Body Mass Index Range Research Articles

Detection of The Lower Limb Asymmetries and Discomfort Considering Foot Pressure as an Attribute

A greater number of diseases and chronic conditions are making their presence since more than a decade. It has really taken its toll during the COVID-19 period. Our concern is totally the lower part of our body which includes the hip portion along with upper thigh, knees, lower limbs and ankles. Some diseases which we have surveyed has been taking place as such are Achilles’s tendonitis, arthritis in the ankle or ankles, bunions, hammertoes, plantar pressure diseases, et cetera. There are also a lot of conditions associated with lower limb muscles such as irregular muscle toning, muscle stressing, fatigue, et cetera which takes place in individuals of almost all kinds of ages. In order to nullify these conditions, we have decided to concentrate on various foot pressure points in our body. We will be analyzing the positions and intensity of these pressure points and conclude our experiment by chalking out a graphical representation of all the data accumulated with the help of certain equipment. We will be asking the subject by giving instructions to place his or her feet on the multiple sensors insole normally (with no extra pressure from the subject’s side). Each sole sensor will send analog input data as the values of the applied foot pressure. Voltage outputs are collected from each input sensor. We will then compare the different output from different sensors with predetermined standard data (collecting from those who have normal Body Mass Index range). The comparative graph of the current subject and the standard data will then be able to help us to analyze where the disease condition is taking place. Key Words: Foot pathology, foot pressure points, lower-limb asymmetry, sole sensor, body mass index range.

Prevalence of pelvic floor dysfunction among women with polycystic ovarian syndrome: a case-control study

BackgroundPelvic floor dysfunction (PFD) is a wide term, involving a large array of conditions that negatively impact many women around the world. Polycystic ovarian syndrome (PCOS) is another disorder with long-term serious consequences. Being a disease of hormonal imbalances, PCOS may possibly affect the function of the pelvic floor muscles leading to PFD. Thus, the current study aimed to explore the prevalence of PFD among women with PCOS.MethodsThis is an observational, case-control study. A total of 368 women, aged from 20 to 35 years, with a body mass index (BMI) range of 20 to 30 kg/m2 recruited from Kasr El-Ainy teaching hospital shared in the study. They were classified into case group (PCOS patients; n=184) and control group (non-PCOS participants; n=184), with matched age and BMI for comparison. All case-group women were diagnosed with PCOS, based on Rotterdam diagnostic criteria, while the control group women had regular menstrual cycles. Pelvic Floor Distress Inventory-20 (PFDI-20) was used to identify PFD in the tested groups. The demographic features of the two groups were compared using the unpaired t test, while the chi-squared test was used to determine the prevalence of PFD among women with PCOS. Also, multiple linear regression was done to asses other PFD risk factors in both groups.ResultsOut of 380 women, 368 were involved in the study with mean ± standard deviation (SD) for the age and BMI of 28.48±4.87 years and 25.9±5.8 kg/m2, respectively, for the control group, and 28.76±5.33 years and 27±6.1 kg/m2, respectively, for the PCOS group, without a significant difference in either of the age and BMI between groups (P > 0.05). The frequency distribution of women with and without PFD in both groups revealed that the PCOS group included 68 (37%) women with PFD. While the control group included 12 (6%) women with PFD, with a significant difference (P=0. 03) in the prevalence between both groups. Also, multiple regression revealed that PCOS condition significantly affected PFD.ConclusionPFD was prevalent among women with PCOS, compared to the control group, suggesting a possible link between both conditions.

Effect of Body Mass Index on Early Outcomes of Endovascular Abdominal Aortic Aneurysm Repair

This study compares the presentation, management, and outcomes of patients undergoing endovascular abdominal aortic aneurysm repair (EVAR), based on their weight status as defined by their body mass index (BMI). Patients with primary EVAR for ruptured and intact abdominal aortic aneurysm (AAA) were identified in the National Surgical Quality Improvement Program database (2016-2019). Patients were categorized by weight status (underweight: BMI < 18.5kg/m2, normal weight: 18.5-24.9kg/m2, overweight: 25-29.9kg/m2, Obese I: 30-34.9kg/m2, Obese II: 35-39.9kg/m2, Obese III: > 40kg/m2). Preoperative characteristics and 30-day outcomes were compared. Of 3,941 patients, 4.8% were underweight, 24.1% normal weight, 37.6% overweight, and 22.5% with Obese I, 7.8% Obese II, and 3.3% Obese III status. Underweight patients presented with larger (6.0 [5.4-7.2] cm) and more frequently ruptured (25.0%) aneurysms than normal weight patients (5.5 [5.1-6.2] cm and 4.3%, P<0.001 for both). Pooled 30-day mortality was worse for underweight (8.5%) compared to all other weight status (1.1-3.0%, P<0.001), but risk-adjusted analysis demonstrated that aneurysm rupture (odds ratio [OR] 15.9, 95% confidence interval [CI] 8.98-28.0) and not underweight status (OR 1.75, 95% CI 0.73-4.18) accounted for increased mortality in this population. Obese III status was associated with prolonged operative time and respiratory complications after ruptured AAA, but not 30-day mortality (OR 0.82, 95% CI 0.25-2.62). Patients at either extreme of the BMI range had the worst outcomes after EVAR. Underweight patients represented only 4.8% of all EVARs, but 21% of mortalities, largely attributed to higher incidence of ruptured AAA at presentation. Severe obesity, on the other hand, was associated with prolonged operative time and respiratory complications after EVAR for ruptured AAA. BMI, as an independent factor, was however not predictive of mortality for EVAR.

Relationship between perceived and structural leg length discrepancies of patients with hip osteoarthritis dysplasia

BackgroundOnly few studies have been conducted on leg length discrepancy (LLD) in patients with hip osteoarthritis (OA). This study aimed to examine the relationship between perceived LLD (pLLD) and structural LLD (sLLD) in patients with advanced OA and to determine the factors influencing both LLDs. This retrospective study aimed to answer the following questions: (1) are older adults less likely to perceive LLD than younger adults? (2) is there a relationship between pLLD and sLLD? and (3) is pLLD associated with patient satisfaction? HypothesisWe hypothesized that older adults are less likely to perceive LLD than younger adults. Patients and methodsWe recruited 125 patients (102 women and 23 men) with hip OA associated with developmental dysplasia of the hip defined as grade 3 or higher according to the Tönnis classification and excluding contralateral grade 2 or higher. The mean age of the patients was 65.2±11.2 (36–85) years. Before surgery, 2-mm and 5-mm thick plates were placed on the floor on the plantar surface of the short leg to measure pLLD. Preoperative computed tomography (CT) was performed and sLLDs were measured using the 3D planning software ZedHip. The following associated factors were evaluated: age, height, weight, body mass index (BMI), adduction and abduction range of motion (ROM) of the affected hip joint, Crowe classification, standing pelvic inclination in the coronal plane, Cobb angle and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). ResultsThe absolute difference between pLLD and sLLD was modestly positively correlated with age (R=0.206; p<0.05) indicating older patients were less prone to perceive LLD. A strong positive correlation was found between pLLD (4.8±7.3mm; range: -37 to 28mm) and sLLD (6.4±7.0mm; range: -29.9 to 23.7mm) (R=0.714, p<0.05). The greater the pLLD, the smaller the hip abduction ROM (24.8±11.6°; range: 0 to 45°) tended to be, while the greater the sLLD, the smaller the hip abduction and adduction ROM (10.3±5.7°; range: 0 to 25°) tended to be (R= -0.259 and R= -0.297, respectively; p<0.05) The clinical significance of this finding is that pLLD may be improved if hip ROM training is performed before surgery. pLLD was significantly smaller in the group without pelvic inclination (8.0±14.1mm; range: -37 to 22mm) than in the group with pelvic inclination to the affected side (6.9±7.5mm; range: -12 to 28mm) and in the group with no inclination to the affected side (7.3±7.6mm; range: -8 to 25mm) (p<0.05) The clinical significance of this finding is that improving pelvic inclination with hip ROM training or muscle stretching may also reduce pLLD. No significant differences were noted between pLLD and JHEQ total scores or subgroups. DiscussionOlder patients had less pLLD. Preoperative pLLD was strongly correlated with sLLD but not with patient satisfaction. These results may be useful for conservative treatment of OA, preoperative planning and intraoperative leg length correction. Level of evidenceIV; case control study.

The reference value of anti-Müllerian hormone to diagnose polycystic ovary syndrome is inversely associated with BMI: a retrospective study

BackgroundThis study aimed to evaluate the cut-off value of anti-Müllerian hormone (AMH) combined with body mass index (BMI) in the diagnosis of polycystic ovary syndrome (PCOS) and polycystic ovary morphology (PCOM).MethodsThis retrospective study included 15,970 patients: 3775 women with PCOS, 2879 women with PCOM, and 9316 patients as controls. Multivariate logistic regression analysis was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for AMH. We randomly divided the patients into two data sets. In dataset 1, a receiver operating characteristic (ROC) curve was generated to analyze the accuracy of basic AMH levels in diagnosing PCOS and PCOM. The optimal cut-off value was calculated in dataset 1 and validated in dataset 2, expressed as sensitivity and specificity.ResultsIn the PCOS group, obese patients had the lowest AMH levels, while underweight patients had the highest AMH level (P < 0.001). After adjusting for age, the ratio of luteinizing hormone (LH) and follicle stimulating hormone (FSH), serum testosterone level, and BMI, AMH was an independent predictor of PCOS and PCOM. In the group with BMI < 18.5 kg/m2, the optimistic AMH cut-off value was 5.145 ng/mL with a sensitivity of 84.3% and specificity of 89.1%, whereas in the BMI ≥ 28 kg/m2 group, the optimistic AMH cut-off value was 3.165 ng/mL with a sensitivity of 88.7% and specificity of 74.6%. For the BMI range categories of 18.5–24, 24.0–28 kg/m2, the optimistic AMH cut-off values were 4.345 ng/mL and 4.115 ng/mL, respectively. The tendency that the group with lower weight corresponded to higher AMH cut-off values was also applicable to PCOM. In the same BMI category, patients with PCOM had a lower AMH diagnosis threshold than those with PCOS (< 18.5 kg/m2, 5.145 vs. 4.3 ng/mL; 18.5–24 kg/m2, 4.345 vs. 3.635 ng/mL; 24.0–28 kg/m2, 4.115 vs. 3.73 ng/mL; ≥ 28 kg /m2, 3.165 vs. 3.155 ng/mL). These cut-off values had a good diagnostic efficacy in the validation dataset. Based on different phenotypes and severity of ovulation disorders, the distribution of AMH in PCOS were also significantly different (P < 0.001).ConclusionsAMH is a potential diagnostic indicator of PCOS and is adversely associated with BMI. The AMH cut-off value for diagnosing PCOS was significantly higher than that for PCOM.

Visceral Adipose Tissue Bioenergetics Varies According to Individuals' Obesity Class.

Obesity is associated with complex adipose tissue energy metabolism remodeling. Whether AT metabolic reprogramming differs according to body mass index (BMI) and across different obesity classes is unknown. This study’s purpose was to evaluate and compare bioenergetics and energy substrate preference of visceral adipose tissue (VAT) pertaining to individuals with obesity class 2 and class 3. VAT obtained from patients with obesity (n = 15) class 2 (n = 7; BMI 37.53 ± 0.58 kg/m2) or class 3 (n = 8; BMI 47.79 ± 1.52 kg/m2) was used to assess oxygen consumption rate (OCR) bioenergetics and mitochondrial substrate preferences. VAT of patients with obesity class 3 presented significantly higher non-mitochondrial oxygen consumption (p < 0.05). In VAT of patients with obesity class 2, inhibition of pyruvate and glutamine metabolism significantly decreased maximal respiration and spare respiratory capacity (p < 0.05), while pyruvate and fatty acid metabolism inhibition, which renders glutamine the only available substrate, increased the proton leak with a protective role against oxidative stress (p < 0.05). In conclusion, VAT bioenergetics of patients with obesity class 2 depicts a greater dependence on glucose/pyruvate and glutamine metabolism, suggesting that patients within this BMI range are more likely to be responsive to interventions based on energetic substrate modulation for obesity treatment.

Cardiopulmonary Fitness of Preschoolers with Congenital Heart Disease: An Observational Study.

With advancements in cardiopulmonary rehabilitation over the past few decades, the survival rate of patients with congenital heart disease (CHD) has increased. However, the Cardiopulmonary fitness (CPF) of these patients is poor. Here, we aimed to investigate CPF in preschoolers with CHD (aged 4 to 6 years) using cardiopulmonary exercise testing. We retrospectively compared 102 healthy preschoolers with 80 preschoolers with CHD. The latter had lower peak oxygen consumption, oxygen consumption at anaerobic threshold and metabolic equivalent at anaerobic threshold. The same result was observed in boys with CHD, but not in girls, when sex was sub-analyzed. Considering the body composition, children with CHD had a lower fat-free mass index (FFMI) than their healthy peers. Healthy preschoolers with a normal body mass index (BMI) had higher anaerobic threshold and peak metabolic equivalent values than overweight or underweight children. This was categorized under the BMI reference of the Ministry of Health and Welfare in Taiwan. In conclusion, the CPF difference between the CHD and healthy groups was identified as early as in preschool age, and better CPF in healthy preschoolers within the normal BMI range suggests the importance of weight control in young children.

Classic and 11-oxygenated androgens in serum and saliva across adulthood: a cross-sectional study analyzing the impact of age, body mass index, and diurnal and menstrual cycle variation.

11-oxygenated androgens significantly contribute to the circulating androgen pool. Understanding the physiological variation of 11-oxygenated androgens and their determinants is essential for clinical interpretation, for example, in androgen excess conditions. We quantified classic and 11-oxygenated androgens in serum and saliva across the adult age and body mass index (BMI) range, also analyzing diurnal and menstrual cycle-dependent variation. Cross-sectional. Morning serum samples were collected from 290 healthy volunteers (125 men, 22-95 years; 165 women, 21-91 years). Morning saliva samples were collected by a sub-group (51 women and 32 men). Diurnal saliva profiles were collected by 13 men. Twelve women collected diurnal saliva profiles and morning saliva samples on 7 consecutive days during both follicular and luteal menstrual cycle phases. Serum and salivary steroids were quantified by liquid chromatography-tandem mass spectrometry profiling assays. Serum classic androgens decreased with age-adjusted BMI, for example, %change kg/m2 for 5α-dihydrotestosterone: men -5.54% (95% confidence interval (CI) -8.10 to -2.98) and women -1.62% (95%CI -3.16 to -0.08). By contrast, 11-oxygenated androgens increased with BMI, for example, %change kg/m2 for 11-ketotestosterone: men 3.05% (95%CI 0.08-6.03) and women 1.68% (95%CI -0.44 to 3.79). Conversely, classic androgens decreased with age in both men and women, while 11-oxygenated androgens did not. Salivary androgens showed a diurnal pattern in men and in the follicular phase in women; in the luteal phase, only 11-oxygenated androgens showed diurnal variation. Classic androgens decrease while active 11-oxygenated androgens increase with increasing BMI, pointing toward the importance of adipose tissue mass for the activation of 11-oxygenated androgens. Classic but not 11-oxygenated androgens decline with age.

Variability of oral/taste sensitivity to fat: An investigation of attribution from detection threshold methods with repeated measurements

Accumulating psychophysical evidence suggests substantial individual variability in oral/taste sensitivity to non-esterified, long-chain fatty acids (NEFA), which is commonly referred to as fat taste or oleogustus. Recent studies have sought to determine its associations with human factors such as body mass index (BMI) and food preferences, as it has been claimed that excessive fat consumption is related to several health conditions, including obesity. Yet, the findings are controversial. On the other hand, it has been noted that considerable variability also occurs based on the methodology used to measure the fatty acid taste. Specifically, learning effects have been observed over repeated measurements of the detection threshold of NEFA, yet there has been no methodology available to take into account these learning effects. Accordingly, in the present study, a novel methodology using a descending-block dual reminder A-Not A (DR A-Not A) method with a warm-up has been proposed to measure the NEFA detection threshold based on the signal detection theory and considering NEFA taste learning effects over repeated sessions. Homogeneous subjects (young adult Korean females within the normal BMI range, non-vegetarians) were randomized to either the novel descending-block DR A-Not A method or ascending triangle method that is commonly used for fat perception studies. Pure oleic acid emulsions were used as fat taste stimuli to be discriminated from pure mineral water. Each subject completed 14 repeated visits. For the ascending triangle method, 14 thresholds were determined using a stopping rule, while for the novel method, 7 thresholds were determined each per two consecutive days, using a criterion of a lower limit of 50% confidence interval of d' = 0.5, considering the practical aspects of taste studies in food sensory science. Based on the group median results of the last two visits, the variability of the detection thresholds was reduced using the novel descending-block DR A-Not A method due to better learning effects over repeated sessions. This shows the potential of the descending-block DR A-Not A threshold method for further studies on oral/taste sensitivity to fat.

Standardization of Bindu Pramana for Nasya

ABSTRACT Introduction: Nasya (nasal administration of medication) is one of Dinacharya (daily regimen) mentioned by Acharyas. Two Bindu is considered the recommended dose of Pratimarsha Nasya (done as a part of daily regimen). Bindu is defined as the total quantity of liquid medicine that dribbles down when the first two digits of index finger (distal and middle phalanges) are dipped into it and taken out of the same. Considering the above definition of Bindu, it is evident that Bindu Pramana varies from person to person probably due to the variation in size of one’s index finger and also viscosity of the liquid used for Nasya. Materials and Methods: A total of 405 apparently healthy subjects with body mass index (BMI) between 18.5 and 24.9 kg/m2 coming under the age group of 18–60 years were selected. The subjects had to dip their index finger up to middle interphalangeal joint in Anu Taila, Tila Taila, and Sarshapa Taila one after the other. The whole amount of Taila (oil) that dripped down after dipping finger was collected in a watch glass and sucked into calibrated syringe for further calculations. Results: The Bindu Pramana for subjects with BMI range within 18.50–24.99 kg/m2 was found to be 0.55 ml (12.4 drops) for Tila Taila, 0.57 ml (12.4 drops) for Anu Taila, and 0.56 ml (11.8 drops) for Sarshapa Taila. Conclusion: This study of standardization of Bindu Pramana for Nasya concluded that Bindu Pramana for subjects with BMI range within 18.50–24.99 kg/m2 is 0.6 ml which is approximately 12 drops for all three Taila.

Technical Tips Following 850 Consecutive One Anastomosis Gastric Bypass (OAGB) Patients.

The surgical procedure One Anastomosis Gastric Bypass (OAGB) has become widely used worldwide. Since its inception, many modifications have been introduced to improve results. The primary aim of this study was to share the modifications that we have introduced to our OAGB technique after reflecting on the problems and complications we have faced during the evolution of this procedure in our unit. A total of 850 patients who underwent OAGB under the same surgical team at two different hospitals in the United Kingdom were displayed according to demography and comorbidities. All complications were reviewed and analysed to instigate the changes in our technique. There were 756 (89%) primary and 94 (11%) revisional procedures. There were 596 females (70.11%) and 254 males (29.89%) in our study group. The body mass index range was 32-84 and the mean was 45. The pre-operative weight range was 89-274 kg and the mean was 126.4 kg. With experience and reflecting on our complications we have modified our surgical approach, and these alterations have helped us to adopt OAGB as the mainstream bariatric procedure. We want to share our experience with the bariatric community for the benefit of patient care.

Hypothalamic volume is associated with body mass index

The hypothalamus is an important neuroendocrine hub for the control of appetite and satiety. In animal studies it has been established that hypothalamic lesioning or stimulation causes alteration to feeding behaviour and consequently body mass, and exposure to high calorie diets induces hypothalamic inflammation. These findings suggest that alterations in hypothalamic structure and function are both a cause and a consequence of changes to food intake. However, there is limited in vivo human data relating the hypothalamus to obesity or eating disorders, in part due to technical problems relating to its small size. Here, we used a novel automated segmentation algorithm to exploratorily investigate the relationship between hypothalamic volume, normalised to intracranial volume, and body mass index (BMI). The analysis was applied across four independent datasets comprising of young adults (total n = 1,351 participants) spanning a range of BMIs (13.3 – 47.8 kg/m2). We compared underweight (including individuals with anorexia nervosa), healthy weight, overweight and obese individuals in a series of complementary analyses.We report that overall hypothalamic volume is significantly larger in overweight and obese groups of young adults. This was also observed for a number of hypothalamic sub-regions. In the largest dataset (the HCP-Young Adult dataset (n = 1111)) there was a significant relationship between hypothalamic volume and BMI.We suggest that our findings of a positive relationship between hypothalamic volume and BMI is potentially consistent with hypothalamic inflammation as seen in animal models in response to high fat diet, although more research is needed to establish a causal relationship. Overall, we present novel, in vivo findings that link elevated BMI to altered hypothalamic structure. This has important implications for study of the neural mechanisms of obesity in humans.

Assessment of Relationship between Anthropometric Measurements and Reproductive Hormonal Profiles, Among Females of Childbearing Age at a Tertiary Health Facility in Nigeria

Background:Increasing prevalence of overweight and obesity has profound impacts on health generally, including the reproductive system. Traditionally, pear body shapes, from narrow waist and wide hip circumferences, have been associated with high fecundability among females. Although this has been scientifically demonstrated by a number of researches only a few of these investigations were conducted with black women in Africa who were of reproductive age.Objectives:The objectives of the study were to compare the mean reproductive hormone levels between the different waist-to-hip ratio (WHR) and body mass index (BMI) categories and also to determine the correlations between the two anthropometric measurements and the reproductive hormones in a black African population.Materials and Methods:It was an analytical cross-sectional study of 180 females of a childbearing age. The WHR and BMI were measured as per standard recommendations. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, day-21 progesterone, and testosterone were assayed.Results:A majority of the research participants were within the age group 21–30 years. Thirty three percent (33%) and 28.9% of participants were overweight and obese, respectively, using BMI compared with 26.7% and 20%, respectively, using WHR. Seventy six point nine percent (76.9%) of participants with an optimal BMI range ovulated with 61.5% having adequate luteal phase support compared with 75% and 54.2%, respectively, using WHR. Day-21 serum progesterone and serum estradiol were significantly negatively correlated with WHR and BMI (P&lt; 0.05). BMI, however, showed a better correlation than WHR (r = -0.535 vs. -0.397;P= 0.001 vs. 0.008, respectively). Gonadotropins were significantly lower among overweight and obese groups for both BMI and WHR (P&lt; 0.05), but only WHR showed moderately positive significant correlation with gonadotropins (LH: r = 0.050 vs. r = 0.215,P= 0.003, respectively; FSH: r = 0.159 vs. r = 0.431,P= 0.001, respectively), same as serum testosterone (r = 0.580 vs. r = 0.611,P= 0.002, respectively).Conclusions:Anthropometric measurements can serve as objective clues to functionality and optimal concentrations of reproductive hormones. Weight control should therefore aid the optimization of reproductive hormones and fertility among females of reproductive age.

A single night of moderate at-home sleep restriction increases hunger and food intake in overweight young adults

ObjectivesExperimental studies under laboratory conditions have shown a close link between acute sleep restriction and metabolic disorders. The aim of this study was to assess the effect of a single night of moderate sleep restriction implemented under ambulatory settings on sleep organization, food intake, blood pressure, and heart rate in overweight young adults. MethodsIn a non-randomized experimental study, we evaluated 15 young, overweight adults (mean age [± SEM] 20.8 ± 0.6 y) with a mean body mass index (BMI) 27.5 ± 6.2 kg/m2 (BMI range 18.9–36.6 kg/m2). Each participant was recorded at home during two successive nights under:1) Regular sleep routine (from 2330 to 0730 h, ‘night1’) and2) Restricted sleep (6 h in bed, from 0300 to 0900 h, "night2").Sleep was assessed by a non-invasive mobile system (Watch-PAT200) placed on the non-dominant wrist, measuring peripheral arterial tonometry. We measured sleep duration, rapid eye movement sleep (REM), light sleep (LS), deep sleep (DS), and waking. Starting 2 d before night1, four consecutive food records assessed daily food intake. Preceding and succeeding each night, hunger/satiety feelings (measured by self-reported visual analog scales), blood pressure, and heart rate were also evaluated. ResultsTotal sleep time was reduced in night2 (P = 0.007), with higher DS percentage (P = 0.03). Sleep onset and REM sleep latencies, LS time, and the number of wake episodes did not differ between nights. Energy intake was increased the day after night2 (P = 0.007), with increased fat and protein intakes (both P < 0.01) and feelings of hunger (P = 0.002). Systolic blood pressure was higher and heart rate faster in the morning after night2 (both P < 0.05). ConclusionsAn acute moderate at-home sleep restriction exacerbated food intake and feelings of hunger, and impaired blood pressure and heart rate regulation in young, overweight adults.

Left atrial epicardial adipose tissue exacerbates electrical conduction disturbance in normal-weight patients undergoing pulmonary vein isolation for atrial fibrillation.

Epicardial adipose tissue (EAT) exacerbates both electrical and structural remodeling in obese atrial fibrillation (AF) patients, but the impacts of EAT on atrial arrhythmogenicity remain unclear in normal-weight AF patients. Therefore, we sought to investigate this issue using electroanatomic mapping. We enrolled drug-refractory 105 paroxysmal AF patients in the normal body mass index range (18.5-24.9 kg/m2 ), who had undergone electroanatomic mapping after pulmonary vein isolation (PVI). One day before PVI, we assessed P-wave duration in a 12-lead electrocardiogram and left atrial (LA)-EAT volumes using contrast-enhanced computed tomography. The patients were divided into two groups based on the median LA-EAT volume (16.0 ml); the high LA-EAT group (≥16.0 ml, n = 53) and low LA-EAT group (<16.0 ml, n = 52). We compared P-wave duration, LA conduction velocity and bipolar voltage, the presence of low-voltage zone (<0.5 mV), and LA volume index on echocardiography between the two groups. The LA bipolar voltage, low-voltage zone, and LA volume index were not different between the high and low LA-EAT groups. However, P-wave duration was significantly longer in the high group than in the low group (p < .001). Additionally, the LA conduction velocity was significantly more depressed in the high group than in the low group (p < .001). Multivariate linear regression analysis revealed that LA-EAT volume was correlated with P-wave duration (β = .367, p < .001) and conduction velocity (β = -.566, p < .001), respectively. Increased LA-EAT volumes were associated with electrical conduction disturbance after PVI in normal-weight patients with AF. P-wave duration may be a clinically useful predictor of LA-EAT.

Inflammatory potential of diet and risk of mortality in normal-weight adults with central obesity

Inflammatory potential of diet may contribute to poor health outcomes in individuals with metabolic disorders. In a representative sample of the U.S. population, we investigated the association between consuming a pro-inflammatory diet and mortality risk in adults with normal range of body mass index (BMI) but with central obesity. This prospective cohort study included 3521 adults 20-90 years of age with normal BMI who participated in the National Health and Nutrition Examination Survey III, 1988-1994 and did not have a history of cardiovascular disease (CVD) or cancer and did not change their dietary intake in the year preceding baseline measurements. Mortality from all causes, CVD, and cancer was ascertained from the National Death Index. Normal-weight central obesity (NWCO, n=1777) was defined as those with BMI 18.5 to <25kg/m2 and waist-to-hip ratio (WHR) ≥0.85 in women and ≥0.90 in men. Severe central obesity was defined as WHR ≥0.92 in women and ≥1.00 in men. The dietary inflammatory index (DII®) was computed based on baseline dietary intake using 24-h dietary recalls, and associations with mortality were estimated using multivariable Cox proportional hazards regression. In individuals with NWCO, DII score (i.e., more pro-inflammatory diet) was associated with increased risk of CVD mortality (HRT3 vs T1, 1.89 [95% CI, 1.01-3.53], P trend=0.04; HR 1 SD increase 1.29 [95% CI, 1.06-1.57]). This association was stronger with more severe central obesity (HRT3 vs T1, 2.79 [95% CI, 1.10-7.03], P trend=0.03; HR 1 SD increase 1.52 [95% CI, 1.05-2.21]). DII score was not associated with increased risk of mortality in normal-weight individuals without central obesity or with risk of cancer mortality in either group. Among individuals in the normal-weight range of BMI, a pro-inflammatory diet assessed by high DII scores was associated with increased risk of CVD mortality in those with central obesity.

Bowel movement changes after laparoscopic cholecystectomy

Background &amp; objectives: Laparoscopic Cholecystectomy is the first choice of therapy in patients with symptomatic gallstone disease. This technique has been dramatically effective in decreasing the need for open cholecystectomy and its complications. However, not all patients are free from complications following cholecystectomy. This study was aimed at evaluating the prevalence of changes in bowel movement in patients undergoing laparoscopic cholecystectomy in a sample population in Erbil city. Methods: In this prospective clinical trial, 221 patients diagnosed with gallstone disease attended Rizgary Teaching hospital. The patients were screened clinically and by investigations for the eligibility criteria between November 1st, 2018, and October 31st, 2019. Out of these; 172 were included underwent laparoscopic cholecystectomy under general anesthesia. The patients were given appointment for follow up postoperatively at two weeks and three months for the bowel movement changes, such as diarrhea, constipation, and other complications. Results: The mean and range of age and body mass index of the patients were 40.77 (15-92 years) and 27.07 (17.92-45.20), respectively. Majority of the patients were females (82.6%), and the remaining were males (17.4%). The study revealed that 93.0% and 93.6% of the patients had no changes in their bowel movement upon follow-up for two weeks and three months postoperatively, respectively. The study found no significant differences in the diarrhea rate in patients with different body mass indices at three weeks and three months. The rate at which diarrhea occurred was significantly higher in younger aged patients at three-month follow-up (32.00 vs. 40.83 years). Conclusions: The current study showed a low rate of bowel movement changes in patients who underwent LC at two weeks and three months postoperatively.

Methylenetetrahydrofolate Reductase C677T Gene Variant in Relation to Body Mass Index and Folate Concentration in a Polish Population.

Methylenetetrahydrofolate reductase (MTHFR) is an enzyme responsible for producing an active form of folate. The MTHFR T677T genotype may have adverse health effects associated with weight gain and a reduction in folate availability. In this study, we examined the influence of the MTHFR C677T variant on BMI and determined its role as a risk factor for obesity. We also assessed the relationships between the MTHFR C677T genotype and folate and vitamin B12 concentrations in subjects before and after radical weight loss. The study group consisted of 1712 Caucasian adults of Polish nationality with a wide range of body mass indexes (BMIs). DNA was extracted from the blood, and the C677T variant was tested with RFLP-PCR and real-time-PCR. There was no significant influence found for the MTHFR 677 TT genotype on BMI or the obesity risk in codominant, dominant or recessive inheritance models. Individuals with obesity and the TT genotype had significantly lower folate concentrations. After radical weight reduction, the impact of the risk genotype, as well as homeostasis between folate and vitamin B12 in TT homozygotes, seems to be attenuated. Although the MTHFR 677TT genotype is not directly related to a higher BMI in Polish adults, it has a detrimental effect on folate concentrations in individuals with high BMI values.

The effect of obesity on the outcome of total knee replacement (TKR)

Background: The objective of this study was to look for the outcome of TKR in obese individuals. Methods: The data of all patients who had undergone primary TKR between 2005 and 2015 were collected from the QuadruMed Patient Care System and crosschecked with the operating room. The biometric data of age, gender, weight and postoperative follow up, any complications were collected from the medical charts. Patients were classified as per the BMI (Body Mass Index). BMI is classified as per the WHO classification of 2000. Results: Two hundred and four patients fulfilled the criteria for inclusion. The demographic data is given in Table 2. The average age 59.8±9.3 years. Right side was operated in 103 and left in 101 patients. The average BMI was 35.88±7.47 (Range 21.95-54.78); mean duration of surgery was 163.37±29.9 (Range 88-250) minutes. The range of follow up was 5-14 years with the average of 7.49±2.56 years. There were 18 (8.8%) complications. One hundred and three (50.5%) of the patients belonged to Class II Obesity (BMI ≥36Kg/M2). Between class II obesity and Class III obesity (BMI ≥41Kg/M2, the later had 94.4% of the complications. The level of satisfaction was similar in all the groups at 80%. High BMI and longer duration of surgery were important and statistically significant risk factors (p &lt;0.0001 and &lt;0.009) for complications during TKA. Post operative data on VAS, Modified Knee Scoring Score and WOMAC grading, showing low scores of all the assessment in the patients with higher BMI. Conclusions: Our analysis shows that our patients with Class III obesity had over 90% of the complications and we believe that patients in this BMI range should seek ways to reduce their body weight to avoid complications and long-term morbidity.

Knowledge, Attitude and Practice (KAP) on Salt Intake and its Relationship with Blood Pressure among Chinese Adults in Johor

Hypertension is one of the most serious health problem worldwide as well as in Malaysia with high salt intake as the major risk factor related to it. Therefore, this study was aimed to determine knowledge, attitude and practice (KAP) on salt intake and its relationship with blood pressure among Chinese adults in Johor. This cross-sectional study comprised of 90 subjects (36 males, 54 females), aged 18 to 59 years old. Subjects were required to answer the online questionnaire regarding KAP of salt intake. Self-reported anthropometry data and blood pressure measurement were recorded. Sodium intake was determined using a single 24-hour dietary recall method through face-to face or telephone interview. Results showed that majority subjects were within normal Body Mass Index (BMI) range and optimal blood pressure range. BMI was found to have significant correlation with systolic blood pressure (r=0.563, p&lt;0.05) and diastolic blood pressure (r=0.444, p&lt;0.05). Mean sodium intake of subjects was 2399 mg/day, exceeded the WHO recommendation of 2000 mg/day. Sodium intake was found to have significant correlation with systolic blood pressure (r=0.220, p&lt;0.05). Results indicated that the overall KAP score was fair (64.14%). The knowledge of most subjects was fair (69.95%) besides having positive attitude towards salt intake (74.17%). However, practice of healthy salt intake among them was inadequate (49.53%). Sociodemographic characteristic of female gender was significantly associated (p&lt;0.05) with better attitude. Additionally, older subjects, married subjects and subjects with higher level of education were significantly associated (p&lt;0.05) with better practice towards healthy salt intake. In this study, there were no significant (p&gt;0.05) associations between KAP on salt intake with sodium intake and blood pressure. In conclusion, BMI and sodium intake were significantly associated with blood pressure among Chinese adults. Further effort and interventions are needed to reduce the salt intake among Chinese adults and thus reduce the risk of hypertension.