Presence Of Overweight Research Articles

The impact of obesity and weight gain on development of sleep problems in a population-based sample

ObjectivesThe objective of this study was to investigate the role of obesity and weight gain in the development of sleep problems in a population-based cohort. Material and methodsA population-based sample of men (n = 1896, aged 40–79 years) and women (n = 5116, age ≥20 years) responded to questionnaires at baseline and follow-up after 10–13 years. Sleep problems were assessed through questions about difficulties initiating sleep (DIS), difficulties maintaining sleep (DMS), excessive daytime sleepiness (EDS), and insomnia. Body mass index (BMI) was calculated from self-reported weight and height at both baseline and follow-up, while confounding factors (physical activity, tobacco and alcohol use, somatic disease, and snoring) were based on responses at baseline. ResultsAlthough overweight and obese subjects reported more sleep problems at baseline, there was no independent association between BMI level at baseline and development of new sleep problems. Subjects in the quartile with the highest rise in BMI with a weight gain exceeding 2.06 kg/m2 had a higher risk of developing DMS [adjusted odds ratio (OR) 1.58; 95% confidence interval (CI) 1.25–2.01), EDS (2.25; 1.65–3.06], and insomnia (2.78; 1.60–4.82). Weight gain was not associated with the development of DIS. ConclusionsWeight gain is an independent risk factor for developing several sleep problems and daytime sleepiness. The presence of overweight and weight gain should be considered when treating patients with sleep problems.

Self-reported eating speed in relation to non-alcoholic fatty liver disease in adults

Non-alcoholic fatty liver disease (NAFLD), known to be related to insulin resistance, has been the focus of intensive research efforts due to its increasing prevalence and clinical significance. Rapid eating behavior is another emerging health issue associated with insulin resistance. We aimed to clarify the correlation between self-reported eating speed and NAFLD, both known to be related to insulin resistance. A cross-sectional study was conducted during routine medical checkups on 7,917 consecutively enrolled participants. Anthropometric, biochemical, nutritional, and social parameters were checked. The self-reported eating speed per their usual meal (<5, 5-10, 10-15, and more than 15 min) was recorded by a registered dietitian. The faster eating groups had a higher proportion of NAFLD, and the grade of NAFLD was advanced. After controlling for anthropometric, cardiometabolic, social, and nutritional parameters, the fastest eating group (<5 min) showed an increased risk of NAFLD compared with the lowest eating speed group (≥15 min) both in total [odds ratio (OR) 1.81, 95% confidence interval (CI) 1.24-2.63] and the participants with BMI < 25 kg/m(2) (OR 1.79, 95% CI 1.22-2.61). As the self-reported eating speed increased, the risk of NAFLD also increased in total and those with BMI < 25 kg/m(2) (P for trend <0.001). Fast eating is associated with an increased risk of the presence and grade of NAFLD in Korean adults, especially those with BMI < 25 kg/m(2), since presence of overweight or obesity may be overwhelming the effect on NAFLD.

Relación entre el déficit de sueño nocturno, el exceso de peso y las alteraciones metabólicas en adolescentes

Sleep modulates neuroendocrine function and metabolism; therefore, changes in sleep duration may lead to developing obesity during adolescence. To assess the possible association among nocturnal sleep duration, the presence of overweight and metabolic alterations in a group of adolescents. Cross-sectional, analytical study conducted at a school in Valencia, Venezuela, during the 2012-2013 school year. Participants were 12 to 17 year-old adolescents. A survey on nocturnal sleep duration was administered; weight, height and waist circumference were recorded; and glycemia, lipid profile and insulinemia levels were measured. Body mass index and the homeostasis model assessment of insulin resistance (HOMA-IR) index were calculated. Ninety adolescents were included. Compared to the group with normal weight, adolescents with excessive weight had, in average, fewer sleep hours Sundays through Thursdays (p < 0.05) and a higher rate of sleep deficit and sleep debt (p < 0.05). Low HDL cholesterol and insulin resistance was significantly associated with sleep debt (p < 0.05). Among adolescents with sleep debt, the risk of having excess weight was 2.70 times higher (95% CI= 1.09-6.72; p= 0.032) regardless of age, gender, sexual maturity, sleep deficit Sundays through Thursdays, and history of cardiovascular disease and diabetes in first-degree relatives. Nocturnal sleep deficit and sleep debt were significantly associated with excess weight and metabolic alterations related to a high cardiometabolic risk.

Relationship among nocturnal sleep deficit, excess weight and metabolic alterations in adolescents.

Sleep modulates neuroendocrine function and metabolism; therefore, changes in sleep duration may lead to developing obesity during adolescence. To assess the possible association among nocturnal sleep duration, the presence of overweight and metabolic alterations in a group of adolescents. Cross-sectional, analytical study conducted at a school in Valencia, Venezuela, during the 2012-2013 school year. Participants were 12 to 17 year-old adolescents. A survey on nocturnal sleep duration was administered; weight, height and waist circumference were recorded; and glycemia, lipid profile and insulinemia levels were measured. Body mass index and the homeostasis model assessment of insulin resistance (HOMA-IR) index were calculated. Ninety adolescents were included. Compared to the group with normal weight, adolescents with excessive weight had, in average, fewer sleep hours Sundays through Thursdays (p < 0.05) and a higher rate of sleep deficit and sleep debt (p < 0.05). Low HDL cholesterol and insulin resistance was significantly associated with sleep debt (p < 0.05). Among adolescents with sleep debt, the risk of having excess weight was 2.70 times higher (95% CI= 1.09-6.72; p= 0.032) regardless of age, gender, sexual maturity, sleep deficit Sundays through Thursdays, and history of cardiovascular disease and diabetes in first-degree relatives. Nocturnal sleep deficit and sleep debt were significantly associated with excess weight and metabolic alterations related to a high cardiometabolic risk.

Television, sleep, outdoor play and BMI in young children: the GECKO Drenthe cohort.

In this study, we investigated the interplay between screen time, sleep duration, outdoor play, having a television in the bedroom and the number of televisions at home and their association with body mass index (BMI) in preschool children. All participants, 3-4 years of age (n = 759), were part of the Groningen expert center for kids with obesity (GECKO) Drenthe birth cohort. Weight and height were measured. Total screen time, number of televisions at home, a television in the bedroom, sleep duration and time of outdoor play were self-reported by parents in a questionnaire. Ordinary least square (OLS) regression-based path analysis was used to estimate direct and indirect effects on BMI in mediation models. A television in the bedroom or more televisions at home gave a higher screen time, which were associated with decreased sleep duration and resulted in higher BMI (indirect effect = 0.0115, 95% bootstrap interval = 0.0016; 0.0368 and indirect effect = 0.0026, 95% bootstrap interval = 0.0004; 0.0078, respectively). In contrast to the direct effect of screen time, sleep duration and a television in the bedroom on BMI, no direct effect was found for outdoor play and number or televisions at home on BMI. Short sleep duration, long screen time and a television in the bedroom were associated with the presence of overweight in preschool children.

Study of the association between 3111T/C polymorphism of the CLOCK gene and the presence of overweight in schoolchildren

ObjectivesTo evaluate the association between 3111T/C polymorphism of the CLOCK gene and the presence of obesity and sleep duration in children aged 6‐13 years. In adults, this genetic variant has been associated with duration of sleep, ghrelin levels, weight, and eating habits. Although short sleep duration has been linked to obesity in children, no study has aimed to identify the possible molecular mechanisms of this association to date. MethodsWeight, height, and circumferences were transformed into Z‐scores for age and gender. Genotyping was performed using TaqMan methodology. A questionnaire regarding hours of sleep was provided to parents. The appropriate statistical tests were performed. ResultsThis study evaluated 370 children (45% males, 55% females, mean age 8.5 ± 1.5 years). The prevalence of overweight was 18%. The duration of sleep was, on average, 9.7hours, and was inversely related to age (p<0.001). Genotype distribution was: 4% CC, 31% CT, and 65% TT. There was a trend toward higher prevalence of overweight in children who slept less than nine hours (23%) when compared to those who slept more than ten hours (16%, p=0.06). Genotype was not significantly correlated to any of the assessed outcomes. ConclusionsThe CLOCK 3111T/C polymorphism was not significantly associated with overweight or sleep duration in children in this city.

Study of the association between 3111T/C polymorphism of the CLOCK gene and the presence of overweight in schoolchildren

ObjectivesTo evaluate the association between 3111T/C polymorphism of the CLOCK gene and the presence of obesity and sleep duration in children aged 6‐13 years. In adults, this genetic variant has been associated with duration of sleep, ghrelin levels, weight, and eating habits. Although short sleep duration has been linked to obesity in children, no study has aimed to identify the possible molecular mechanisms of this association to date. MethodsWeight, height, and circumferences were transformed into Z‐scores for age and gender. Genotyping was performed using TaqMan methodology. A questionnaire regarding hours of sleep was provided to parents. The appropriate statistical tests were performed. ResultsThis study evaluated 370 children (45% males, 55% females, mean age 8.5 ± 1.5 years). The prevalence of overweight was 18%. The duration of sleep was, on average, 9.7hours, and was inversely related to age (p<0.001). Genotype distribution was: 4% CC, 31% CT, and 65% TT. There was a trend toward higher prevalence of overweight in children who slept less than nine hours (23%) when compared to those who slept more than ten hours (16%, p=0.06). Genotype was not significantly correlated to any of the assessed outcomes. ConclusionsThe CLOCK 3111T/C polymorphism was not significantly associated with overweight or sleep duration in children in this city.

Postprandial metabolism and inflammatory markers in overweight adolescents.

Lifestyle changes have an impact on lipid metabolism. The overload of circulating lipids may lead to endothelial dysfunction, oxidative stress and exaggerated inflammatory response, which may be further aggravated in the presence of overweight. This study aims to describe the postprandial metabolism and inflammatory response in overweight and normal-weight adolescents. Sixty-two adolescents aged 11-18 years were divided into two groups: overweight (OW; n=38) and normal weight (NW; n=24). Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), fibrinogen and leukocytes were collected for fasting and 4 and 6 h after a oral fat tolerance test (OFTT) consisting of a high-fat meal with 1.000 Kcal, 27.4% carbohydrates, 14.7% protein and 57.8% lipids (30.4% saturated, 32.7% monounsaturated, 26.5% polyunsaturated fatty acids and 288 mg TC). Data were analyzed with repeated measures ANOVA, multiple linear regression, and Pearson, Spearman and partial correlations. OW adolescents showed significantly higher fasting values of TC (P=0.036), LDL-C (P=0.010), fibrinogen (P=0.036) and hs-CRP (P=0.004). All variables, except for glucose, increased in response to OFTT, but there were no interactions between group and time. body mass index z-score was positively correlated to LDL-C, TG, fibrinogen and hs-CRP, and inversely correlated to HDL-C. In conclusion, adolescents with OW showed higher TC, LDL-C and inflammatory markers levels than NW adolescents. These findings have clinical implications for prevention of chronic diseases, as we spend most of our days in a postprandial state.

Nuevos fármacos antidiabéticos: avanzando hacia el control integral de la diabesidad

Obesity and type 2 diabetes mellitus (T2DM) are twin pandemics of modern society. In recent decades, in Spain, as in the rest of the world, a dramatic rise in the prevalence of both conditions has been observed. The presence of overweight or obesity is very common in patients with T2DM. Paradoxically, the standard treatments for hyperglycemia in T2DM, excepting metformin, usually lead to weight gain. The appearance of two new therapeutic groups, GLP-1 receptor agonists and sodium-glucose co-transporter type 2 inhibitors, which simultaneously improve HbA1c, weight and other cardiovascular risk factors without causing hypoglycemias, represents a major change in the management of patients with diabesity. Several ongoing clinical trials with these drugs will determine whether the global control of risk factors leads to a reduction in cardiovascular morbidity and mortality.

Correlation between Body Mass Index and Waist Circumference in Patients with Metabolic Syndrome.

Metabolic syndrome is defined as a group of coexisting metabolic risk factors, such as central obesity, lipid disorders, carbohydrate disorders, and arterial hypertension. According to the 2005 IDF criteria, subsequently revised in 2009, abdominal obesity is identified as the waist circumference of ≥80 cm in women and ≥94 cm in men. It is responsible for the development of insulin resistance. The aim of our study was to demonstrate a correlation between waist circumference (WC) and body mass index (BMI) in patients with metabolic syndrome in relation with hypertension, lipid disorders, and carbohydrate disorders. A cross-sectional two-site study was conducted in the Kuyavian-Pomeranian Voivodeship for 24 months. The study group consisted of 839 patients with diagnosed metabolic syndrome: 345 men (41.1%) and 494 women (58.9%) aged 32–80. In the study group, WC was found to be significantly correlated with BMI (R = 0.78, P < 0.01). The presence of overweight in men (BMI 25, 84 kg/m2) and even normal body weight in women (BMI 21,62 kg/m2) corresponds to an increased volume of visceral tissue in the abdomen. Introduction of primary prophylaxis in those people to limit the development of diabetes mellitus type 2 and cardiovascular diseases should be considered.

Stages of changes for fruit and vegetable intake and their relation to the nutritional status of undergraduate students.

ABSTRACTObjective:To assess the nutritional and dietetic profile of freshman Nutrition undergraduate students, and its association with stages of changes (Transtheoretical Model) for fruit and vegetable intake.Methods:Demographic (age and gender), anthropometric (body mass index and waist circumference) and nutritional (pattern of fruit and vegetable intake) data were obtained. The Transtheoretical Model was used to identify the stages of change for fruit and vegetable intake. Food consumption was assessed with a questionnaire developed by the Ministry of Health. The significance level considered for all statistical tests was 0.05 (p<0.05).Results:From 433 eligible students, anthropometric measurements were taken from 219 (50.6%), and 299 (69%) underwent food intake evaluation. The sample included undergraduate students with a low frequency of adequate fruit and vegetables intake (29.8%), being the majority (64.9%) of them classified as at the preparation stage to increase the intake of these food groups. Prevalence of adequate fruit and vegetables intake was higher among students at the action/maintenance stages (83.3%) compared to those at the precontemplation/contemplation (18.3%) and at the preparation stages (32.0%). Students at the preparation stage presented the highest medians for body mass index (p=0.004) and waist circumference (p=0.039) compared to those at the precontemplation/contemplation stages. There was no association between fruit and vegetables intake and the presence of overweight or abdominal obesity (p=0.373).Conclusion:This instrument is effective to predict the food intake and, even among aware individuals and ready to change their food behavior, the prevalence of nutritional risk is high.

Артериальная гипертензия как фактор риска развития сахарного диабета

Цель исследования — изучение в возрастном аспекте распространенности артериальной гипертензии (АГ) среди мужчин и женщин городской и сельской популяции как одного из факторов риска развития сахарного диабета 2-го типа. Общее количество обследованных среди сельского населения составило 1062 больных (из них 461 мужчина и 601 женщина) в возрасте от 45 до 70 лет и старше и 1156 лиц городского населения (241 мужчина и 915 женщин). Гипертоническая болезнь довольно часто встречается среди как сельского, так и городского населения обоих полов и в разных возрастных группах и является довольно важным фактором риска развития сахарного диабета 2-го типа, который необходимо учитывать при обследовании. У мужчин сельского региона заболевание диагностировано в меньшем количестве случаев, чем у женщин, а среди жителей города, наоборот, у мужчин чаще, чем у женщин, в разных возрастных группах. Это свидетельствует о том, что среди женщин молодого и среднего возраста, жительниц города, распространенность артериальной гипертензии меньше, чем среди жительниц сельского региона. Наличие избыточной массы тела и ожирения II–ІІІ ст. способствует повышению риска возникновения артериальной гипертензии.

Asociación entre la dieta y la presencia de sobrepeso y obesidad. Método de evaluación dietética de la Encuesta Nacional de Salud Española 2006

Introducción: analizar la asociación entre la frecuencia de consumo de alimentos y la presencia de sobrepeso-obesidad a partir de datos de la Encuesta Nacional de Salud Española 2006 (ENS-06).Material y métodos: estudio transversal retrospectivo de fuentes secundarias de la ENS-06. Se seleccionaron 29.321 individuos que respondieron el Cuestionario de Frecuencia de Consumo de Alimentos, compuesto por una lista de 12 grupos, sobre los que se preguntaba su frecuencia de consumo en 5 opciones de respuesta y que se categorizaron en 3 para el análisis (consumo diario, semanal y ocasional). Se realizó un análisis descriptivo del consumo de grupos de alimentos categorizados por frecuencia de consumo, y calculando la diferencia (brecha) entre hombres y mujeres. La asociación entre frecuencia de consumo de alimentos y sobrepeso-obesidad serealizó mediante regresión logística.Resultados: el 40,7% de la población consume a diario verduras-hortalizas y el 65,2% consume frutas a diario. El 69,8%, y el 46,3% de las mujeres cumplen las recomendaciones de consumo de frutas (brecha -7,2), y de verduras-hortalizas (brecha -14,0) respectivamente. Consumir fruta ocasionalmente, disminuye la probabilidad de padecer obesidad (OR=0,72 IC95%: 0,63-0,82), frente a consumirla a diario. Consumir embutidos a diario, disminuye la probabilidad de padecer obesidad (OR=0,75 IC95%: 0,68-0,83), frente a un consumo ocasional.Conclusiones: Los resultados muestran contradicciones científicas por la presencia de sesgos en el instrumento utilizado en la recogida de la información, sugiriendo la necesidad de que la ENS incluya un método de recogida de información dietética-nutricional validado y adoptado, que permita mediciones de mayor calidad y exactitud.

Obesity portends increased morbidity and earlier recurrence following liver transplantation for hepatocellular carcinoma

BackgroundObesity has been associated with poor oncologic outcomes following pancreatoduodenectomy for pancreatic cancer. However, there is a paucity of evidence on the impact of obesity on postoperative complications, oncologic outcome and survival in patients with hepatocellular carcinoma (HCC) undergoing orthotopic liver transplantation (OLT). MethodsFrom a database of over 1000 patients who underwent OLT during 1996–2008, 159 patients with a diagnosis of HCC were identified. Demographic data, body mass index (BMI), perioperative parameters, recurrence and survival were obtained. Complications were grouped according to Clavien–Dindo grading (Grades I–V). ResultsThere were increased incidences of life‐threatening complications in overweight (58%) and obese (70%) patients compared with the non‐obese patient group (41%) (P < 0.05). Furthermore, the incidence of recurrence of HCC was doubled in the presence of overweight (15%) and obesity (15%) compared with non‐obesity (7%) (P < 0.05). Time to recurrence also decreased significantly. Differences in mean ± standard deviation survival in the overweight (45 ± 3 months) and obese (41 ± 4 months) groups compared with the non‐obese group (58 ± 6 months) did not reach statistical significance. ConclusionsThese findings indicate that BMI is an important surrogate marker for obesity and portends an increased risk for complications and a poorer oncologic outcome following OLT for HCC.

High blood pressure during pregnancy is associated with future cardiovascular disease: an observational cohort study

ObjectivesThe study aimed to determine if having a hypertensive disorder of pregnancy (HDP) is a risk factor for future cardiovascular disease (CVD), independent of age and body mass index (BMI).DesignData...

Comparative Analysis of Cardiovascular Disease Risk Factors Influencing Nonfatal Acute Coronary Syndrome and Ischemic Stroke

The aim of the present work was to compare the influence of classic cardiovascular disease (CVD) risk factors on the development of acute coronary syndrome (ACS) and ischemic stroke. During 2009-2010, 1,000 participants were enrolled: 250 were consecutive patients with a first ACS, 250 were consecutive patients with a first ischemic stroke, and 500 were population-based, control subjects, 1-for-1 matched to the patients by age and gender. The following CVD risk factors were evaluated: smoking/passive smoking, family history of CVD, physical inactivity, hypertension, hypercholesterolemia, diabetes mellitus, presence of overweight and obesity, trait anxiety (assessed with the Spielberger State-Trait Anxiety Inventory form Y-2), and adherence to the Mediterranean diet (assessed by the MedDietScore). Furthermore, participants graded the perceived significance of the aforementioned factors, using a scale from 1 (not important) to 9 (very important). The risk factors with the highest effect size for ACS, as determined by the Wald criterion, were smoking and hypercholesterolemia; regarding stroke, they were anxiety and family history of CVD (all p <0.01). When the odds ratios of each factor for ACS and stroke were compared, insignificant differences were observed, except for smoking. On the basis of the participants' health beliefs, smoking and stress emerged as the most important risk factors, whereas all subjects graded passive smoking as a least important factor. In conclusion, similarities of the risk factors regarding ACS and ischemic stroke facilitate simultaneous primary prevention measures.

White Blood Cells Count and Incidence of Type 2 Diabetes in Young Men

OBJECTIVEAssociation between white blood cell (WBC) count and diabetes risk has been recently suggested. We assessed whether WBC count is an independent risk factor for diabetes incidence among young healthy adults.RESEARCH DESIGN AND METHODSWBC count was measured in 24,897 young (mean age 30.8 ± 5.36 years), normoglycemic men with WBC range of 3,000 to 12,000 cells/mm3. Participants were periodically screened for diabetes during a mean follow-up of 7.5 years.RESULTSDuring 185,354 person-years of follow-up, diabetes was diagnosed in 447 subjects. A multivariate model adjusted for age, BMI, family history of diabetes, physical activity, and fasting glucose and triglyceride levels revealed a 7.6% increase in incident diabetes for every increment of 1,000 cells/mm3 (P = 0.046). When grouped in quintiles, a baseline WBC count above 6,900 cells/mm3 had an independent 52% increase in diabetes risk (hazard ratio 1.52 [95% CI 1.06–2.18]) compared with the lowest quintile (WBC <5,400 cells/mm3). Men at the lowest WBC quintile were protected from diabetes incidence even in the presence of overweight, family history of diabetes, or elevated triglyceride levels. After simultaneous control for risk factors, BMI was the primary contributor of the variation in multivariate models (P < 0.001), followed by age and WBC count (P < 0.001), and family history of diabetes and triglyceride levels (P = 0.12).CONCLUSIONSWBC count, a commonly used and widely available test, is an independent risk factor for diabetes in young men at values well within the normal range.

High Blood Pressure in Children and its Correlation with Three Definitions of Obesity in Childhood

Background Several authors have correlated the increase of cardiovascular risk with the nutritional status, however there are different criteria for the classification of overweight and obesity in children. Objectives To evaluate the performance of three nutritional classification criteria in children, as definers of the presence of obesity and predictors of high blood pressure in schoolchildren. MethodsEight hundred and seventeen children ranging 6 to 13 years old, enrolled in public schools in the municipality of Vila Velha (ES) were submitted to anthropometric evaluation and blood pressure measurement. The classification of the nutritional status was established by two international criteria (CDC/NCHS 2000 and IOTF 2000) and one Brazilian criterion (Conde e Monteiro 2006). ResultsThe prevalence of overweight was higher when the criterion of Conde e Monteiro (27%) was used, and inferior by the IOTF (15%) criteria. High blood pressure was observed in 7.3% of children. It was identified a strong association between the presence of overweight and the occurrence of high blood pressure, regardless of the test used (p < 0.001). The test showing the highest sensitivity in predicting elevated BP was the Conde e Monteiro (44%), while the highest specificity (94%) and greater overall accuracy (63%), was the CDC criterion. ConclusionsThe prevalence of overweight in Brazilian children is higher when using the classification criterion of Conde e Monteiro, and lower when the criterion used is IOTF. The Brazilian classification criterion proved to be the most sensitive predictor of high BP risk in this sample.

Relationship between Physical Fitness and utritional Status in a Portuguese Sample of School Adolescents

The presence of overweight and obesity in children and adolescents it’s real. Although there is a trend toward the decrease in physical fitness levels, the intensity of this decrease due to the nutritional status in adolescents is not well-known, particularly in school adolescents of inner Portuguese regions. The aim of this study is to describe physical fitness levels, nutritional status and analyze their association in school adolescents of Castelo Branco district, according to gender. Cardiorespiratory fitness (20 meters shuttle run test), muscular fitness (curl ups, pushups and back arch tests) and nutritional status (body mass index) were carried out in 924 school adolescents (429 males and 495 females) aged between 12 and 17 years old. Descriptive, correlation and covariance analyses were performed. The prevalence ratio was analyzed thought Poisson regression. For males and females, the overweight prevalence was 15.6% and 19.2%, respectively. Obesity prevalence was 5.1% for males and 3.8% for females. In both genders, low performances on cardiorespiratory and muscular fitness were found. Curl-ups and back-arch tests are in accordance to healthy fitness zone. Overweight and obese adolescents achieved low cardiorespiratory and muscular fitness levels. No differences were found on back-arch test between body mass status groups. Opposite correlations were found between physical fitness tests with BMI, excepting back-arch test. The prevalence ratios expose a strong trend toward the decrease of physical fitness tests in overweight and obese adolescents. Assessing physical fitness and nutritional status in school adolescents is essential to primary prevention of century diseases. This study alert health care professionals to find and promote solutions that lead young people to be more active and healthy.

Prevalence of clinical hip abnormalities in haemophilia A and B: an analysis of the UDC database

Clinical hip abnormalities, secondary to recurrent joint and/or muscle bleeding in persons with haemophilia, have not been well characterized and have the potential for significant morbidity. We aimed to examine the prevalence of clinical hip abnormalities in the US haemophilia population and to explore associations between these findings and putative risk factors. We conducted a study of hip abnormalities of 8192 subjects aged 2-69 years with haemophilia A and haemophilia B (54% of haemophilia A and haemophilia B are severe) currently enrolled in the Universal Data Collection (UDC) database. Associations between hip abnormality and type/severity of haemophilia A/B, current age, history of high-titre (≥ 5 BU) inhibitor (HTinh), concomitant ankle (AA) and knee arthropathy (KA), overweight and obesity and prophylaxis were examined using logistic regression. Overall prevalence of hip abnormality at the last recorded UDC visit for all subjects was 16.7%. Haemophilia A (aOR = 1.3, 1.0-1.4), severe haemophilia (aOR = 1.3, 1.0-1.5), a history of HTinh (aOR = 1.4, 1.1-1.7), and concomitant AA (aOR = 1.7, 1.4-1.9) were each independently associated with hip abnormality. Older age (45-69 years) was significantly associated with hip abnormality prevalence only in subjects with KA (aOR = 3.4, 1.9-5.9). The presence of overweight (aOR = 1.4, 1.1-1.8) and obesity (aOR = 2.1, 1.6-2.8) was associated with hip abnormality only among subjects without KA. Hip abnormality prevalence was not influenced by prophylaxis (aOR = 0.9, 0.8-1.1). These data suggest that hip abnormalities in US patients with haemophilia are associated with haemophilia severity and type, HTinh, concomitant AA and, depending on the presence or absence of KA, advancing age and obesity.