference was in BASFI (p=0.001) in favor of the obese group. In binary group comparisons for BASFI; there was a significant difference in favor of the obese group between normal and obese (p=0.002) and between overweight and obese (p=0.001). Obese was significantly associated with higher BASFI score compared to the normal weight group without adjustment for covariates (β:-0.37, 95%CI -0.66/-0.08, p=0.006). On the other hand, there was no association between BASDAI and obesity (β:-0.50, 95%CI -1.11/ 1.22, p:0.130). Conclusion: The BMI of Turkish AS individuals in a single center cohort had no effect on disease activity, but obesity had a worse effect on functional level.

Profile of Schoolchildren with Different Nutritional Status After Social Isolation: Sedentary Behavior, Aerobic Fitness, Secretory Immunoglobulin-A, and Anxiety Symptoms

ABSTRACT Background The COVID-19 pandemic imposed social isolation measures, which impacted the child population, especially regarding physical and mental health aspects. Purpose The aim of this study was to investigate the relationship between sedentary behavior, cardiorespiratory fitness, immunoglobulin -A secretion, and anxiety symptoms in 267 children aged 6–11 years, eutrophic or overweight. Methods Sedentary behavior was evaluated by the time of exposure to screens. Cardiorespiratory fitness was assessed using the 6-minute run/walk test and immunoglobulin-A by salivary samples. Anxiety symptoms were reported by the SCAS-version for parents. Results It was observed that after a period of confinement, overweight in children had a negative impact on cardiorespiratory performance and sedentary behavior. Differences were also observed in the concentration and secretion rate of SIgA in the overweight group compared to the normal weight group. Discussion The return to face-to-face classes brought a high proportion of overweight students, who showed lower aerobic performance. Considering sedentary behavior, all groups presented values greater than 2 hours of daily exposure to screens. Translation to Health Education Practice Special attention is needed from health professionals and teachers in relation to reducing sedentary behavior and improving cardiorespiratory fitness in schoolchildren.

Food-related inhibitory control deficits in young male adults with obesity: Behavioral and ERP evidence from a food-related go/no-go task

PurposeObesity poses a pervasive challenge to global public health, which is linked to adverse physical health outcomes and cognitive decline. Cognitive function, particularly food-related cognitive function, plays a critical role in sustaining a healthy weight and mitigating the progression of obesity. The aim of this study was to investigate the behavioral and neuroelectronic aspects of food-related inhibitory functions in young adult males with obesity. MethodsForty-nine participants with obesity and healthy-weight were recruited (BMI = 35.83 ± 5.06 kg/m2 vs. 22.55 ± 1.73 kg/m2, age = 24.23 ± 4.55 years vs. 26.00 ± 3.97 years). A food-related Go/No-go task which included 6 distinct blocks in a randomized order was conducted to investigate the general and food-related inhibitory control. 180 stimulus images from the Food Picture Database encompassing high-calorie food, low-calorie food, and neutral images were selected. Behavioral (Go RT, Go ACC, No-go ACC) and event-related potential measures (N2 and P3 amplitude) during the food-related Go/No-go task were measured. ResultsThe main findings indicated that the group with obesity exhibited lower No-go accuracy, slower go reaction times, and smaller P3 amplitudes in high-calorie, low-calorie foods, and neutral picture, compared to the normal-weight group, but with no group difference in N2. Additionally, high-calorie food induced larger N2 and P3 amplitude than the neutral stimuli. ConclusionsYoung male adults with obesity exhibit poorer inhibitory control in both food and non-food domains, specifically in slower reaction time and reduced accuracy, featuring difficulties in neural resource recruitment during the inhibitory control process. Additionally, the P3 component could serve as sensitive indicators to reveal the neural mechanisms of inhibitory control deficits in obesity, while the N2 and P3 components may differentiate the neural differences between high-calorie foods and non-foods in inhibitory control processing. Food, especially high-calorie food, induces more neural resources and may exacerbate the poor inhibitory ability towards food in obesity. Targeted interventions such as exercise interventions, cognitive training as well as neuromodulation interventions are warranted in the future to improve impaired general and food-related inhibitory functions in the obese populations, offering both theoretical and practical frameworks for obesity prevention and treatment.

Bacillus subtilis alleviates excessive apoptosis of intestinal epithelial cells in intrauterine growth restriction suckling piglets via the members of Bcl-2 and caspase families.

The intestine is a barrier resisting various stress responses. Intrauterine growth restriction (IUGR) can cause damage to the intestinal barrier via destroying the balance of intestinal epithelial cells' proliferation and apoptosis. Bacillus subtilis has been reported to regulate intestinal epithelial cells' proliferation and apoptosis. Thus, the purpose of this study was to determine if B. subtilis could regulate intestinal epithelial cells' proliferation and apoptosis in intrauterine growth restriction suckling piglets. Compared with the normal birth weight group, the IUGR group showed greater mean optical density values of Ki-67-positive cells in the ileal crypt (P < 0.05). IUGR resulted in higher ability of proliferation and apoptosis of intestinal epithelial cells, by upregulation of the messenger RNA (mRNA) or proteins expression of leucine rich repeat containing G protein coupled receptor 5, Caspase-3, Caspase-7, β-catenin, cyclinD1, B-cell lymphoma-2 associated agonist of cell death, and BCL2 associated X (P < 0.05), and downregulation of the mRNA or protein expression of B-cell lymphoma-2 and B-cell lymphoma-2-like 1 (P < 0.05). However, B. subtilis supplementation decreased the mRNA or proteins expression of leucine rich repeat containing G protein coupled receptor 5, SPARC related modular calcium binding 2, tumor necrosis factor receptor superfamily member 19, cyclinD1, Caspase-7, β-catenin, B-cell lymphoma-2 associated agonist of cell death, and Caspase-3 (P < 0.05), and increased the mRNA expression of B-cell lymphoma-2 (P < 0.05). IUGR led to excessive apoptosis of intestinal epithelial cells, which induced compensatory proliferation. However, B. subtilis treatment prevented intestinal epithelial cells of IUGR suckling piglets from excessive apoptosis. © 2024 Society of Chemical Industry.

The Effect of Recruitment Maneuver on Static Lung Compliance in Patients Undergoing General Anesthesia for Laparoscopic Cholecystectomy: A Single-Centre Prospective Clinical Intervention Study.

Background and Objectives: The aim of this study was to examine whether the use of an alveolar recruitment maneuver (RM) leads to a significant increase in static lung compliance (Cstat) and an improvement in gas exchange in patients undergoing laparoscopic cholecystectomy. Material and Methods: A clinical prospective intervention study was conducted. Patients were divided into two groups according to their body mass index (BMI): normal-weight (group I) and pre-obese and obese grade I (group II). Lung mechanics were monitored (Cstat, dynamic compliance-Cdin, peak pressure-Ppeak, plateau pressure-Pplat, driving pressure-DP) alongside gas exchange, and hemodynamic changes (heart rate-HR, mean arterial pressure-MAP) at six time points: T1 (induction of anesthesia), T2 (formation of pneumoperitoneum), T3 (RM with a PEEP of 5 cm H2O), T4 (RM with a PEEP of 7 cm H2O), T5 (desufflation), and T6 (RM at the end). The RM was performed by increasing the peak pressure by +5 cm of H2O at an equal inspiration-to-expiration ratio (I/E = 1:1) and applying a PEEP of 5 and 7 cm of H2O. Results: Out of 96 patients, 33 belonged to group I and 63 to group II. An increase in Cstat values occurred after all three RMs. At each time point, the Cstat value was measured higher in group I than in group II. A higher increase in Cstat was observed in group II after the second and third RM. Cstat values were higher at the end of the surgical procedure compared to values after the induction of anesthesia. The RM led to a significant increase in PaO2 in both groups without changes in HR or MAP. Conclusions: During laparoscopic cholecystectomy, the application of RM leads to a significant increase in Cstat and an improvement in gas exchange. The prevention of atelectasis during anesthesia should be initiated immediately after the induction of anesthesia, using protective mechanical ventilation and RM.

Circulating Fatty Acids Associate with Metabolic Changes in Adolescents Living with Obesity.

Fatty acids play a crucial role in obesity development and in the comorbidities of obesity in both adults and children. This study aimed to assess the impact of circulating fatty acids on biomarkers of metabolic health of adolescents living with obesity. Parameters such as blood lipids, redox status, and leukocyte telomere length (rLTL) were measured alongside the proportions of individual fatty acids. The Mann-Whitney U test revealed that individuals with obesity exhibited an unfavorable lipid and redox status compared to the control normal weight group. The group with obesity also had lower plasma n-3 polyunsaturated fatty acids (PUFAs) and a higher ratio of n-6 to n-3 PUFAs than the control group. They also had a shorter rLTL, indicating accelerated biological aging. There was an inverse association of rLTL and plasma n-6-to-n-3 PUFA ratio. Future studies should explore the impact of recommended nutrition plans and increased physical activity on these parameters to determine if these interventions can enhance the health and well-being of adolescents with obesity, knowing that early obesity can track into adulthood.

Association Between Maternal Body Mass Index and Fetal Acidosis in Term Twin Pregnancies: A Retrospective Cohort Study

ObjectivesGiven the increased risk of fetal acidosis in singleton neonates born to pregnant people with an elevated BMI, our objective was to evaluate the association between pre-pregnancy/first-trimester BMI and fetal acidosis among term twin pregnancies. MethodsRetrospective study of pregnant people with twin gestation and their term infants admitted to our centre between 2014 and 2019. Using a generalized estimating equation, the association between maternal BMI and fetal acidosis was determined using odds ratios (ORs) with 95% CIs. A two-sided P < 0.05 was considered significant. ResultsA total of 275 pregnant people and 550 infants were analyzed. The number (%) of pregnancies in each BMI class were 10 (4%) underweight, 155 (56%) normal weight, 66 (24%) overweight, 22 (8%) class I, 9 (3%) class II, and 13 (5%) class III. The prevalence of maternal diabetes and hypertension was highest in class III (31%) and class II (44%), respectively. Fetal acidosis was diagnosed in 35 (6%) infants. After adjusting for confounders (maternal age, diabetes, and hypertension), infants born to those with elevated BMI did not have increased odds of fetal acidosis compared to those born to underweight and normal weight group (OR 1.29; 95% CI 0.38–4.41 for class I, P = 0.67 and OR 2.80; 95% CI 0.62–12.62 for the combined classes II and III, P = 0.18). ConclusionsMaternal BMI was not associated with fetal acidosis in term twin pregnancies. Further research is required to corroborate study findings due to small sample size.

The association between body mass index and osteoporosis in a Taiwanese population: a cross-sectional and longitudinal study

This study investigates the correlation between body mass index (BMI) and osteoporosis utilizing data from the Taiwan Biobank. Initially, a comprehensive analysis of 119,009 participants enrolled from 2008 to 2019 was conducted to assess the association between BMI and osteoporosis prevalence. Subsequently, a longitudinal cohort of 24,507 participants, initially free from osteoporosis, underwent regular follow-ups every 2–4 years to analyze the risk of osteoporosis development, which was a subset of the main cohort. Participants were categorized into four BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese groups (BMI ≥ 27 kg/m2). A T-score ≤ − 2.5 standard deviations below that of a young adult was defined as osteoporosis. Overall, 556 (14.1%), 5332 (9.1%), 2600 (8.1%) and 1620 (6.7%) of the participants in the underweight, normal weight, overweight and obese groups, respectively, had osteoporosis. A higher prevalence of osteoporosis was noted in the underweight group compared with the normal weight group (odds ratio [OR], 2.20; 95% confidence interval [95% CI], 1.99 to 2.43; p value < 0.001) in multivariable binary logistic regression analysis. Furthermore, in the longitudinal cohort during a mean follow-up of 47 months, incident osteoporosis was found in 61 (9%), 881 (7.2%), 401 (5.8%) and 213 (4.6%) participants in the underweight, normal weight, overweight and obese groups, respectively. Multivariable Cox proportional hazards analysis revealed that the risk of incident osteoporosis was higher in the underweight group than in the normal weight group (hazard ratio [HR], 1.63; 95% CI 1.26 to 2.12; p value < 0.001). Our results suggest that BMI is associated with both the prevalence and the incidence of osteoporosis. In addition, underweight is an independent risk factor for developing osteoporosis. These findings highlight the importance of maintaining normal weight for optimal bone health.

Metabolic dysfunction, rather than obesity, is a risk factor for chronic kidney disease in Chinese population

Background Metabolic dysfunction and obesity are closely related to chronic kidney disease (CKD). However, studies on the relationship between various metabolic syndrome-body mass index (MetS-BMI) phenotypes and the risk of CKD in the Chinese population have not yet been explored. Materials and methods Data from the China Health and Retirement Longitudinal Study (CHARLS) 2015 were analyzed in this study. This study enrolled 12,054 participants. Participants were divided into six distinct groups according to their MetS-BMI status. Across the different MetS-BMI groups, the odd ratios (ORs) for CKD were determined using multivariable logistic regression models. Results The prevalence of CKD was higher in metabolically unhealthy groups than in the corresponding healthy groups. Moreover, the fully adjusted model showed that all metabolically unhealthy individuals had an increased risk of developing CKD compared to the metabolically healthy normal weight group (OR = 1.62, p = 0.002 for the metabolically unhealthy normal weight group; OR = 1.55, p < 0.001 for the metabolically unhealthy overweight group; and OR = 1.77, p < 0.001 for the metabolically unhealthy obesity group. Conclusions This study is the first to evaluate the relationship between the MetS-BMI phenotype and renal prognosis in the Chinese population. Individuals with normal weights are at different risk of developing CKD depending on their different metabolic phenotypes.

Association between obesity and risk for all-cause mortality in patients with type 2 diabetes

Objective: To investigate the association between obesity and the risk for all-cause mortality in type 2 diabetes (T2DM) patients. Methods: The participants were from a rural community-based T2DM patient cohort in Zhejiang Province. The study used the data collected from baseline survey in 2016 and follow-up until December 31, 2021. A total of 10 310 participants were included, excluding those who were lost in follow-up or had incomplete data in follow-up. According to BMI and waist circumference, the study subjects were divided into 6 groups: low body weight, normal body weight, simple abdominal obesity, simple body obesity, complex overweight and complex obesity. Cox proportional hazards regression model was used to analyze hazard ratios (HRs) of all-cause mortality and their 95%CIs in T2DM patients with different obesity status. Results: The cumulative follow-up period was 57 049.47 person-years with an average follow-up of (5.53±0.89) person-years. During this period, 971 subjects died. The death density was 1 702.03/100 000 person-years. After adjusting for confounders, low-weight patients had a 104% increased risk for all-cause death compared with normal-weight patients (HR=2.04, 95%CI:1.42-2.92). The risk for all-cause death decreased by 34% (HR=0.66, 95%CI: 0.53-0.82), 22% (HR=0.78,95%CI: 0.66-0.92), 38% (HR=0.62, 95%CI: 0.49-0.78) in the patients with simple body obesity, complex overweight and complex obesity, respectively, there was no significant difference for all-cause death in the patients with simple abdominal obesity alone. In subgroup analysis, the risk of all-cause mortality increased in low-weight T2DM patients of different sexes and ages, the mortality risk in women with complex obesity was 50% lower than that in the women with normal body weight, but there was no significant difference in men in the comparison between complex obesity group and normal body weight group. The risk for all-cause mortality was significantly lower in ≥65 years old patients with simple body obesity, complex overweight and complex obesity than in patients with normal body weight (HR=0.61, 95%CI: 0.48-0.78; HR=0.76, 95%CI: 0.63-0.91; HR=0.56,95%CI: 0.42-0.73), there was no significant difference in the patients aged <65 years. There was no significant change in sensitivity analysis. Conclusions: There was an "obesity paradox" in the risk for all-cause mortality in T2DM patients. The risk of all-cause mortality in the low-weight patients was significantly higher than that in normal-weight patients, and the risk for death in the patients with simple body obesity or complex overweight and obesity were significantly lower.

Diversity Analysis of Intestinal Bifidobacteria in the Hohhot Population.

(1) Background: Bifidobacterium plays a pivotal role within the gut microbiota, significantly affecting host health through its abundance and composition in the intestine. Factors such as age, gender, and living environment exert considerable influence on the gut microbiota, yet scant attention has been directed towards understanding the specific effects of these factors on the Bifidobacterium population. Therefore, this study focused on 98 adult fecal samples to conduct absolute and relative quantitative analyses of bifidobacteria. (2) Methods: Using droplet digital PCR and the PacBio Sequel II sequencing platform, this study sought to determine the influence of various factors, including living environment, age, and BMI, on the absolute content and biodiversity of intestinal bifidobacteria. (3) Results: Quantitative results indicated that the bifidobacteria content in the intestinal tract ranged from 106 to 109 CFU/g. Notably, the number of bifidobacteria in the intestinal tract of the school population surpassed that of the off-campus population significantly (p = 0.003). Additionally, the group of young people exhibited a significantly higher count of bifidobacteria than the middle-aged and elderly groups (p = 0.041). The normal-weight group displayed a significantly higher bifidobacteria count than the obese group (p = 0.027). Further analysis of the relative abundance of bifidobacteria under different influencing factors revealed that the living environment emerged as the primary factor affecting the intestinal bifidobacteria structure (p = 0.046, R2 = 2.411). Moreover, the diversity of bifidobacteria in the intestinal tract of college students surpassed that in the out-of-school population (p = 0.034). This was characterized by a notable increase in 11 strains, including B. longum, B. bifidum, and B. pseudolongum, in the intestinal tract of college students, forming a more intricate intestinal bifidobacteria interaction network. (4) Conclusions: In summary, this study elucidated the principal factors affecting intestinal bifidobacteria and delineated their characteristics of intestinal bifidobacteria in diverse populations. By enriching the theory surrounding gut microbiota and health, this study provides essential data support for further investigations into the intricate dynamics of the gut microbiota.

FTO rs9939609: T>A Variant and Physical Inactivity as Important Risk Factors for Class III Obesity: A Cross-Sectional Study.

The prevalence of obesity has been increasing worldwide. It has been reported that physiological and environmental factors such as diet, culture, physical activity, and genetics are the principal factors related to obesity. The fat mass and obesity-associated (FTO) gen variant (rs9939609: T>A) has been associated with class III obesity. The A variant has been correlated with anthropometric and metabolic alterations. Therefore, the purpose of this study was to analyze the association of the FTO rs9939609: T>A variant and environmental factors with clinical, anthropometric, and biochemical variables in subjects with class III obesity. The A variant frequency was higher in the class III obesity group compared with the normal weight group (44% vs. 25%, p < 0.001). Subjects with the AA genotype had a higher body mass index (BMI) than those with the AT genotype (35.46 kg/m2 (31-39.8) vs. 26.91 kg/m2 (23.7-30), p = 0.005). Women with the AA genotype showed higher waist circumferences than the AT group (101.07 cm (90.9-111.1) vs. 85.45 cm (77-93.8) p = 0.047). The FTO A variant increases the risk by 3.54 times and physical inactivity increases the risk by 6.37 times for class III obesity. Our results suggest that among the studied variables, those most related to class III obesity were the FTO risk genotype (A allele) and physical inactivity.