Body Mass Index Range Research Articles

The steady-state pharmacokinetics of fixed-dose combination dolutegravir+rilpivirine in hemodialysis

Objective: Fixed dose combination (FDC) dolutegravir (DTG) plus rilpivirine (RPV) is an approved antiretroviral treatment regimen for people with HIV. The steady-state pharmacokinetics (PK) of FDC DTG+RPV in hemodialysis (HD) has not been previously studied. Design: We performed a single-center, prospective evaluation of the steady-state PK of FDC DTG +RPV in 4 adults without HIV either requiring HD and in 4 matched participants with normal renal function. Methods: All participants received FDC DTG(50mg)+RPV(25mg) daily for 10-14 days with food before undergoing an intensive 24-hour PK evaluation (performed between dialysis days for those requiring HD). Plasma drug and metabolite concentrations were measured using a validated UHPLC/MS/MS. Descriptive PK parameters were calculated. Results: The HD and normal renal function participants (each group with 2 men and 2 women) were of similar ages (range, 50-60 years) and body mass index (range, 18.5-34.5 kg/m2). No participant experienced serious or grade 3-4 adverse events; there were no study discontinuations. The AUC0-τ mean (SD) ratios of HD to normal renal function for DTG and RPV were 1.1 (0.4) and 1.1 (0.9), respectively. The mean (SD) Cmin for DTG and RPV in the HD group were 1033 (252) ng/mL and 49 (18) ng/mL, respectively. Conclusions: HD did not lead to clinically appreciable differential exposures to DTG and RPV. Exposures throughout the dosing interval were greater than the reported protein-binding adjusted IC90 efficacy values for DTG (64 ng/mL) and RPV (12 ng/mL) in all participants. These data suggest no dosing modifications are needed for the FDC DTG+RPV regimen in HD.

Association of obesity and metabolic syndrome with incident primary open angle glaucoma in the UK Biobank.

We sought to investigate the association between obesity, metabolic syndrome, and metabolic health with incident primary open-angle glaucoma (POAG). We included 103 249 UK Biobank participants without previously diagnosed glaucoma or glaucoma-related procedures at enrolment. The primary outcome was POAG identified from diagnostic coding via linked hospital inpatient and primary care data. We used multivariable Cox regression to evaluate the association of body mass index (BMI), and the interaction with metabolic syndrome (MetS) and a novel definition of metabolic health status with incident POAG. BMI was modelled as a time-varying coefficient. Multivariable analysis was adjusted for age, sex, ethnicity, intraocular pressure, spherical equivalent, polygenic risk score and stratified by the presence of primary care data. There were 647 events of incident POAG over 464 117 580 person-years and a mean follow-up of 12.6 years. At baseline (time = 0), each one unit increase in BMI was associated with a 9% lower hazard of incident glaucoma (HR 0.91, CI 0.86-0.97, p = 0.0066). Further, compared to a normal BMI range of 18.5-24 kg/m2, a BMI ≥30 kg/m2 was associated with a 65% relative hazard reduction (HR 0.35, CI 0.16-0.80, p = 0.012). There was no significant interaction between BMI and metabolic syndrome or metabolic health (all p > 0.05). The effect of BMI on the risk of incident POAG varied with time. Higher BMI was associated with a decreased risk of incident POAG in this large prospective cohort. There was no significant association with systemic metabolic health.

Body mass index and clinical outcomes in patients with diabetes and stable coronary artery disease in THEMIS

Abstract Background Physiologic changes due to extremes of body weight may affect the efficacy and tolerability of antiplatelet treatment. However, it remains unclear whether the risks and benefits of intensified antiplatelet therapy among patients with diabetes and stable coronary artery disease (CAD) are affected by body mass index (BMI). Purpose To assess the relationship between baseline BMI and major adverse cardiovascular (CV) events, and to determine if the effects of ticagrelor vs. placebo varied across the BMI spectrum, in patients with diabetes and stable CAD. Methods THEMIS was a randomized, controlled trial of 19,220 individuals aged ≥50 years with type 2 diabetes and stable CAD, randomly allocated to ticagrelor or placebo on top of aspirin. Patients with a prior myocardial infarction (MI) or stroke, or already on dual antiplatelet therapy, were excluded. The primary efficacy outcome was a composite of CV death, MI, or stroke. The primary safety outcome was TIMI major bleeding. We examined prognostic implications of BMI using 1) restricted cubic splines for the overall trends with outcomes; 2) Cox regression models with predefined BMI intervals (<25 kg/m2, 25-29.9 kg/m2, and ≥30 kg/m2) adjusted for demographic, clinical, and laboratory variables; and 3) Cox regression models for the effects of ticagrelor vs. placebo on outcomes across the spectrum of BMI values (test for interaction). A two-sided P-value <0.01 was considered statistically significant to control the overall chance of type I errors. Results BMI was available in 19,202 (99.9%) participants, with a median of 29 kg/m2 (interquartile range: 26-33). A total of 3352 (17.5%) individuals had a BMI <25 kg/m2, 7644 (39.8%) had a BMI 25-29.9 kg/m2, and 8206 (42.7%) had a BMI ≥30 kg/m2. Median follow-up was 39.9 months (range 0-57), with 1554 primary efficacy events and 306 primary safety events occurring over the course of the study. BMI was not associated with the primary efficacy or safety outcome, or with their individual components. However, BMI was significantly associated with hospitalization for heart failure (HHF) (BMI <25 kg/m2: reference; hazard ratio [HR] for BMI 25-29.9 kg/m2: 1.07, 95% confidence interval [CI], 0.82 to 1.40; HR for BMI ≥30 kg/m2: 1.41, 95% CI, 1.07 to 1.84) and with the composite of HHF or CV death (comparable estimates) after multivariable adjustment (Figure). BMI was also significantly, positively associated with serious adverse events (BMI <25 kg/m2: reference; HR for BMI 25-29.9 kg/m2: 0.99, 95% CI, 0.93 to 1.06; HR for BMI ≥30 kg/m2: 1.20, 95% CI, 1.12 to 1.29). BMI did not modify the risks and benefits of ticagrelor vs. placebo. Conclusions BMI was independently associated with the risk of HHF and the composite of HHF or CV death, but not with other efficacy or safety outcomes, in patients with stable CAD and type 2 diabetes. Ticagrelor was of similar benefit on the primary efficacy outcome vs. placebo across the full range of BMI.

Human Herpesvirus-6B Infection and Alterations of Gut Microbiome in Patients with Fibromyalgia: A Pilot Study

Fibromyalgia (FM) is a chronic disorder characterized by widespread musculoskeletal pain often accompanied by fatigue, sleep disturbances, memory issues, and mood disorders. The exact cause of FM remains unknown, and diagnosis is typically based on a history of persistent widespread pain, as there are no objective biomarkers usable in diagnosis of this disorder available. The aim of this study was to identify measurable indicators specific to FM with potential as biomarkers. This study included 17 individuals diagnosed with FM and 24 apparently healthy persons. Using real-time polymerase chain reaction (qPCR), we detected the presence of human herpesvirus (HHV)-6A and B genomic sequences in DNA isolated from peripheral blood mononuclear cells (PBMCs) and buccal swabs. HHV-6-specific IgG and IgM class antibodies, along with proinflammatory cytokine levels, were measured using enzyme-linked immunosorbent assay (ELISA) and bead-based multiplex assays. Additionally, the gut microbiome was analyzed through next-generation sequencing. HHV-6B was more frequently detected in the PBMCs of FM patients. FM patients with a body mass index (BMI) of 30 or higher exhibited elevated cytokine levels compared to the control group with the same BMI range. Gut microbiome analysis revealed significant differences in both α-diversity and β-diversity between the FM and control groups, indicating a shift in species abundance in the FM group.

7413 Postsurgical Complications In Gender Affirmation Surgery According To Body Mass Index: Case Series

Abstract Disclosure: H. Tovar Cortes: None. Introduction: Therapeutic approach to gender dysphoria includes surgical interventions as part of the gender affirmation process.To make these procedures safe, it is recommended for the patient to have a normal BMI (body mass index). Obesity can increase the risk of complications during the perioperative period. To date, no studies have been published in Colombia documenting the results, and complications in patients undergoing gender affirmation surgery, and the relation to BMI. Case series A case series of patients diagnosed with gender dysphoria and multidisciplinary treatment is presented. Patients undergoing a gender affirmation surgical procedure, both in the context of transition from man to woman and from woman to man, who presented post-surgical complications are described. An analysis of the anthropometric measurements obtained through bioelectrical impedance analysis (BIA) of each of the patients was carried out; including weight, height, and BMI, with the objective of describing the surgical complications that occurred, as well as the categorization according to BMI range, and its possible correlation. From a database of 121 records of patients brought to a medical-surgical board for approval of gender affirmation procedures, a total of 78 patients were included, of which 33 presented post-surgical complications; 37 patients underwent feminization surgeries and 41 masculinization surgeries. In patients with post-surgical complications, it was found that 3% had a BMI less than 20 kg/m², 47% of the population had a BMI between 20 and 24 kg/m², 28% had a BMI between 25 and 29 kg/m², and 9 % of patients had a BMI grater than 30 kg/m². Most frequent complications were derived from thoracic masculinization surgery, highlighting suture dehiscence (7 cases), pectoral collections (6 cases) and tension hematomas (2 cases). All patients had in common post-surgical complications secondary to thoracic masculinization and BMI within normality. Conclusions Overweight and obesity are associated with an increase in surgical complications. Therefore, it is recommended that patients undergoing gender affirmation interventions should have a normal BMI, with the aim of reducing it, and achieving better surgical results. However, in our study, it was evident that these complications occurred predominantly in patients with BMI within normal range. These results could suggest that obesity is not associated with a significant increase in post-surgical complications. This provides important bases to carry out new studies that allow confirming these findings and bringing them to clinical practice. More evidence will reduce treatment barriers in these patients, allowing comprehensive treatment, and thereby improving the quality of life and biopsychosocial dysfunction of individuals with this condition. Abbreviations Body mass index (BMI), Bioelectrical impedance analysis (BIA) Presentation: 6/3/2024

Nonlinear effect of body mass index on postoperative survival following isolated heart transplantation

BackgroundGuidelines regarding recipient's Body Mass Index (BMI) for heart transplant are evolving with variable cutoffs depending on the country and institution. It is imperative to provide updated nonlinear estimates of postoperative risk attributable to a recipient’s BMI to evaluate relevance of existing cutoffs. MethodsA total of 30,787 patients were analyzed from the UNOS database. Patients receiving an isolated heart transplant ages 18 and older since 2010 were included. Overall survival was the primary outcome. A multivariate Cox proportional hazards model was applied and included a penalized smoothing spline term for recipient BMI and risk factors such as diabetes. We assessed the overall significance of the nonlinear penalized spline terms using an asymptotic Wald test. ResultsThe cohort consisted of 662 (2.2%) BMI<18.5, 9359 (30%) BMI 18.5-24.9, 10997 (36%) BMI 25-29.9, 9550 (31%) BMI 30-39.9, and 206 (0.7%) BMI≥40 patients. The nonlinear spline terms for recipient BMI were statistically significant (p<0.01). The Hazard Ratio appeared to grow linearly in BMI at an inflection point of BMI=26. No inflection point was observed at either of the ISHLT recommended cutoffs of BMI=30 (HR 1.11, CI 1.07-1.15) or BMI=35 (HR 1.29, CI 1.24-1.37). ConclusionsAfter multivariable adjustment, there is no sharp cutoff in survival risk at either BMI=30 or BMI=35. Unlike previously reported, postoperative survival risk grows approximately linearly in the BMI range from BMI=26 to BMI=40.

Effects of Letrozole And Metformin Versus Metformin alone on incretin in Iraqi patients with PCOS

I Background: The emergence of numerous novel therapeutic agents for managing T2DM has expanded the assortment of tailored therapies available for PCOS sick. One illustration of these is the incretin-based therapeutic agents. Patients and methods:The extanttrainingcomprised 75 sickthrough an age extent of 18 to less than 40 years. Patients were categorized into three groups: metformin group (positive control group) and they received metformin as 500 mg per-oral (bid); letrozole group who were treated using 2.5 mg per-oral (bid), and combination groups who received both agents with similar doses as above. Each group included 25 females. Informationalmost age and body mass index (BMI) stayed included in the study. Serum measurement of incretin (GLP-1) was done before treatment and 90 days after treatment using Enzyme-Linked Immunosorbent Assay. Results: There stayed no importantvariance in mean age (p = 0.981) betweentraining groups and means of age were 29.24 ± 6.10 years, 29.56 ± 5.50 years and 29.44± 5.83 years, respectively and the range of age was between 18 and 40 years. In addition, in this training, there stayed no importantalteration in mean BMI (p = 0.534) among study groups and means of BMI were 28.80 ±2.72 kg/m2, 27.53 ±1.95 kg/m2 and 27.07 ±1.99 kg/m2, respectively and the range of BMI was between 21.07 and 31.18 kg/m2. Serum incretin (GLP-1) level showed no significant variation among study groups, the mean levels were in the range of 10.87 -13.79 ng/ml and the range of values was from 9.56 -14.49 ng/ml. Changes in BMI are shown in. Metformin alone caused in more important weight decrease; nevertheless, adding of letrozole caused significant reduction in body mass index, letrozole alone also affect body weight significantly. It was observed that combined use of either drug resulted in more significant change of GLP-1 level at (p ≤ 0.001). Conclusion: Combined treatment with letrozole and metformin is safe and efficient in femalesby PCOS resultant in weight decrease, improved insulin

Association of Prepregnancy Cardiometabolic Factors With Gestational Diabetes Among Asian Populations in the United States

BackgroundAsian individuals are among the highest immigrant group to the United States and at particularly high risk of gestational diabetes, which is associated with long-term maternal cardiovascular disease. Limited data are available on the association of prepregnancy cardiometabolic risk factors with gestational diabetes among Asian American subjects. ObjectivesThis study sought to determine the association of prepregnancy hypertension and body mass index (BMI) among Asian ancestry subgroups and by maternal nativity. MethodsUsing data from the National Vital Statistics System from 2016 to 2019, the prevalence of gestational diabetes, stratified according to prepregnancy hypertension and obesity, was examined according to maternal race. Predicted probability of gestational diabetes with continuous BMI was calculated across Asian ancestry subgroups and by maternal nativity. ResultsAmong 13.3 million pregnancies, gestational diabetes occurred in 6.5%. Asian subjects had the highest prevalence (12.3%). Among those with prepregnancy hypertension, Asian subjects had the highest prevalence (29.3%). Across the range of BMI (18-42 kg/m2), Asian subjects had the highest predicted probability. There was substantial heterogeneity across Asian ancestry subgroups between the association of BMI with gestational diabetes, with highest probability among Japanese and Korean American subjects at BMI >23 kg/m2. Predicted probability of gestational diabetes was higher for mothers born outside the United States among all Asian subgroups, except for Japanese American subjects. ConclusionsAsian American individuals have the highest prevalence of gestational diabetes at any BMI and with hypertension. Substantial variation in risk is present across Asian subgroups. Findings suggest a need for more tailored screening and intervention for gestational diabetes among Asian American subjects, with a specific focus on risk for individuals born outside the United States.

Correlations and consistency of body composition measurement indicators and BMI: a systematic review.

It is critical to accurately determine the level of obesity and health status since overweight/obesity has become a main global public health problem. This systematic review attempted to evaluate the consistency and correlation between body composition measurement indicators and body mass index (BMI) in childhood and adolescence. Seven electronic databases (Web of Science, PubMed, Cochrane Library, Embase, CNKI, WANFANG DATA, SinoMed) were searched to collect the literature published since 1999 with the focus on the relationship between body composition measurement indicators and BMI to measure obesity in childhood and adolescence. Among the 28 articles included, 13 articles reported a moderate to very strong correlation between %BF and BMI in obesity measurement (range: 0.49-0.907), while two articles reported a strong to very strong correlation between FM and BMI (range: 0.60-0.86). Six articles reported good to excellent obesity measurement consistency between %BF and BMI (range: 0.441-0.876), one article reported WC (0.58) and WHtR (0.46) in the moderate consistency with BMI, and one article reported a relatively poor to fair consistency between FM and BMI (range: 0.167-0.409). WC, WHtR, and BMI showed the moderate consistency in pre-adolescent children. In pre-adolescence and adolescence, the measurement consistency between %BF and BMI was higher than that between FM and BMI. Gender difference existed in the consistency between %BF and BMI during adolescence. A range of body composition indicators such as %BF, WC, WHtR, and FM could provide valuable body composition measurements, complement BMI for obesity assessment in children and adolescents, and facilitate efficient and comprehensive surveillance of childhood obesity. PROSPERO CRD42024506932.

Preconception and Early-Pregnancy Body Mass Index in Women and Men, Time to Pregnancy, and Risk of Miscarriage

Obesity in women is associated with reduced fertility and an increased risk of miscarriage. These associations might also be present across the full range of body mass index (BMI) categories as well as among men. To investigate the associations of preconception BMI in both partners with time to pregnancy and miscarriage. This population-based prospective cohort study was conducted in Rotterdam, the Netherlands, between August 9, 2017, and July 1, 2021. A total of 3604 women and their partners were included from the preconception period onward with follow-up until birth. The date of analysis was July 12, 2024. Body mass index (calculated as weight in kilograms divided by height in meters squared) measured in preconception or early pregnancy. Fecundability, defined as the probability of conceiving within 1 month; subfertility, defined as time to pregnancy or duration of actively pursuing pregnancy of more than 12 months or use of assisted reproductive technology; and miscarriage, defined as pregnancy loss before 22 weeks of gestation. These measures were assessed using questionnaires and via the obstetric caregiver. The study population for time-to-pregnancy analyses consisted of 3033 episodes among women (median age, 31.6 years [IQR, 29.2-34.5 years]; median BMI, 23.5 [IQR, 21.2-26.5]) and 2288 episodes among men (median age, 33.4 years [IQR, 30.5-36.8 years]; median BMI, 24.9 [IQR, 23.0-27.4]). The study population for miscarriage analyses consisted of 2770 pregnancy episodes among women (median age, 31.5 years [IQR, 28.9-34.3 years]; median BMI, 23.5 [IQR, 21.3-26.7]) and 2189 pregnancy episodes among men (median age, 33.5 years [IQR, 30.4-36.8 years]; median BMI, 25.0 [IQR, 23.0-27.5]). Higher BMI in women and men was associated with lower fecundability: for every unit increase in BMI, fecundability decreased (fecundability ratio [FR]: women, 0.98 [95% CI, 0.97-0.99]; men, 0.99 [95% CI, 0.98-1.00]). Women with overweight (FR, 0.88 [95% CI, 0.80-0.98]) and obesity (FR, 0.72 [95% CI, 0.63-0.82]) had lower fecundability compared with women with normal weight. Compared with normal weight in women, underweight (odds ratio [OR], 1.88 [95% CI, 1.22-2.88]), overweight (OR, 1.35 [95% CI, 1.11-1.63]), and obesity (OR, 1.67 [95% CI, 1.30-2.13]) were associated with increased odds of subfertility. In men, obesity was associated with increased odds of subfertility (OR, 1.69 [95% CI, 1.24-2.31]). Compared with normal weight in women, overweight (OR, 1.49 [95% CI, 1.12-1.98]) and obesity (OR, 1.44 [95% CI, 1.00-2.08]) were associated with increased odds of miscarriage. In this cohort study, BMI outside of the normal category in women and men during the preconception or early-pregnancy periods was associated with time to pregnancy and miscarriage. Optimizing BMI in women and men from the preconception period onward might be an important strategy to improve fertility outcomes.

Magnitude of obesity alone does not alter the alveolar lipidome.

Obesity may lead to pulmonary dysfunction through complex and incompletely understood cellular and biochemical effects. Altered lung lipid metabolism has been identified as a potential mechanism of lung dysfunction in obesity. Although murine models of obesity demonstrate changes in pulmonary surfactant phospholipid composition and function, data in humans are lacking. We measured untargeted shotgun lipidomes in two bronchoalveolar lavages (BALs) from apical and anteromedial pulmonary subsegments of 14 adult subjects (7 males and 7 females) with body mass indexes (BMIs) ranging from 24.3 to 50.9 kg/m2. The lipidome composition was characterized at the class, species, and fatty acyl/alkyl level using total lipid molecular ion signal intensities normalized to BAL protein concentration and epithelial lining fluid volumes. Multivariate analyses were conducted to identify potential changes with increasing BMI. The alveolar lipidomes contained the expected composition of surfactant-associated phospholipids, sphingolipids, and sterols in addition to cardiolipin and intracellular signaling lipid species. No significant differences in lipidomes were detected between the two BAL regions. Though a small number of lipid species were associated with BMI in multivariate analyses, no robust differences in lipidome composition or specific lipid species were identified over the range of body habitus. The magnitude of obesity alone does not substantially alter the alveolar lipidome in patients without lung disease. Differences in lung function in patients with obesity and no lung disease are unlikely related to changes in alveolar lipid composition.NEW & NOTEWORTHY Altered lung lipid metabolism has been identified as a potential mechanism of lung dysfunction in obesity, but data in humans are lacking. We measured the alveolar lipidome in bronchoalveolar lavages from subjects with healthy lungs with a wide range of body mass index. There were no differences in lipidome composition in association with the magnitude of obesity. In patients with healthy lungs, obesity alone does not alter the alveolar lipidome.

362. DELAY IN SOLID GASTRIC EMPTYING IS ASSOCIATED WITH SILENT REGURGITATION EVENTS, PULMONARY MICROASPIRATION AND LARYNGOPHARYNGEAL REFLUX DISEASE

Abstract Background Pulmonary micro-aspiration (PMA) is a feared complication of severe and sometimes silent gastroesophageal reflux disease (GORD). A novel scintigraphic test that shows refluxate contamination of the pharynx, upper and lower airways has recently been developed. This test and multiple observations allowed the development of a hypothesis that prolongation in solid gastric emptying (SGE) may be a more critical than delays in liquid gastric emptying (LGE) in micro-aspiration into the airways. Methods Standard LGE and SGE studies together with the novel microaspiration test were evaluated in paired studies in patients with medially resistant symptoms GORD to measure rates of micro-aspiration after each meal. Either water labelled with 99m Technetium Phytate for the LGE or a labelled egg sandwich for the solid meal was utilised. Major symptoms were noted and the cough and reflux severity index (CSI &amp; RSI) obtained in all patients. Results A total of 131 patients were included in this study (59M/72F). The age range was 21 to 83 years with a mean of 52 years. Patients were in the overweight range for body mass index (BMI), with a mean of 26.8. Major symptoms were of bloating, nausea, belching and dyspepsia as well as cough, throat clearing and globus. Less than 20% complained of heartburn. Results. SGE was abnormal in 92% (Mean 766 min) and LGE was abnormal in 53% (Mean 82 min). PMA was shown in 35% after the SGE and in 71% after the LGE. PMA positive patients were older. SGE and PMA were significantly correlated (p&amp;lt;0.00) but not LGE. The only significant symptom in the PMA group was bloating. RSI was abnormal in 64% and CSI in 46%. Conclusion The majority of patients with PMA do not complain of heartburn. Bloating in patients with severe GORD should raise the possibility of gastroparesis and PMA. Prolonged SGE may be critical in the physiology of atypical reflux and present another treatment goal with addition of pyloroplasty to anti-reflux procedure of choice.

Factors Influencing Long-term Outcomes After Matrix-Induced Autologous Chondrocyte Implantation: Long-term Results at 10 Years

Background: Matrix-induced autologous chondrocyte implantation (MACI), the third-generation of the technique, is an established procedure for the treatment of focal cartilage defects in the knee. However, the literature lacks long-term results of MACI with good statistical power. Purpose: To determine long-term survival and patient-reported outcomes (PROs) in a representative cohort and to identify patient- and surgery-related parameters that may influence long-term clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: A total of 103 patients were clinically evaluated at the current follow-up of 8.1 years (range, 5-11.9 years). PRO measures (PROMs) included the Knee injury and Osteoarthritis Outcome Score (KOOS), EQ-5D, visual analog scale for pain, and Tegner Activity Scale. Magnetic resonance imaging results were evaluated by using the AMADEUS (area measurement and depth and underlying structures) and MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 knee score classification systems. Potential factors influencing PROs were first identified univariately and investigated in a multivariate regression model. Results: The defects had a mean size of 4.8 cm2 (range, 1.2-12 cm2) and were predominantly femorotibial (66%). The mean Kaplan-Meier survival rate of revision for any reason was 97.2% ± 1.6% at 10 years. In comparison to preoperative values, all PROMs were significantly improved at the current follow-up (P < .05). The MOCART 2.0 score peaked at 12 months (mean, 80.2 ± 15.3 months) and showed no significant change at 96 months (mean, 76.1 ± 19.5 months; P = .142). The linear multivariate regression model identified an association of body mass index (BMI), MOCART 2.0 score, and number of previous knee surgeries with KOOS (R2 = 0.41; f2 = 0.69). Further analysis of the individual determinants revealed an optimal BMI range of 20 to 29 for favorable PROs at 96 months. Significant correlations of MOCART subscores with the overall KOOS were found for graft surface and structure, bony reaction, and subchondral detectable changes. Only 30% of patients with2 previous surgeries and 20% of patients with 3 previous surgeries achieved a Patient Acceptable Symptom State (χ2 = 10.93; P = .012). Conclusion: The present study shows consistently good long-term clinical outcomes after MACI with a low revision rate and high patient satisfaction. BMI and number of previous knee surgeries may influence clinical outcomes and should be considered in patient selection and education. There is a correlation between graft structure, subchondral bone changes on magnetic resonance imaging, and long-term PROMs.

The association between caffeine intake and BMI

Caffeine, a widely consumed psychoactive substance, has attracted interest because of its potential effects on body weight. This study examines the relationship between caffeine intake and Body Mass Index (BMI) across genders and obesity subgroups using data of 4,937 adult participants from the NHANES examination. The findings indicate that there is a significant positive correlation between caffeine intake and BMI in both male and female groups respectively. This suggests that higher caffeine consumption is associated with increased BMI. The association remains consistent within the normal BMI range but becomes less pronounced among individuals classified as obese. However, due to the limitations of the cross-sectional design and the exclusion of certain variables, this model still needs to be further refinement. This study highlights needs for further research into the association between caffeine consumption and body weight, with relevant implications for individuals and the health and wellness industry.

Effect of health lifestyle on the risk of stroke: A prospective cohort study from Chongqing, China

ObjectiveTo prospectively investigate the associations of healthy lifestyle factors on the risk of stroke and stroke subtypes, as studies exploring this relationship are limited in China. MethodsThe 22,661 participants in the prospective cohort study in Chongqing, China, aged 30–79 years and stroke-free at baseline completed follow-up from 2018 to 2022. We included seven healthy lifestyle factors, including non-smoking, non-excessive drinking, sufficient physical activity, healthy diet, sleep duration of 7–9 h/d, and standard range of body mass index and waist-to-hip ratio. The healthy lifestyle score was calculated based on the number of healthy lifestyle factors. ResultsCompared with participants who had scores ≤2, participants with scores ≥6 had an HRs (95 % CIs) of 0.56 (0.34, 0.92) for total stroke and 0.53 (0.30, 0.93) for ischemic stroke. For every 1-point increase in healthy lifestyle scores, the HRs (95 % CIs) for total stroke and ischemic stroke was 0.86 (0.78, 0.95) and 0.86 (0.77, 0.96), respectively. ConclusionsMaintaining multiple healthy lifestyle factors can significantly reduce the risk of stroke. As the number of healthy lifestyle factors increased, the stroke risk gradually decreased. Our findings emphasize the significance of comprehensive lifestyle interventions.

Associations between body mass index and all-cause and CVD mortality in agriculture, forestry, and fishing occupations: A prospective cohort study using NHANES data (1999-2014).

Obesity, as indicated by elevated Body Mass Index (BMI), is a well-established global health concern associated with increased morbidity and mortality across diverse populations. However, the influence of BMI on individuals in Agriculture, Forestry, and Fishing (AFF) occupations, characterized by unique challenges and environmental factors, has received limited research attention. Our study, a prospective cohort analysis, utilized National Health and Nutrition Examination Survey (NHANES) data from 1999-2014, targeting adults above 18 in AFF occupations with comprehensive BMI data, omitting individuals with a history of cancer. Mortality outcomes were extracted from the NHANES mortality file, and BMI was segmented into eight categories. Essential covariates such as age, sex, race, and various health factors were incorporated. The statistical analysis encompassed Cox regression, generalized additive models, smooth curve fitting, and stratified analyses. During 1,005 person-years with 201 all-cause and 57 CVD deaths, we observed L-shaped and U-shaped correlations of BMI with all-cause and CVD mortality, featuring a pivotal inflection at 26.69 and 27.40 kg/m2. Above this BMI threshold of 26.69 and 27.4 kg/m2, all-cause mortality association was not significant while CVD mortality was positive. This study highlights a unique BMI-mortality association in AFF occupations, diverging from standard patterns. The rigorous labor and environmental conditions in AFF jobs suggest that a certain range of higher BMI could reduce mortality risk. This highlights the necessity for tailored health guidelines in different occupations. Future research should concentrate on diverse health indicators and enhanced risk assessment for physically strenuous occupations.

Brain dopamine responses to ultra-processed milkshakes are highly variable and not significantly related to adiposity in humans.

Ultra-processed foods high in fat and sugar may be addictive, in part, due to their purported ability to induce an exaggerated postingestive brain dopamine response akin to drugs of abuse. Using standard [11C]raclopride positron emission tomography (PET) displacement methods used to measure brain dopamine responses to addictive drugs, we measured postingestive striatal dopamine responses to an ultra-processed milkshake high in fat and sugar in 50 young, healthy adults over a wide body mass index range (BMI 20-45 kg/m2). Surprisingly, milkshake consumption did not result in significant postingestive dopamine response in the striatum (p=0.62) nor any striatal subregion (p>0.33) and the highly variable interindividual responses were not significantly related to adiposity (BMI: r=0.076, p=0.51; %body fat: r=0.16, p=0.28). Thus, postingestive striatal dopamine responses to an ultra-processed milkshake were likely substantially smaller than many addictive drugs and below the limits of detection using standard PET methods.

Could headache in children be a biomarker for dyslipidemia?

Here we present the patients whose body mass index is in the normal range and who visited with the complaint of headache. The differences in lipid profile in this group compared to healthy children and the risk factors that may be associated with this were investigated. 195 patients who applied to the Pediatric Neurology outpatient clinic with headache complaints between April 2021 and October 2022 were retrospectively examined. 201 healthy children were included as the control group. The gender, age, headache type, lipid profile blood test after at least 8h of fasting [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and TG/HDL ratio], and body mass index (BMI) were recorded. Those patients who had a BMI range of 18.5-24.9kg/m2 were included in the study. The study group had 195 patients; 118 girls (60.5%). The average age was 12,57 ± 3,48years, and 114 patients (58.5%) had tension-type headaches and 81 (41.5%) had migraine-type headaches. There was no significant difference in age and gender between the two groups. Blood pressure, folate, and thyroid function tests were normal. In the lipid profile, a significant difference was observed between total cholesterol, LDL, HDL, and TG in the study group compared to the control group (p < 0.05). However, there was no difference in the TG/HDL ratio between those two groups. No significant statistical difference was observed in the lipid profile and other laboratory findings between headache types. In children presenting with headache complaints, which can be both worrying for families and cause significant loss of functionality, it is detectable (obviously) that headache is an important marker for dyslipidemia; even if BMI is in a normal range. The lipid profile should be seen both to control the complaint with an appropriate diet and to observe the risk of future atherosclerotic processes.

Association of Physical Fitness With the Work Ability of Aging Workers With Physically Demanding Jobs in a University Hospital in Thailand

BackgroundA decrease in physical fitness with age can impact work ability. Exploring the role of physical fitness is important for identifying interventions to enhance work ability among aging workers. We sought to determine the association between physical fitness and physically demanding work ability in aging workers. MethodsWe recruited workers aged 45–65 years from eight departments of a university hospital in Bangkok, Thailand. Work ability was assessed using the work ability index (WAI), and physical fitness components were evaluated through various tests. Associations between work ability and physical fitness were examined using a multivariable regression analysis. ResultsThe response rate was 46.4% (n = 216). The mean WAI score was 41.6. Participants with an overweight or obese body mass index (BMI) had 1.8 (95% CI –3.1, –0.4) points lower WAI scores than did those within a healthy BMI range. A handgrip strength test revealed that participants in the good/very good group had 2.5 (95% CI: 0.6, 4.3) higher WAI scores than did those in the very poor/poor group. For a single-leg stance test, participants in the above-average group had 2.1 (95% CI: 0.7, 3.5) points greater WAI scores than did those in the below-average group. No significant associations were found between work ability and 3-min step, chair stand, or sit-and-reach test scores. ConclusionThe overall work ability of the participants was good. Body composition, muscle strength, and balance were associated with work ability. Promoting physical fitness is a viable strategy for enhancing work ability among aging workers.

Body Mass Index as a Factor Influencing Oocyte Competence and Implantation Potential – Distribution and Results in 4,882 Women Undergoing Fertility Treatment

Abstract Introduction The large amount of excess adipose tissue affects negatively every single step of the assisted reproductive treatment process – from the controlled ovarian hyperstimulation (COH) to obstetric complications and health consequences for the fetus. A number of scientific data show correlation between impaired clinical pregnancy rates (CPR) and obese patients maintaining high body mass index (BMI). The debate whether high proportion of body fat negatively affects oocyte quality or only impacts endometrial receptivity remains open. Aim The aim of this study is to investigate the specific effect of the different BMI range in patients undergoing assisted reproductive technology (ART) treatment with reference to oocyte quality, fertilization capacity and Implantation potential. Materials and methods We analyzed a total of 4,882 women from partner couples who underwent ART treatment. Height and weight data were entered at the start of the in vitro fertilization (IVF) procedure. According to their BMI the female patients were divided in four distinct groups: in group 1 (underweight and BMI below 18.5 kg/m2) – 498 women, group 2 (normal range from 18.5 to 24.9 kg/m2) – 3021 women, group 3 (overweight with BMI between 25 – 29.9 kg/m2) – 789 women and group 4 (obese with BMI over 30 kg/m2) - 484 women. Results Distribution of the women in different BMI groups indicates that most of the Bulgarian patients undergoing fertility treatment are in the normal range. No association between BMI and ovarian response was found. A total of 33,205 oocytes were obtained after the COH. The mean numbers of the retrieved oocytes were similar (6,85 in group 1; 6,83 in group 2, 6,77 in group 3 and 6,67 in group 4) per woman and the fertilization rate was comparable in the four groups as it varies between 74-75%. Proportional categories of good, fair and bad embryos at cleavage stage were found. On the contrary according to CPR, Statistical difference between normal weight group (34,38%) versus overweight (29,6%) and obese groups (28,80%) (p &lt; 0,05) was found. Conclusion No correlation was found between the number of the retrieved oocytes and BMI values. Statistically lower pregnancy rates were reported in overweight women with BMI ≥ 25 kg/m2 group and further onwards in the obesity group (BMI ≥ 30 kg/m2), which may be associated with impaired endometrial receptivity as a result of abnormally high levels of adipose tissue.