Prevalence Of Obesity In Patients Research Articles

Bariatric Surgery Is Highly Effective and Underutilized in Patients with ADHD: A 5-Year Retrospective Cohort Study.

Obesity and ADHD have become increasingly common diagnoses. In the last decade, research has found that there is a high prevalence of obesity in patients with ADHD. The mainstays of management in the general population include lifestyle modifications, pharmacotherapies, and/or bariatric surgery. However, there is a lack of understanding of appropriate management of patients with both ADHD and obesity. We identified those with obesity for at least five consecutive years (BMI > 30) in the TriNetX database before separating into two groups based on the presence or absence of ADHD. We assessed both the distribution of treatment modalities and the change in average BMI over time in each of our four groups across 5years. Average BMI decreased over time in all groups, with the smallest change seen in the ADHD Pharmacology cohort (- 0.366kg/m2) and the largest in the ADHD Surgery group (- 8.532kg/m2). Average BMIs at the 5-year mark were significantly different. Our research found that pharmacological management of individuals with ADHD was only half as effective for individuals with ADHD than our control. Though surgical management of patients with ADHD is roughly 20 times more effective in managing obesity, it was not used as frequently in comparison to medication for management of weight.

Prevalence of obesity in patients with obstructive sleep apnea

Prevalence of obesity in patients with obstructive sleep apnea

Prevalence of Obesity and its Effects in Patients With COVID-19: A Systematic Review and Meta-analysis

Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease worldwide. Obesity has been proven to increase the susceptibility of an individual to infections, but the relationship between obesity and COVID-19 is still unclear. This study aimed to conduct a systematic review and meta-analysis of the prevalence of obesity and its effects in patients with COVID-19. Methods: Web of Science, PubMed and Embase were searched for English language studies up to May 22, 2020. We used a random or fixed-effects model to calculate pooled prevalence rates and odds ratio (OR) with 95% confidence intervals (CI). Results: Twelve studies with a total of 14 364 patients met the inclusion criteria. The pooled prevalence of obesity in patients with COVID-19 was 32.0% (95% CI, 26%-38%, P < .001). The prevalence of obesity in ICU COVID-19 patients were 37.0% (95% CI, 29%-46%, P < .001). Comparing between obese and non-obese patients, the meta-analysis showed that obesity was an important risk factor associated with COVID-19 patients needed for ICU care (OR: 1.36, 95% CI 1.22-1.52, P < .001). Conclusion: Obesity was highly prevalent (32.0%) in patients with COVID-19, especially in ICU patients (37.0%), and was an important risk factor for COVID-19 patients needed for ICU care.

Obesity prevalence in patients with acromegaly

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Abstract #1405583: Efficacy and Safety of Medical Weight Loss Interventions in Patients with Advanced Chronic Kidney Disease

The prevalence of obesity in patients with chronic kidney disease is higher than in general population. Obesity may limit accessibility to kidney transplantation, reduces quality of life and increases mortality rates, yet treatments for obesity are vastly underutilized in this population due to concerns related to feasibility and tolerability. This study aimed to evaluate the real-world efficacy and safety outcomes of medical weight loss therapies in patients with advanced chronic kidney disease. This is a retrospective analysis of all individuals with eGFR ≤30 mL/min/1.73m2 referred to an academic medical weight management clinic from 01/2015 through 09/2022. We report body weight changes through 60 months of follow-up, treatment-related side effects and reasons for treatment discontinuation. Overall 89 individuals met inclusion criteria, of which 16 individuals (average age 47.5±14.39 years, weight 114.1±24.27kg, 68.7% women, 75% on dialysis) were treated with intensive lifestyle modifications (ILM) alone and 73 individuals (average age 52.07±14.09 years, weight 120.3±21.63kg, 54.8% women, 53.4% on dialysis) were treated with anti-obesity medications (AOMs) along with ILM [all treated with a glucagon-like peptide-1 receptor agonist (GLP1-RA)+/-other AOMs]. Mean duration of follow-up was significantly longer in those treated with GLP1-RA compared to those treated with ILM: 1036.03±834.81 days versus 180.31±254.37 days, respectively, as such outcome data beyond 3 months of follow-up is only available for those treated with GLP1-RA. Percentage body weight change at 3 months was -0.83+/-11.6% for those treated with ILM and -4.03+/-5.4% for those treated with GLP1-RA (p=0.16 between groups). GLP1-RA group experienced the following percentage weight change from baseline: -5.1+/-6.3% at 6 months, -6.27+/-7.3% at 9 months, -6.44+/-7.8% at 12 months, -7.74+/-10.8% at 24 months, -9.38+/-13.8% at 36 months, -10.06+/-13.8% at 48 months and -7.19+/-14.6% at 60 months. At the time of data extraction 49.3% of patients were continuing treatment with GLP1-RA; 9.58% of individuals treated with GLP1-RA discontinued treatment due to gastrointestinal side effects, only one discontinued due to excessive weight loss. There were 3 events of pancreatitis in the GLP1-RA treated group and none in the ILM group. Of those treated with GLP1-RA, 21.91% reached the maximum dose licensed for obesity, 46.57% the maximum dose licensed for diabetes, and 31.51% were on lower doses. Most patients with advanced chronic kidney disease referred to a weight management program were treated with GLP1-RA based AOMs. These agents successfully induced and maintained weight change over a long period of follow-up, with few experiencing side effects and very few having to discontinue treatment due to side effects.

Schizophrenia and obesity: May the gut microbiota serve as a link for the pathogenesis?

AbstractSchizophrenia (SZ) places a tremendous burden on public health as one of the leading causes of disability and death. SZ patients are more prone to developing obesity than the general population from the clinical practice. The development of obesity frequently causes poor psychiatric outcomes in SZ patients. In turn, maternal obesity during pregnancy has been associated with an increased risk of SZ in offspring, suggesting that these two disorders may have shared neuropathological mechanisms. The gut microbiota is well known to serve as a major regulator of bidirectional interactions between the central nervous system and the gastrointestinal tract. It also plays a critical role in maintaining physical and mental health in humans. Recent studies have shown that the dysbiosis of gut microbiota is intimately associated with the onset of SZ and obesity through shared pathophysiological mechanisms, particularly the stimulation of immune inflammation. Therefore, gut microbiota may serve as a common biological basis for the etiology in both SZ and obesity, and the perturbed gut–brain axis may therefore account for the high prevalence of obesity in patients with SZ. On the basis of these findings, this review provides updated perspectives and intervention approaches on the etiology, prevention, and management of obesity in SZ patients by summarizing the recent findings on the role of gut microbiota in the pathogenesis of SZ and obesity, highlighting the role of gut‐derived inflammation.

The Prevalence of Obesity Among Children With Type 2 Diabetes

The childhood obesity epidemic is presumed to drive pediatric type 2 diabetes (T2D); however, the global scale of obesity in children with T2D is unknown. To evaluate the global prevalence of obesity in pediatric T2D, examine the association of sex and race with obesity risk, and assess the association of obesity with glycemic control and dyslipidemia. MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science were searched from database inception to June 16, 2022. Observational studies with at least 10 participants reporting the prevalence of obesity in patients with pediatric T2D were included. Following the Meta-analysis of Observational Studies in Epidemiology reporting guideline, 2 independent reviewers in teams performed data extraction and risk of bias and level of evidence analyses. The meta-analysis was conducted using a random-effects model. The primary outcomes included the pooled prevalence rates of obesity in children with T2D. The secondary outcomes assessed pooled prevalence rates by sex and race and associations between obesity and glycemic control and dyslipidemia. Of 57 articles included in the systematic review, 53 articles, with 8942 participants, were included in the meta-analysis. The overall prevalence of obesity among pediatric patients with T2D was 75.27% (95% CI, 70.47%-79.78%), and the prevalence of obesity at diabetes diagnosis among 4688 participants was 77.24% (95% CI, 70.55%-83.34%). While male participants had higher odds of obesity than female participants (odds ratio, 2.10; 95% CI, 1.33-3.31), Asian participants had the lowest prevalence of obesity (64.50%; 95% CI, 53.28%-74.99%), and White participants had the highest prevalence of obesity (89.86%; 95% CI, 71.50%-99.74%) compared with other racial groups. High heterogeneity across studies and varying degrees of glycemic control and dyslipidemia were noted. The findings of this systematic review and meta-analysis suggest that obesity is not a universal phenotype in children with T2D. Further studies are needed to consider the role of obesity and other mechanisms in diabetes genesis in this population.

[Heart failure and obesity].

Obesity is an independent predictor of cardiovascular diseases (CVD), including heart failure (HF). Nevertheless, numerous studies have shown that patients with CVD who are overweight and slightly obese have a better short-term and moderate prognosis than thinner patients with CVD. This phenomenon has been called the obesity paradox. Understanding the obesity paradox is important in patients with HF, given the high prevalence of obesity in patients with HF. The article presents an overview of clinical studies devoted to the study of obesity as a risk factor for HF, the pathogenesis of HF in obesity, and highlights the issues of the obesity paradox and the treatment of obesity in this category of patients.

Prevalence of Obesity and Cardiovascular Risk Factors Among Type 2 Diabetes Mellitus Patients in Al-Khobar, Saudi Arabia.

The prevalence of obesityhas grown significantly worldwide. It is considered a major cardiovascular risk factor among type II diabetes mellitus (T2DM) patients. The main objective of this study is to determine the prevalence of obesity in patients with T2DMat King Fahd University Hospital (KFUH), Al-Khobar, and to assess the relationship between T2DMand cardiovascular risk factors with body mass index (BMI) and waist to hip ratio (WHR). A retrospective, cross-sectional study, included T2DMpatients from the Internal Medicine departmentat KFHU. The investigators recorded patient demographics (age and gender), weight (kg), height (cm), body mass index (Kg/m2), waist and hip circumference (cm), smoking status, physical activity, blood pressure measurements (mmHg) and laboratory results of fasting blood glucose (FBG), glycated haemoglobin (HbA1c) and lipid profile. Among 346 patients, the prevalence of obesity and overweight was 62.4% and 27.2%, respectively. The relationship between BMI and demographic data including age and gender was statistically significant (P<0.05). The correlation between the BMI with cardiovascular risk factors including smoking, physical activity and WHR found to be statistically significant (P<0.05). Our study showed that obesity and overweight affect 89.6% of patients with T2DM. Therefore, it is important to take into consideration weight control strategies to effectively manage diabetic patients.

POS1013 HOW DOES BODY MASS INDEX AFFECT SECUKINUMAB TREATMENT OUTCOMES AND SAFETY IN PATIENTS WITH PSORIATIC ARTHRITIS? – REAL WORLD DATA FROM THE GERMAN AQUILA STUDY

BackgroundThere is a higher prevalence of obesity in patients (pts) with psoriatic disease1. The German non-interventional study AQUILA provides real-world data on the influence of body mass index (BMI) of pts with psoriatic arthritis (PsA) on therapeutic effectiveness and safety under treatment with secukinumab, a fully human monoclonal antibody that selectively inhibits IL-17A.ObjectivesThe aims of this interim analysis are to describe selected baseline (BL) demographics and to evaluate secukinumab treatment outcomes on disease activity and impact of disease on health and to report safety profile depending on the BMI of PsA pts.MethodsAQUILA is an ongoing, multi-center study including up to 3000 pts with active PsA or ankylosing spondylitis. Pts were observed from BL up to week (w) 52. Real-world data were assessed prospectively and analyzed as observed. Data were collected on Psoriatic Arthritis Impact of Disease-12 items (PsAID-12 score) and Patient’s Global Assessment (PGA). For calculation of proportion of pts that experienced (serious) adverse events ((S)AEs), all PsA pts were included that received at least one dose of secukinumab. This interim analysis focuses on BMI subgroups ≤25 kg/m2 (normal weight), &gt;25 to ≤30 kg/m2 (overweight) and &gt;30 kg/m2 (obese) in PsA pts.ResultsAt BL, BMI data were available for 1228 PsA pts: 26.5% (n=325) normal weight, 35.0% (n=430) overweight and 38.5% (n=473) obese PsA pts. Proportion of men was lower in normal weight and obese PsA pts. As BMI increased, so did age and comorbidities/extraarticular manifestations (EAMs; Table 1); e.g. percentage of PsA pts with heart-related disease increased from 5.2% in normal weight to 9.3% in obese PsA pts.Table 1.Overview of baseline characteristics in PsA pts depending on BMIDemographicsBMI ≤25 kg/m2(N=325)BMI &gt;25 to ≤30 kg/m2(N=430)BMI &gt;30 kg/m2(N=473)Male*105 (32.3)219 (50.9)188 (39.7)Age, years**49.5 (±12.7)53.2 (±11.0)54.1 (±10.6)PsAID**4.7 (2.4)4.9 (2.2)5.4 (2.0)PGA**4.8 (2.6)5.4 (2.4)5.5 (2.4)Comorbidities/EAMs* Heart-related disease17 (5.2)29 (6.7)44 (9.3) Coronary heart disease10 (3.1)25 (5.8)35 (7.4) Stroke1 (0.3)9 (2.1)11 (2.3) Heart insufficiency9 (2.8)15 (3.5)15 (3.2) Uveitis5 (1.5)6 (1.4)10 (2.1) Depression137 (53.5)190 (55.2)231 (58.5)*variables are given as n (%); **variables given as mean (SD)Mean PsAID at BL was similar for all BMI subgroups (≤25: 4.7; &gt;25-≤30: 4.9; &gt;30: 5.4; Figure 1A). Mean improvement from BL to w52 was 1.9 (40.4%) for normal weight, 1.8 (36.7%) for overweight, and 1.7 (31.5%) for obese PsA pts.Figure 1.Impact of disease and PGA in PsA pts stratified by BMI.Note: p-values are of exploratory nature. Wilcoxon tests were used to show significant subroup differences.Mean PGA developed in a similar way over time with lowest scores for normal weight and highest scores for obese PsA pts (Figure 1B). Mean improvement from BL to w52 was 2.0 (41.6%) for normal weight, 2.2 (40.7%) for overweight, and 1.8 (32.7%) for obese PsA pts.The occurrence of AEs/SAEs with or without suspected relationship to secukinumab was most frequent in overweight and obese PsA pts. For example, the percentage of SAEs in normal weight PsA pts was 21.6%, in overweight 26.3% and in obese 25.9%. There were no unexpected safety signals in either subgroup. One male obese PsA patient died. Cause of death was not reported, however, treating physician did not suspect a causal relationship to secukinumab.ConclusionIn a real-world setting, secukinumab improved impact of disease and patient´s global assessment of disease activity in all BMI subgroups of PsA pts. However, normal weight PsA pts had numerically better PsAID and PGA scores than obese PsA pts. Altogether, real-world data of this interim analysis show that secukinumab is an effective treatment with a favorable safety profile up to 52 weeks in PsA pts in all BMI subgroups.

Prevalence of Obesity in Patients with Dysphonia

To investigate the prevalence of obesity in patients with dysphonia and the association between Body Mass Index (BMI) and the Voice Handicap Index-10 (VHI-10). This is a retrospective study that included 304 patients who visited the senior author's Otolaryngology practice between the years 2018 and 2020. Patients were divided into two groups, those presenting for dysphonia and those presenting for other otolaryngologic complaints (Controls). Patients were also stratified as Normal weight (BMI < 25 kg/m2) vs. Overweight (BMI between 25-30 kg/m2), vs. Obese (BMI ≥ 25 kg/m2). The VHI-10 was used as a subjective outcome measure reported by patients with dysphonia. A total of 304 patients included in this study, 203 presenting with dysphonia and 101 with other otolaryngologic complaint. Within the dysphonia group, a significantly higher percentage of patients had a BMI ≥ 25 (70.4%) as compared to the control group (57.4%). The odds ratio were 1.76, meaning that obese patients were 1.76 times more likely to present with dysphonia. There was a weak negative correlation between overweight, obesity, and VHI-10 scores (r=-0.007 and r=-0.039, respectively). There was a significantly higher prevalence of overweight and obesity in patients with dysphonia vs. patients with no dysphonia. Although there was a weak correlation between BMI and VHI, our results demonstrate that overweight and obese patients are more likely to have dysphonia.

Prevalence of obesity and its association with cardiometabolic risk factors, heart failure phenotype and mortality among patients hospitalized for heart failure in Egypt

BackgroundObesity is an established risk factor for cardiometabolic disease and heart failure (HF). Nevertheless, the relationship between obesity and HF mortality remains controversial.ResultsThe goal of this study was to describe the prevalence of obesity in patients hospitalized for HF in Egypt and investigate the relationship of obesity to cardiometabolic risk factors, HF phenotype and mortality. Between 2011 and 2014, 1661 patients hospitalized for HF across Egypt were enrolled as part of the European Society of Cardiology HF Long-term Registry. Obese patients, defined by a BMI ≥ 30 kg/m2, were compared to non-obese patients. Factors associated with mortality on univariate analysis were entered into a logistic regression model to identify whether obesity was an independent predictor of mortality during hospitalization and at one-year follow-up. The prevalence of obesity was 46.5% and was higher in females compared to males. Obese as compared to non-obese patients had a higher prevalence of diabetes mellitus (47.0% vs 40.2%, p = 0.031), hypertension (51.3% vs 33.0%, p < 0.001) and history of myocardial infarction (69.2% vs 62.8% p = 0.005). Obese patients as compared to non-obese patient were more likely to have acute coronary syndrome on admission (24.8% vs 14.2%, p <  < 0.001). The dominant HF phenotype in obese and non-obese patients was HF with reduced ejection fraction (EF); however, obese patients as compared to non-obese patient had higher prevalence of HF with preserved EF (22.3% vs 12.4%, p < 0.001). Multivariable analysis demonstrated that obesity was associated with an independent survival benefit during hospitalization, (OR for mortality 0.52 [95% CI 0.29–0.92]). Every point increase in BMI was associated with an OR = 0.93 [95% CI 0.89–0.98] for mortality during hospitalization. The survival benefit was not maintained at one-year follow-up.ConclusionsObesity was highly prevalent among the study cohort and was associated with higher prevalence of cardiometabolic risk factors as compared to non-obese patients. Obesity was associated with an independent “protective effect” from in-hospital mortality but was not a predictor of mortality at 1-year follow-up.

Prevalence of obesity in patients with breast cancer followed-up at an oncology service in Goiania

Objective: To verify the prevalence of obesity in patients undergoing cancer follow-up at Hospital das Clínicas in Universidade Federal de Goiás, analyzing the epidemiological and laboratory profile. Methods: Retrospective, analytical and observational study. The final sample consisted of 498 medical records of patients under regular follow-up with indication for chemotherapy between June 2018 and 2020. Anthropometric data, gestational history, personal and family history, menopausal status, comorbidities, staging, and laboratory tests were observed. Results: A mean body mass index of 28.3 kg/m² was found among the patients, and 26.51% were obese. Mean age at diagnosis was 52.79 years, and 51.81% were in menopause. Also, 26.23% had a personal history of breast cancer, and 44.76% had family history. Regarding comorbidities, 51.15% had them, being the most frequent one systemic arterial hypertension, more prevalent in the obese group compared to the normal body mass index. Also, 11.96% of the patients were nulliparous. Regarding staging, most were in T2N0M0 at diagnosis. In laboratory tests, it was found that among patients with breast cancer who had information on lipid profile, low-density lipoprotein and total cholesterol were above the reference limit. Conclusion: 57.63% were obese or overweight, demonstrating body mass index as a risk factor for breast cancer. It was observed that the group of patients with obesity had a statistically significant relationship with the presence of concomitant comorbidities; however, no statistically significant results were found regarding the relationship between body mass index and menopausal status.

Коморбідність у хворих на бронхіальну астму та ризики тяжкого перебігу COVID-19

Absract. Coronavirus disease (COVID-19) affects people of all ages and ethnic groups, men and women, and can lead to serious conditions such as pneumonia, acute respiratory distress syndrome, multiple organ failure, and even death. Patients with bronchial asthma (BA) do not have an increased risk of infection, severe COVID-19, and no increased risk of COVID-19 –related death in patients with well-controlled mild to moderate asthma. In the general population, in patients with comorbidities (diabetes mellitus, cardiovascular disease, chronic obstructive pulmonary disease (COPD), kidney disease, malignancy, obesity), COVID-19 has a more rapid progression and severe course. The aim of this study was to study the characteristics of concomitant diseases in patients with ВА as risk factors for COVID-19 according to literature sources. Patients with asthma have a higher incidence of comorbidities than the general population. In patients with asthma, the risk of detecting type I diabetes mellitus increases by 41 % compared with people without asthma, and type II diabetes, according to various estimates, from 21 to 37 %. The presence of asthma increases the risk of cardiovascular disease by 1.33 times, the presence of asthma also increases the risk of developing hypertension by 66 %, and the combination of asthma and hypertension can reach 75 % in patients with severe asthma. Up to 26 % of asthma patients have co-existing COPD. Adults with asthma have a 75 % higher risk of developing cancer compared to those without asthma. Patients with asthma may have an increased risk of developing chronic kidney disease — 6.26 % compared with 3.91 % in healthy individuals. The prevalence of obesity in patients with asthma ranges from 21.3 to 32.8 %, and in patients with severe asthma — 60 %. In general, the frequency of comorbid diseases in asthma can be 89 %, so the diagnosis of ВА does not exclude a high risk of severe COVID-19 in asthma patients with comorbidities. Appropriate intake of prescribed basic therapy, especially inhaled corticosteroids, along with treatment of comorbid conditions, is recommended for all asthma patients during the COVID-19 pandemic. Key words: bronchial asthma, comorbidity, COVID-19.

Sacroiliac joint dysfunction is one of an important cause of low back pain

Objective: This prospective study about importance to consider Sacroiliac joint ( SIJ ) dysfunction as one of important cause of low back pain and estimation the occurrence of SIJ dysfunction in low back pain.Background: The SIJ is formed by the articular surfaces between the sacral and iliac bones.The joint dysfunction with slightly joint subluxation, which are majority of SIJ disorders. Establishing the diagnosis of SIJ pain are difficult because history, clinical examination and imaging studies are not helpful in confirming the diagnosis. Patient and Method: fifty patients participated through eighteen months period from October 2017 to March 2019 estimated occurrence SIJ dysfunction in low back pain below L5 group Patients with low back pain and have three or more positive provocative SIJ tests on physical examination these patients candidate diagnostic injection of local lidocaine into the SIJ, patient pain improve more than 70% in his or her pain within 30 to 60 minutes and diagnosis of SIJD confirmed.Results:Our prospective study included fifty patients, the 20% of LBP group have SIJ dysfunction, more prevalence in obese patients, among female gender.SIJ dysfunction more common on left side 70%, right side in 30%.Conclusion:Sacroiliac joint dysfunction remarkably missed underestimated cause of low back pain.The prevalence of SIJ dysfunction are15% to 30% of LBP in many studies.High suspicion and accurately diagnosis required of SIJ dysfunction to be cost effective in management of patients with low back pain and avoid unnecessary lumbosacral spine surgical interventions and decrease failed back surgery syndrome (FBSS) incidence.

Nutritional Status, Selected Nutrients Intake and Their Relationship with the Concentration of Ghrelin and Adiponectin in Patients with Diabetic Nephropathy.

Background: Overnutrition is one of the risk factors of chronic kidney disease (CKD). The factors related to both obesity and CKD are adiponectin and ghrelin. The aim of the study was to assess if there is a link of nutritional status and selected nutrients intake with adiponectin and ghrelin in patients with diabetic nephropathy (DN). Methods: The study involved 55 patients diagnosed with DN in the pre-dialysis period (two groups: GFR < 30 and >30 mL/min/1.73 m2). In all participants standard blood tests, total ghrelin and total adiponectin plasma concentrations and anthropometric measurements (BMI, WHR- waist–hip ratio, body composition analysis) were performed. The evaluation of energy and nutrient intakes was made using the three-day food record method. Results: Excessive body weight was found in 92.80% patients. The average daily energy intake was 1979.67 kcal/day (14.45% protein energy, 28.86% fat, and carbohydrates 56.89%). In the group with eGFR < 30 mL/min/1.73 m2 the analysis showed a negative relationship between ghrelin and WHR value, and the creatine and albumin concentrations. There was a positive correlation between ghrelin concentration and the consumption of carbohydrates and sucrose. In the group of patients with eGFR > 30 mL/min/1.73 m2, a positive correlation was found between the concentration of ghrelin and the consumption of vegetable protein, carbohydrates, and glucose. Conclusions: The study confirms the high prevalence of obesity in patients with DN-Excessive supply of protein was found in the patients’ diets, which may contribute to the deterioration of the course of the disease and its prognosis. In patients with eGFR < 30 there was a negative correlation between ghrelin concentration and nutritional status, and in patents with eGFR > 30 between ghrelin concentration and some nutrients intake.

Obesity in cystic fibrosis

The prevalence of obesity in patients with cystic fibrosis (CF) is increasing and around one-third of adults with CF are now overweight or obese. The causes of excess weight gain in CF are likely multifactorial, including: adherence to the high-fat legacy diet, reduced exercise tolerance, therapeutic advances, and general population trends. Increased weight has generally been considered favorable in CF, correlating with improved pulmonary function and survival. While the optimal BMI for overall health in CF is unknown, most studies demonstrate minimal improvement in pulmonary function when BMI exceeds 30 kg/m2. Dyslipidemia and cardiovascular disease are important co-morbidities of obesity in the general population, but are uncommon in CF. In people with CF, obesity is associated with hypertension and higher cholesterol levels. With longer life expectancy and rising obesity rates, there may be an increase in cardiovascular disease among people with CF in coming years. Overweight CF patients are more likely to be insulin resistant, taking on features of type 2 diabetes. Treating obesity in people with CF requires carefully weighing the metabolic risks of overnutrition with the impact of low or falling BMI on lung function. This article describes current knowledge on the epidemiology, causes, consequence, and treatment of obesity in people with CF.

Obesity and the Latissimus Dorsi Flap: A Radiologic Study.

Introduction: The increasing prevalence of obesity in patients with breast cancer has prompted a reappraisal of the role of the latissimus dorsi flap (LDF) in breast reconstruction. Although the reliability of this flap in obese patients is well-documented, it is unclear whether sufficient volume can be achieved through a purely autologous reconstruction (eg, extended harvest of the subfascial fat layer). Additionally, the traditional combined autologous and prosthetic approach (LDF + expander/implant) is subject to increased implant-related complication rates related to flap thickness in obese patients. The purpose of this study is to provide data on the thicknesses of the various components of the latissimus flap and discuss the implications for breast reconstruction in patients with increasing body mass index (BMI). Methods: Measurements of back thickness in the usual donor site area of an LDF were obtained in 518 patients undergoing prone computed tomography-guided lung biopsies. Thicknesses of the soft tissue overall and of individual layers (e.g., muscle, subfascial fat) were obtained. Patient, demographics including age, gender, and BMI were obtained. Results: A range of BMI from 15.7 to 65.7 was observed. In females, total back thickness (skin, fat, muscle) ranged from 0.6 to 9.4 cm. Every 1-point increase in BMI resulted in an increase of flap thickness by 1.11 mm (adjusted R2 of 0.682, P < .001) and an increase in the thickness of the subfascial fat layer by 0.513 mm (adjusted R2 of 0.553, P < .001). Mean total thicknesses for each weight category were 1.0, 1.7, 2.4, 3.0, 3.6, and 4.5 cm in underweight, normal weight, overweight, and class I, II, III obese individuals, respectively. The average contribution of the subfascial fat layer to flap thickness was 8.2 mm (32%) overall and 3.4 mm (21%), 6.7 mm (29%), 9.0 mm (30%), 11.1 mm (32%), and 15.6 mm (35%) in normal weight, overweight, class I, II, III obese individuals, respectively. Conclusion: The above findings demonstrate that the thickness of the LDF overall and of the subfascial layer closely correlated with BMI. The contribution of the subfascial layer to overall flap thickness tends to increase as a percentage of overall flap thickness with increasing BMI, which is favourable for extended LDF harvests. Because this layer cannot be separated from overall thickness on examination, these results are useful in estimating the amount of additional volume obtained from an extended latissimus harvest technique.

Evaluation of Nutritional Risk and Prevalence of Obesity in Patients with Covid-19 in A Reference Hospital in Salvador, Bahia, Brazil: A Cross-Sectional Study

AbstractIntroduction The Coronavirus has spread to almost every country in the world, causing the coronavirus disease (COVID-19). The coronavirus stands out among the other infections especially by it's high contagious power and important effects on the respiratory system. The COVID-19 has differents ways of presentation and these are influenced by the patient's previous nutricional status, correlated with the patient's lifestyle and comorbities.Objective this survey seeks to analyze the nutritional status and the prevalence of obesity in patients hospitalized with SARS-CoV-2. Methods: this is a descriptive, prospective and cross-sectional study type, which 41 patients affected by COVID-19 were interviewed. Patient's weight and height were used to assess the BMI, and nutritional risk assessment was performed using the Nutritional Risk Screening tool (NRS 2002). For the analysis, Absolute (AF) and Relative Frequency (RF), the mean and the standard deviation were calculated.Results It was observerd that 78% of the participants had a high nutritional risk, while only 22% had a low nutritional risk. Besides that, 34% showed overweight and 41.4% showed obesity.Conclusion the existence of a high prevalence of increased nutritional risk was evidenced, in addition to the high frequency of overweight in patients affected by SARS-CoV-2.

Prevalence of Obesity and Its Impact on Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis.

Background and ObjectiveObesity has been reported as a risk factor for adverse outcomes in COVID-19. However, available studies presenting data on obesity prevalence in patients with COVID-19 have conflicting results. The objective of this systematic review and meta-analysis is to evaluate the prevalence of obesity in these patients and to stratify the estimates by illness severity.MethodsWe performed a literature search with the use of Medline/PubMed and Google Scholar database from December 1, 2019 to June 27, 2020 and systematically reviewed studies reporting the number of obese patients with real-time reverse transcriptase polymerase chain reaction (rRT-PCR)-confirmed SARS-CoV-2 infection.ResultsNineteen studies were identified. The pooled obesity prevalence rates were 0.32 (95% CI: 0.24–0.41) in hospitalized patients, 0.41 (95% CI: 0.36–0.45) in patients admitted to intensive care unit, 0.43 (95% CI: 0.36–0.51) in patients needing invasive mechanic ventilation (IMV), and 0.33 (95% CI: 0.26–0.41) in those who died. Obesity was associated with a higher risk for hospitalization [Odds ratio (OR): 1.3, 95% CI: 1.00–1.69; I2 52%, p = 0.05], ICU admission (OR: 1.51, 95% CI: 1.16–1.97; I2 72%, p = 0.002), and IMV requirement (OR: 1.77, 95% CI: 1.34–2.35; I2 0%, p < 0.001). The increase in risk of death did not reach statistical significance (OR: 1.28, 95% CI: 0.76–2.16, p = 0.35) which might be due to obesity survival paradox and/or unidentified factors.ConclusionsOur data indicate that obese subjects may be at higher risk for serious illness if infected and obesity may play a role in the progression of COVID-19.