Obese Grade Research Articles

Body mass index as a determinant of scar formation post-AF ablation: Insights from DECAAF II.

Obesity is implicated in adverse atrial remodeling and worse outcomes in patients with atrial fibrillation. The objective of this study is to assess the effect of body mass index (BMI) on ablation-induced scar formation on late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). We conducted an analysis of DECAAF II participants who underwent LGE-CMR scans to measure scar formation 3 months after catheter ablation. Ablation parameters and lesion delivery were not dependent on BMI. The effect of BMI on ablation success was explored. Our analyses included 811 patients. Comorbidities were more prevalent in obese patients. Baseline left atrial volume was higher in obese individuals, 118, 126, 135, 140, and 143 mm3 for normal weight, overweight, obese grade 1, 2, and 3, respectively (p < .001). BMI was associated with scar formation (R = -0.135, p < .001), with patients with Class 3 obesity having the lowest percentage of ablation-induced scar, 11.1%, 10.3%, 9.5%, 8.8%, 6.8% by ascending BMI group. There was an inverse correlation between BMI and the amount of fibrosis covered by ablation scar, 24%, 23%, 21%, and 18% by ascending BMI group (p = .001). For the fibrosis-guided ablation group, BMI was associated with residual fibrosis (R = 0.056, p = .005). Obese patients have lower ablation scar formation, covered fibrosis, and more residual fibrosis postablation compared to nonobese patients, regardless of ablation parameters including impedance drop.

Associations between maternal body mass index and childhood infections in UK primary care: findings from the Born in Bradford birth cohort study

ObjectiveTo explore associations between maternal body mass index (BMI) in early pregnancy and childhood infections.DesignBirth cohort study linked to primary care records.SettingBradford, UK.ParticipantsLive singleton births within the Born in Bradford...

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.

Behavioral change readiness among obese adolescents in Jakarta, Indonesia

BACKGROUND Prochaska’s transtheoretical model of behavioral change process, consisting of stages and processes of change, should be monitored to evaluate obesity management, particularly in adolescents. Two of four processes of change are supporting relationships, which promote behavioral change, and weight management actions, which are activities that push individuals to a particular direction in patients’ weight loss progress. This study aimed to determine the participants’ current stages of change, nutritional status, and their relationship with the processes of change.&#x0D; METHODS This cross-sectional study used secondary data collected in 2018 from 115 obese adolescents aged 15–21 years in Jakarta, Indonesia, using an Indonesian-translated and validated questionnaire adapted from Andrés et al’s study. The questionnaire evaluated participants’ processes of change, focusing on scores of supporting relationships (5 items) and weight management actions (10 items).&#x0D; RESULTS Of the participants, 71.3% were classified as obese grade I, and 28.7% were obese grade II. Most participants were in the contemplation (31.3%) and action (31.3%) stages. The mean supporting relationships and weight management actions scores were different between participants with obese I and obese II (66.67 versus 80, p = 0.004; 64.17 versus 70, p = 0.008, respectively). Meanwhile, no differences were identified in supporting relationships and weight management actions scores in all stages of change.&#x0D; CONCLUSIONS Adolescents with obesity and higher BMI (based on the obesity grading of the WHO Asia Pacific) tended to have significantly higher scores for supporting relationships and weight management actions, indicating that external reinforcement and immediate weight loss actions played pivotal roles in readiness for behavioral change.

Relationship of body mass index and visceral fat area combination with arterial stiffness and cardiovascular risk in cardiovascular disease-free people: NHANES (2011-2018).

Obesity and arterial stiffness are strongly associated with cardiovascular disease; however, their relationship remains controversial. Body mass index was measured using anthropometric evaluation, and visceral fat area was calculated using an absorptiometry scan. The data of 5309 participants were collected from NHANES (National Health and Nutrition Examination Survey) (2011-2018). Based on the normal-weight normal visceral fat group that was considered as a reference, ePWV increased in all other groups, with the obese grade 2 visceral obesity group increasing the most by 26.35 cm/s (95% CI: 13.52, 39.18, P < 0.001), followed by normal-weight visceral obesity group 24.43 cm/s (95% CI: 1.88, 46.98, P = 0.035), which was even higher than obese grade 1 visceral obesity (β: 21.16, 95% CI: 9.24, 33.07, P = 0.001), obese grade 2 normal visceral fat group (β: 13.8; 95% CI: 0.10, 27.5, P = 0.048) and overweight visceral obesity group (β: 10.23; 95% CI: 1.89, 18.57, P = 0.018). For the 10-year cardiovascular risk, the obese grade 2 visceral obesity group had a 9.56-fold increase in compared with the control (OR: 10.56, 95% CI: 4.06, 27.51, P < 0.0001). Normal-weight visceral obesity, obese grade 1 visceral obesity, and overweight visceral obesity groups increased by 8.03-fold (OR: 9.03, 95% CI: 2.66, 30.69; P < 0.001), 7.91-fold (OR: 8.91, 95% CI: 3.82, 20.79, P < 0.001), and 7.28-fold (OR: 8.28, 95% CI: 3.19, 21.46, P < 0.001). The risk was lower in the normal visceral fat group. Except for the obese grade 2 normal visceral fat group, there was no significant difference in other groups. Normal-weight visceral obesity was associated with higher arterial stiffness and 10-year cardiovascular risk.

Relationship of body mass index with frailty and all-cause mortality among middle-aged and older adults

BackgroundParallel to growth of aging and obese populations, the prevalence of metabolic diseases is rising. How body mass index (BMI) relates to frailty and mortality across frailty levels is controversial. We examined the associations of high BMI with frailty and mortality and explored the effects of percent body fat on these associations.MethodsWe included 29,937 participants aged ≥50 years from the 2001–2006 National Health and Nutrition Examination Survey (NHANES) cohorts (N=6062; 53.7% females) and from wave 1 (2004) of Survey of Health, Ageing and Retirement in Europe (SHARE) (N=23,875; 54% females). BMI levels were categorized as: normal: 18.5–24.9 kg/m2, overweight: 25.0–29.9, obese grade 1: 30.0–34.9, and obese grade 2 or 3: >35.0. A frailty index (FI) was constructed excluding nutrition-related items: 36 items for NHANES and 57 items for SHARE. We categorized the FI using 0.1-point increments: FI ≤ 0.1 (non-frail), 0.1 < FI ≤ 0.2 (very mildly frail), 0.2 < FI ≤ 0.3 (mildly frail), and FI > 0.3 (moderately/severely frail). Percent body fat was measured using DXA for NHANES participants. All-cause mortality data were obtained until 2015 for NHANES and 2017 for SHARE to estimate 10-year mortality risk. All analyses were adjusted for age, sex, educational, marital, employment, and smoking statuses.ResultsMean age of participants was 63.3±10.2 years for NHANES and 65.0±10.0 years for SHARE. In both cohorts, BMI levels ≥25 kg/m2 were associated with higher frailty, compared to normal BMI. In SHARE, having a BMI level greater than 35 kg/m2 increased mortality risk in participants with FI≤0.1 (HR 1.31, 95%CI 1.02–1.69). Overweight participants with FI scores >0.3 were at lower risk for mortality compared to normal BMI [NHANES (0.79, 0.64–0.96); SHARE (0.71, 0.63–0.80)]. Higher percent body fat was associated with higher frailty. Percent body fat significantly mediated the relationship between BMI levels and frailty but did not mediate the relationship between BMI levels and mortality risk.ConclusionsBeing overweight or obese is associated with higher frailty levels. In this study, we found that being overweight is a protective factor of mortality in moderately/severely frail people and obesity grade 1 may be protective for mortality for people with at least a mild level of frailty. In contrast, obesity grades 2 and 3 may be associated with higher mortality risk in non-frail people. The relationship between BMI and frailty is partially explained by body fat.

Combined resistance and aerobic training improves lung function and mechanics and fibrotic biomarkers in overweight and obese women.

Background: Obesity impairs lung function and mechanics and leads to low-grade inflammation, but the effects of combined physical exercise (CPE) on that are unknown. Methods: We investigated the effects of 12 weeks of combined physical exercise (aerobic + resistance training), in non-obese (n = 12), overweight (n = 17), and obese grade I (n = 11) women. Lung function and lung mechanics were evaluated. The systemic immune response was evaluated by whole blood analysis and biomarker measurements, while pulmonary fibrotic biomarkers were evaluated in the breath condensate. Result: CPE improved forced vital capacity (FVC) % (p < 0.001) and peak expiratory flow (PEF) % (p < 0.0003) in the obese group; resistance of the respiratory system (R5Hz) in non-obese (p < 0.0099), overweight (p < 0.0005), and obese (p < 0.0001) groups; resistance of proximal airways (R20Hz) in non-obese (p < 0.01), overweight (p < 0.0009), and obese (p < 0.0001) groups; resistance of distal airways (R5Hz–R20Hz) in non-obese (p < 0.01), overweight (p < 0.0012), and obese (p < 0.0001) groups; reactance of the respiratory system (X5Hz) in non-obese (p < 0.01), overweight (p < 0.0006), and obese (p < 0.0005) groups; impedance of the respiratory system (Z5Hz) in non-obese (p < 0.0099), overweight (p < 0.0005), and obese (p < 0.0001) groups; central resistance (RCentral) in non-obese (p < 0.01), overweight (p < 0.001), and obese (p < 0.0003) groups; and the peripheral resistance (RPeripheral) in non-obese (p < 0.03), overweight (p < 0.001), and obese (p < 0.0002) groups. CPE reduced the pro-fibrotic IGF-1 levels in BC in overweight (p < 0.0094) and obese groups (p < 0.0001) and increased anti-fibrotic Klotho levels in BC in obese (p < 0.0001) groups, and reduced levels of exhaled nitric oxide in overweight (p < 0.03) and obese (p < 0.0001) groups. Conclusion: CPE improves lung function, mechanics, and pulmonary immune response in overweight and obese grade I women by increasing anti-fibrotic protein Klotho and reducing pro-fibrotic IGF-1.

School Health Infrastructure and Students' Elevated Body Mass Index.

School-age children with overweight or obesity continue to be problematic in the United States, and are associated with many health, social, and financial problems. Schools provide an excellent venue in which to promote healthy weight in students, and school nurses are well-positioned to play an essential role in controlling obesity. The number of studies reporting relationships among school health infrastructure and prevalence of elevated Body Mass Index (BMI) is limited. The present study explored associations between three components of school health infrastructure (staff, services, budget) and the proportion overweight or obese 1st, 3rd, and 6th grade students, after controlling for selected factors (race, county education level, county poverty level, rurality). Study results supported an independent association between elevated BMI and school health staff. Additionally, independent associations between elevated BMI and the following covariates were supported: household income, race, and parents' educational level. There is an ultimate need for well-designed studies addressing these associations.

Association of sleep duration and sleep quality with body mass index among young adults.

ABSTRACTBackground:It is evident from the research in recent years that short sleep has been found as a risk factor for obesity. However, we still need enough evidence in this field. Therefore, we explored the directionality of the association between sleep duration and sleep quality with body mass index (BMI).Aims:The aim of this study is to evaluate the association of sleep duration and sleep quality with BMI among young adults.Objectives:(a) To assess the association of sleep duration with BMI. (b) To assess the quality of sleep with BMI.Methods:In this cross-sectional study, 88 individuals selected from King George’s Medical University were taken as participants. Majority of patients were males (67%). There were 29 (33.0%) females. Sex ratio of study was 2.03, and we used Pittsburgh sleep quality index (PSQI) questionnaire to assess time spent in bed and sleep quality. BMI was divided into 3 categories. Underweight (BMI <18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), obese grade I (25–34.9 kg/m2), obese grade II (35.0 kg/m2), and above.Results:We observed that short sleep duration ± SD (h) <6 h/day f = 9.04; P < 0.001 is associated with greater chances of being overweight and obese and mean sleep quality (mean PSQI ± SD) f = 12.24; P < 0.001 was poor in obese grade I and II. Mean neck and waist circumference also showed a significant increasing trend with increasing BMI category (P < 0.001).Conclusion:This study concludes that short sleep duration and poor sleep quality were associated with overweight obesity among young adults.

Benefits of telematic monitoring for weight loss in overweight and obese patients in times of confinement

Introduction: the pandemic originated by SARS-Cov-2 in 2019 led to eating habits and physical exercise changes due to home confinement measures. The follow-up of patients in treatment for weight loss through telematic consultation could be a useful tool to prevent treatment failure. Objective: to describe the evolution of anthropometric parameters of patients under follow-up for weight loss through telematic consultation. Methods: a two-stage prospective study (before and after confinement) with a telematic intervention in adult patients under regular follow-up for overweight and obesity. Demographic variables and body composition parameters were analyzed by bioimpendance. In addition, the differences in the presence of drug treatment with GLP-1 hormone (liraglutide or semaglutide) adjuvants were also analyzed. The variables were studied using Wilcoxon's test, Mann-Whitney U-test, and Spearman's correlation. Significance was considered for p ≤ 0.05. Results: a total of 97 patients were included, before confinement 42.3 % were overweight (BMI < 30 kg/m2), 36.1 % were obese grade I (BMI = 30-34.9 kg/m2), 16.4 % were obese grade II (BMI = 35-39.9 kg/m2), and 5.2 % had BMI > 40 kg/m2. In all, 30.9 % had prediabetes and 9.3 % had type-2 diabetes. Between both consultations, 81.4 % of patients lost 4.2 ± 3.4 % of their weight, with a significant mean decrease in fat mass of 3.16 ± 4.4 kg. The group on pharmacological treatment with GLP-1 hormone analogs presented a significantly higher average fat loss without significant loss of skeletal muscle mass. Conclusions: telematic monitoring seems to be a useful tool to prevent weight gain in patients with restricted mobility. A telematic intervention that contains dietary advice and exercise, as a reinforcement to hypocaloric diet, helps to achieve weight loss with a predominant fat component. The presence of drug treatment with GLP-1 hormone analogues appears to significantly help maintain skeletal muscle mass during weight loss.

Single-port magnetic-assisted sleeve gastrectomy

Abstract Rationale: Sleeve gastrectomy is the most frequent surgery performed worldwide in bariatric surgery. In recent years, there has been an increase in the tendency to perform this procedure using a single port; however, to date, there have been no reports of this magnet-assisted surgery. We developed a magnet-assisted sleeve gastrectomy technique to demonstrate the use of magnets in different steps of the surgery to perform this procedure. Patient Concerns: A 38-year-old woman with a body mass index of 36.2 kg/m2 attended the clinic with the desire to lose weight in order to improve her living conditions. Diagnosis: Based on her weight and height, the patient's body mass index was diagnosed as obese grade II. During the examination by the multidisciplinary team, the patient presented with a blood pressure of 133/86 mm Hg and was diagnosed with hypertension. Intervention: The sleeve gastrectomy technique was performed in a standard manner using a single port located in the umbilicus and a 5-mm port in the right upper quadrant. In addition, we used a magnet positioned on the outside of the patient's abdomen, and a grasper coupled to a magnet was positioned in different parts of the cavity to assist in different steps of the surgery. Outcomes: The surgery was successfully completed with no intraoperative complications with the use of magnetic devices. The patient was discharged 36 hours postoperatively with nutritional indications. At the month follow-up the patient lost 7 kg of initial weight. Lessons: The use of a novel magnetic device can achieve a greater degree of ease in the face of difficulties associated with single-port sleeve gastrectomy.

Effectiveness of a polyphenolic extract (Lippia citriodora and Hibiscus sabdariffa) on appetite regulation in overweight and obese grade I population: an 8-week randomized, double-blind, cross-over, placebo-controlled trial

IntroductionPolyphenols have shown capacity to improve appetite sensation, leading to enhanced control of body weight. However, despite being related with hunger-related hormones, metabolic and mechanism are not well known.MethodsThe effectiveness of a nutraceutical composed of extract to Lippia citriodora and Hibiscus sabdarrifa (Lc-Hs) for controlling satiety and hunger was analyzed in a cross-over, placebo-controlled (Pla) clinical intervention. The study was divided in two 60-day periods separated by 30-day length wash-out period. At the end of each period, overweight and obese subjects (n = 33; age = 33.76 ± 12.23; BMI = 28.20 kg/m2 ± 2.47; fat mass 30.65 ± 8.39%; both sexes were proposed to eat an ad-libitum meal. Meanwhile, appetite sensation was determined by visual analog scales at different times. Moreover, blood extraction was performed to determine biochemical parameters (lipid and glucidic profile and safety parameters) and to evaluate hunger-related hormones (insulin, leptin, ghrelin, adiponectin, GLP-1 and peptide YY).ResultsA decrease in appetite sensation was observed in Lc-Hs treatment, showing higher satiety quotient (Pla = 3.36 ± 2.33%mm/kcal; Lc-Hs = 5.53 ± 2.91%mm/kcal; p < 0.0001). Area under the curve was higher in Pla compared to Lc-Hs during the test, from baseline to minute 240 (240 (Pla 9136.65 ± 2261.46% x min−1; Lc-Hs 8279.73 ± 2745.71% x min−1; p < 0.014). Energy consumption was lower for subjects treated with Lc-Hs (774.44 ± 247.77 kcal) compared to those treated with Pla (849.52 ± 246.54 kcal) (p < 0.004). Leptin values varied from baseline (Pla 12.36 ± 1.98 ng/mL; Lc-Hs 13.13 ± 1.99 ng/mL) to the end of the study (Pla 12.60 ± 2.02 ng/mL; Lc-Hs 12.06 ± 2.05 ng/mL; p < 0.047). GLP-1 values varied (p < 0.001) in Lc-Hs treatment from baseline (4.34 ± 0.49 ng/mL) to the end of the study (3.23 ± 0.52 ng/mL).ConclusionThe supplementation with the Lc-Hs extract decreases appetite sensation in overweight and obese population, reducing calorie intake after an ad-libitum meal. Due to variation on hunger-related hormones and the relationship between satiety feeling, it would be interesting to develop future research focused on the variation of the hormones themselves.

Prevalence of Obesity among Young Women in Vellore District

Obesity and overweight is the fifth leading cause for death all over the world and the prevalence rate is increasing in both developing and developed countries. Obesity is a common health problem which affects all age groups. Young women with obesity face the risks of medical, psychological and reproductive challenges and studies also reported that numerous health risks have been associated with overweight including hypertension, respiratory disease, several orthopedic disorders, diabetes and elevated serum lipid concentrations. The study is carried out with the objective to assess the prevalence rate of obesity among young women. The area selected for the study was Vellore District, Tamil Nadu. Out of 123 colleges, 10% were selected representing four areas - North, South, East and West. A total number of 2278 students of 18-25 years were selected with inclusion and exclusion criteria. To assess the obesity, height and weight were measured using standard protocols and the BMI calculated using WHO classification. Among the selected young women 17.4 % were 18-20 years, 57.2 % were 21-22 years and the remaining 25.1 % were 23-25 years. The prevalence rate of underweight was 18.9 %, normal (61.2 %), overweight (7.1%), obese grade I (6.4%) and obese grade II (4 %.) It was found that 17.5 % of young women were obese. The results were analyzed statistically using descriptive statistics namely mean, standard deviation and ‘t' test. P-value of &lt;0.0001 was statistically significant. The results of the present study revealed the need for a suitable intervention strategy for the management of obesity among young women.

The socio-clinical particularities of preeclampsia in a disadvantaged African black environment

Introduction: Pre-eclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etiopathogenesis involves, among other things, age, primi-gravidity, obesity, lack of sensitization to the partner's sperm. Objective: It was to describe the socio-clinical profile of the preeclampsia pregnant woman received in consultation in our service and to compare it with that of a control population. Methodology: We carried out a situational study of prospective descriptive and analytical type during 07 months from 01 November 2018 to May 31, 2019, in the obstetrics and gynecology department of the Laquintinie Hospital in Douala. We recruited in consultation a continuous series of 150 pregnant women including 50 preeclampsia that we matched to 100 non preeclampsia all at a gestational age greater than 20 weeks of amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index. The statistical tests were considered significant for a value of p˂0.05. Results: The preeclampsia pregnant woman in our series had a mean age of 27.80±5.80, mostly in the 25-30years, pauci-gravid, nulliparous and obese grade 1 with a gestational age predominantly ≥37 weeks of amenorrhea. This profile was non-exposing and heterogeneous compared to the control group of the same racial strain and to data from the literature. Conclusion: Our preliminary study suggests the existence of certain socio-clinical peculiarities in the preeclampsia pregnant woman in the black African environment.

The Use of Liraglutide in Obese Patients With COVID-19: A Case Report

Introduction: In December 2019, a new type of coronavirus was discovered in Wuhan, China, characterized by a picture of atypical pneumonia composed of fever, dry cough and progressive dyspnea. Autopsy analyzes of patients with Covid-19 were performed, and hyperactivation of cytotoxic T cells was observed, suggesting an increase in humoral-type immunological signaling, where interleukin 6 (IL-6) is a mediator present that can fit as a potential critical agent for exacerbation of inflammatory conditions. In addition, not only interleukin-6, but also serum C-reactive protein (CRP) and ferritin have been recognized as strong predictors of COVID-19 severity. Recent studies have shown that the use of liraglutide has antioxidant and anti-inflammatory effects in vitro. Thus, the present case report discusses the possible anti-inflammatory properties of the antidiabetic drug liraglutide (Saxenda), in Covid-19. Clinical Case: JCMS, 45 years, male, married, obese grade 2 (BMI: 38.2), sought medical service on August 18, 2020, bringing a positive result of the RT-PCR test for Covid-19, performed in last day. The patient was in good general condition, reporting mild headache and adynamia. He was prescribed to start a treatment with Saxenda (6mg/ml - started 0.6mg/day at week 1, with a gradual increase up to 3mg/day at week 5); Jardiance (25mg / day); Fluimicil (600mg); Ivermectin (6mg) and Colchicine (0.5mg every 12 hours). In addition, collection of laboratory tests was requested. Examination results: IL6: <1.5 pg/mL; Ferritin: 819 ng/ml; C-reactive protein: 5.1mg/L. On August 24, the patient was tachycardic (HR 120–140 bpm) associated with headache and fever (38 °C). Azithromycin (500mg), dexamethasone (4mg) and dipyrone (1g) were prescribed. Collection of laboratory tests was requested. Examination results: IL6: 9.3 pg/mL; Ferritin: 1085 ng/ml; C-reactive protein:23.9mg/L. On September 3, the patient was in good general condition, eupneic, afebrile, with no complaints to declare. On September 6, the collection of laboratory tests was requested. Examination results: IL6: <1.5 pg/mL; Ferritin: 687 ng/ml; C-reactive protein: 1.7mg/L. Conclusion: Based on the described report, it is possible to observe a good clinical and laboratory evolution of the patient with Covid-19 who, among the drugs used, made use of liraglutida. Diabetes and obesity are considered significant risk factors for morbidity and mortality by COVID-19, since they are a condition of low-grade chronic inflammation and in these conditions, inflammatory markers such as CRP, IL-6 and ferritin have strong signs of alteration. Thus, the possible beneficial effect of the administration of liraglutide in obese patients is highlighted, as a potential anti-inflammatory effect, especially in the COVID-19 era.

Maternal and Perinatal Outcome of Maternal Obesity at RSCM in 2014-2019.

Obesity is a pandemic found in many countries. It is estimated that, in 2025, more than 21% of women in the world will suffer from obesity and its number keeps increasing yearly. Obesity in pregnancy is one of the important challenges in obstetric services given the prevalence and potential adverse effects on the mother and fetus. Obese women have a higher risk of developing gestational diabetes, gestational hypertension, preeclampsia, venous thromboembolism, postpartum hemorrhage, cesarean delivery, and maternal death. The aim of this research is to determine the prevalence of maternal and perinatal complication in various obesity grades. This research was an observational descriptive study using the cross-sectional design. The inclusion criterion is obese pregnant women whose delivery was done in Dr. Cipto Mangunkusumo National General Hospital (RSCM) from 2014 to 2019. The exclusion criterion in this study is the incomplete medical record. A total of 111 subjects were included in the study. Obesity grades in this study were based on World Health Organization (WHO) obesity, divided into 3 classifications which are obese I (30–34.9 kg/m2), obese II (35–39.9 kg/m2), and obese III (≥40 kg/m2). Maternal outcomes in this study were birth method, gestational diabetes, preeclampsia, and premature rupture of membrane (PROM). Perinatal outcomes in this study were preterm birth, birth weight, APGAR score, and postdelivery neonatal care. In this study, obese patients had a mean age of 31.23 years, mean gravida 2, parity 1, and abortion 0. Most of these patients used an intrauterine device (IUD) for family planning (74.8%). There were no differences in age, parity status, and family planning methods in each group of patients with different body mass index (p > 0.05). Maternal characteristics are the majority of deliveries performed cesarean delivery (86.5%), cases of diabetes mellitus are more common in obese I patients (50%), preeclampsia is more prevalent in obese grade II patients (34,4%), and premature rupture of membranes (PROM) is more common in patients with obese II (52,4%). However, there was no difference in the prevalence of maternal outcomes between groups. There was a median gestational age of 37 weeks in all obesity grades, the highest percentage of preterm births owned by obese II patients (32,6%), the mean birth weight of babies tends to increase along with the weighting of the body mass index group, and neonatal intensive care unit (NICU) treatment rooms were mostly occupied from mother with obese II groups (18%). There was no difference in the first-minute and fifth-minute APGAR scores between study groups (p > 0.05). There were no differences in perinatal outcomes between groups. There were no significant differences in maternal and perinatal outcomes prevalence between different obesity grades. However, the rate of maternal and perinatal complications in obese women is higher than the normal population, thus requiring sophisticated prevention and approach toward handling the pregnancy.

ACUTE EFFECTS OF STRENGTH TRAINING WITH DIFFERENT INTENSITIES ON INFLAMMATORY MARKERS OF GRADE III OBESE WOMEN

Objective: To compare the acute effects of a high-intensity (AI) resistance training protocol with a moderate-intensity (MI) resistance training protocol on inflammatory markers in grade III obese women. Methods: This is a crossover controlled clinical trial carried out with 9 obese grade III women (BMI=48.29±5.06 kg/m²; age=35.22±10.93 years), where blood samples were collected in the pre, 15 minutes and 24 hours after two different training protocols, high and moderate intensity, being analyzed the plasma concentrations of the cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN- γ. For data analysis, the Friedman and Mann-Whitney tests were used. Participants performed the AI protocol and one week later the MI protocol. The training consisted of 4 exercises with the total volume equalized, with intensities 75 and 85% of 1RM for the MI and AI protocols, respectively. Results: There were no significant differences between the three temporal measures in the AI group [IL-02 (p=0.459); IL-04 (p=0.368); IL-06 (p=0.368); IL-10 (p=0.895); TNF-α (p=0.895) and IFN-γ (p=0.895)] or MI [IL-02 (p=0.459); IL-04 (p=0.368); IL-06 (p=0.459); IL-10 (p=0.368); TNF-α (p=0.641) and IFN-γ (p=0.121)]. In the analysis between groups, the IL-04 value was significantly higher in the AI group at the PRE moment (p=0.008), with no other significant difference for any of the variables and moments analyzed. Conclusion: Moderate and high intensity strength training protocols did not cause acute changes in the inflammatory profile of grade III obese women, and can be applied to this audience without harming low-grade chronic inflammation.

Body Mass Index Vs Fracture Risk Value Primary Osteoporosis (A Case Study on Women Ages 40-45 Years at Sub-Urban Area)

This study aims to determine the relationship between BMI and fracture risk value primary osteoporosis in women aged 40-45 years in sub-urban areas. And how to optimize social activities in the environment as an effort to reduce the risk of osteoporosis. Body mass index is one of the important risk factors for osteoporosis fractures because the protective effects of subcutaneous fat tissue on bone in elderly women are calculated using FRAX®tool. The WHO in collaboration with the Sheffield's University central of metabolic bone disease has created a calculating device, the WHO risk assessment fracture tool (FRAX®tool). FRAX®tool is an online-based device used to calculate the risk of osteoporosis fractures in major bones, namely proximal humerus, wrist, vertebrae, and femur bone in the next ten years. This research is an analytical study using a cross sectional design, the number of samples is 70 female respondents aged 40–45 years in Kelurahan Melong Asih, Cimahi. The relationship between body mass index and the risk of primary osteoporosis fracture, used the rank spearman correlation test. The results of this study indicate a strong negative correlation between body mass index and the risk value of osteoporosis major, while the relationship between body mass index and risk value for osteoporosis femur fracture was found to be a moderate negative correlation. From the results of the risk of major osteoporosis fracture the lower a person's body mass index, the greater the risk of major primary osteoporosis fracture, whereas the results of the risk of femur fracture are only in obese grade II that is low, while other criteria have the same value, so it cannot be concluded if the lower a person's body mass index, the greater the risk value of the femur fracture. Keywords : Body Mass Index; Fracture Risk Value; Osteoporosis.

Acute postprandial effect of yacon syrup ingestion on appetite: A double blind randomized crossover clinical trial

Yacon syrup is a rich source of fructooligosaccharides (FOS); however, its diet supplementation effect on subjective sensation and appetite biomarkers in human is still unknown. This study aimed to evaluate the acute postprandial effect of yacon syrup ingestion on appetite. The double-blind crossover clinical trial was carried out with 40 adult women: 20 eutrophic and 20 obese grade I. On each day, the first blood collection was performed after a 12-h fast. Then, the volunteers ingested either intervention A (breakfast + 40 g of placebo) or intervention B (breakfast + 40 g of yacon syrup, containing 14 g of FOS). New aliquots of blood were collected at 45, 60, 90, 120, and 180 min. Appetite was assessed by estimating ghrelin and glucagon-like peptide-1 (GLP-1) levels and by assessing subjective appetite sensation. Analysis was performed using two-way ANOVA, followed by Bonferroni's multiple comparison test. No effect of yacon syrup was observed on postprandial ghrelin and GLP-1 levels at all times evaluated. Similar observations were made after stratifying the analysis by BMI (body mass index) (eutrophic and obese). The effect of yacon syrup on postprandial subjective sensations of hunger, satiety, fullness, and desire to eat was not evident in the total group of women evaluated and even after BMI stratification. We concluded that yacon syrup had no effect on postprandial ghrelin and GLP-1 levels and on the subjective appetite sensation in young adult women.

Knowledge of Female University Students about Obesity and its Adverse Effects on Reproductive Health

Background & Objective(s): Obesity remains a public health challenge, particularly in developing countries. Research has denoted the relation between obesity and some female general and reproductive health problems including hypertension, diabetes, infertility, miscarriage,stillbirth,birth defectsand cesarean section. The high prevalence rates of obesity in developing countries may reflect lack of adequate knowledge about obesity. The aim of the present work was to estimate the prevalence rate of obesity among female university students and assess their knowledge regarding obesity and its adverse effects on reproductive health. Methods: A cross-sectional study was conducted among 400 female university students attending the Outpatient Clinics affiliated to Alexandria University. Students were selected using systematic random sampling technique.Students’ knowledge about obesity, its risk factors and adverse effects was assessed using a self-administered questionnaire. Weight and height were measured for each student and body mass index (BMI) was calculated. Results: The present study revealed that 31.5% of the studied students were overweight and 11% were obese (grade I). The mean BMI was 25.13 ± 3.63 kg/m2.About one quarter (24%) had poor knowledge about the effect of obesity on reproductive health, as 85% considered oocyte development and maturation better in obese females and 71% reported that obesity reduced the risk of developing early menopause. A notable percentage of them did not know that obesity increased the risk of still birth (28%) and miscarriage (24.2%). Conclusion: Prevalencerate of overweight and obesity among sampled female university students in Alexandria was high and a considerable proportion lacked knowledge about the effect of overweight/obesity on their reproductive health.