Reduction In Body Mass Index Research Articles

Diminished Returns of Educational Attainment on Body Mass Index Among Latino Populations: Insights from UAS Data.

Educational attainment is a well-established predictor of physical health outcomes, including body mass index (BMI). However, according to the theory of Minorities' Diminished Returns (MDRs), the health benefits of education tend to be weaker for ethnic minorities compared to non-Latino Whites, due to structural inequalities and social disadvantages. This study examines whether the association between educational attainment and BMI is weaker among Latino individuals compared to non-Latino individuals, in line with the MDRs framework. Data were drawn from the 2014 wave of the Understanding America Study (UAS), a nationally representative internet-based panel. Body mass index (BMI) was the outcome of interest. Linear regression models were used to analyze the association between educational attainment and BMI, with an interaction term for ethnicity to explore differences in the relationship between Latino and non-Latino people. Models were adjusted for age, sex, marital status, and labor market participation and results were presented as beta coefficients, p-values, and 95% confidence intervals (CIs). Higher educational attainment was associated with lower BMI for both Latino and non-Latino participants (p < 0.001). However, the interaction between educational attainment and ethnicity was significant (p < 0.05), indicating that Latino individuals experienced smaller reductions in BMI because of higher education compared to non-Latino people. This study provides evidence of diminished returns from educational attainment on BMI among Latino individuals. These findings support the MDRs framework, suggesting that structural barriers may limit the health benefits of education for Latino populations. While education is a key determinant of physical and mental health, its benefits are not equitably distributed across ethnic groups. Structural inequalities, chronic stress, poor neighborhood environments, and adverse educational and occupational conditions likely contribute to this disparity. Addressing these underlying factors through targeted policy interventions is necessary to promote health equity for Latino populations.

Comparison of Metformin and Myoinositol on Clinical, Hormonal and Metabolic Profile of Patients with Polycystic Ovarian Syndrome: An Open-label Randomised Clinical Trial

Introduction: The prevalence of Polycystic Ovarian Syndrome (PCOS), one of the common endocrine disorders among women of reproductive age, varies from 2.2% to 26% globally. The treatment for PCOS aims to reduce Body Mass Index (BMI), improve underlying hormonal disturbances, prevent future reproductive and metabolic complications, and enhance the quality of life. Aim: To evaluate the efficacy of metformin and Myoinositol (MI) on the metabolic, hormonal, and clinical profiles in PCOS. Materials and Methods: An open-label randomised clinical trial was conducted at the Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chengelpet, Tamil Nadu, India, from January 2019 to May 2020. The study included 80 women with PCOS who were randomly assigned to two groups. One group received metformin 1500 mg/day (in three divided doses), while the other group received MI 1 gram/day for three months. At the end of the 12-week therapy, the participants were evaluated for changes in clinical, metabolic, and hormonal profiles. The data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics such as frequency, proportion, mean, and standard deviation were used for quantitative data. Results: Both the metformin and MI-treated groups showed a significant reduction in BMI, fasting blood glucose, and fasting insulin. Both drugs were equally effective in changing the hormonal profile. There was a significant improvement in lipid parameters in both groups, with High-density Lipoprotein (HDL) levels being more significantly raised in the metformin group. The post-treatment HDL values in the metformin group were 75.69±19.16 mg/dL compared to 41.43±6.18 mg/dL in the MI group (p&lt;0.0001). Both groups demonstrated similar efficacy in improving menstrual regularity, with 60% of the patients in the metformin group and 65% in the MI group having regular cycles at the end of treatment. Among infertility patients, the conception rate was 40% in the metformin group and 25% in the MI group (p=0.70). Conclusion: Both drugs were equally efficient in improving the clinical, metabolic, and hormonal profiles in PCOS. Metformin was found to be superior to MI in improving fertility and increasing HDL levels.

The effect of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptor agonists in nonalcoholic fatty liver disease in type 2 diabetic patients: a systematic review and meta-analysis

Background: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are prevalent conditions often coexisting and significantly impacting patient health. Glucagon-like peptide-1 (GLP-1) receptor agonists, such as liraglutide, dulaglutide, semaglutide, efinopegdutide, and cotadutide, have shown promise in managing these conditions. This study aims to evaluate the efficacy of these medications on metabolic and liver-related outcomes in patients with T2DM and NAFLD. Methodology: A comprehensive analysis of multiple randomized controlled trials (RCTs) was conducted to assess the impact of GLP-1 receptor agonists on body mass index (BMI), glycemic control (HbA1c), blood pressure, lipid profiles, and liver enzymes. The patient populations, interventions, and control groups were compared across these studies to derive comprehensive insights. Results: GLP-1 receptor agonists significantly improved metabolic and liver-related outcomes. Patients on liraglutide, dulaglutide, and semaglutide showed marked reductions in BMI and HbA1c levels, indicating effective weight management and glycemic control. Improvements in lipid profiles were observed, with notable reductions in triglycerides and increases in HDL levels. Significant reductions in liver enzymes (ALT and AST) were reported, particularly with efinopegdutide and cotadutide, indicating improved liver health. Gastrointestinal side effects, such as nausea and vomiting, were common but generally mild and transient. Conclusion: The study demonstrates that GLP-1 receptor agonists are effective in managing both metabolic and liver-related outcomes in patients with T2DM and NAFLD. These medications significantly reduce BMI, improve glycemic control and lipid profiles, and lower liver enzyme levels, indicating enhanced liver health. While mild gastrointestinal side effects were reported, the overall safety and efficacy profiles of these drugs make them promise therapeutic options. Future research should focus on long-term effects and optimal dosing strategies to maximize therapeutic benefits and minimize side effects.

Preliminary efficacy of a community health worker homebased intervention for the control and management of hypertension in Kiambu County, Kenya- a randomized control trial.

In Sub Saharan Africa, there is a growing burden of non-communicable diseases, which poses a big challenge to the resource-limited health system in these settings. The aim of this study was to determine the feasibility and preliminary efficacy of a community health workers (CHWs) home-based lifestyle interventions to improve blood pressure (BP) control and body composition among hypertensive patients in low-income populations of Kiambu County, Kenya. This was a randomized controlled trial (RCT) involving 80 patients with uncontrolled high BP (systolic BP (SBP) ≥140mmHg and/or diastolic BP (DBP) ≥90) randomized to either a CHW homebased intervention or a usual care (control) arm and followed up for 6 months. The intervention involved monthly CHW home-visits for health education and audits on behavioral risk factors that affect BP. An adapted WHO stepwise questionnaire and international physical activity questionnaire was used to collect data on behavioral cardiovascular risk factors. To assess the main outcomes of BP, body mass index (BMI) and waist-height-ratio (WHtR), a survey was conducted at baseline, 3 months, and 6 months. Data regarding univariate, bivariate and multivariate (repeated measurements between and within groups) analysis at 5% level of significance were analyzed using STATA 18. Generalized estimating equations (GEE) for repeated measures were used to estimate changes in BP, BMI and WHtR, and to examine the association between the CHW intervention and BP control. The study revealed that 77.5% and 92.5% of the participants in usual care and intervention groups completed the follow-up, respectively. After 6 months of follow-up, there was a reduction in the mean SBP and DBP for both arms, and reductions in BMI and WHtR only in the intervention arm. The adjusted mean reduction in SBP (-8.4 mm Hg; 95% CI, -13.4 to -3.3; P = 0.001) and DBP (-5.2 mm Hg 95% CI, -8.3 to -2.0; P<0.001) were significantly higher in the intervention group compared to the control group. The proportion of participants who achieved the controlled BP target of <140/90 mm Hg was 62.2% and 25.8% for the intervention and usual care arm, respectively. The proportion with controlled BP was significantly higher in the intervention arm compared to the usual care arm after adjusting for baseline covariates (AOR 2.8, 95% CI 1.3-6.0, p = 0.008). There was no significant effect of the intervention on BMI and WHtR. A home-based CHW intervention was significantly associated with reduction in BP among hypertensive patients compared to usual care. Future fully powered RCTs to test the effectiveness of such interventions among low-income populations are recommended. Trial registration number: PACTR202309530525257.

Korelacija između rezistencije na insulin i lipida u krvi kod dece

Background: This work focused on the correlation between insulin resistance (IR) and blood lipids (BL) in children with simple obesity, as well as the intervention effects of high-intensity interval training (HIIT) in weight loss in children. Methods: 80 children aged 6 to 17 years with simple obesity were selected from our hospital and randomly grouped into two groups. Children in the control (Ctrl) group underwent traditional moderate-intensity continuous training (MICT), while those in the other group received HIIT (HIIT group). After four weeks, body composition-related indicators, BL levels, and IR were measured. Results: After exercise, children in both groups possessed obvious reductions in body mass index (BMI), body fat percentage (BFP), triglyceride (TG), and homeostasis model assessment of IR (HOMA-IR), demonstrating remarkable differences in contrast to those after intervention (P&lt;0.05). The HIIT group also exhibited considerable differences in waist circumference (WC), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) (P&lt;0.05). After exercise, the HIIT group demonstrated more observable BMI, WC, TG, and HOMA-IR reductions, showing great differences with the Ctrl group (P&lt;0.05). HOMA-IR exhibited positive correlations with TC, TG, and HDL-C but a negative one with LDL-C (P&lt;0.05). Conclusions: HIIT improved the body composition and BL levels in children with simple obesity, downregulated HOMA-IR, and positively impacted their health status. Furthermore, IR was associated with BL-relevant indicators in children with simple obesity.

Plasma irisin and the brain-derived neurotrophic factor levels in sedentary subjects: effect of 8-weeks lifestyle intervention.

Objectives. Sedentary lifestyle increasingly observed in the population contributes to the incremental incidence of obesity, cardiovascular diseases, mental disorders, type 2 diabetes, hyper-tension, dyslipidemia, and others. Physical inactivity together with an imbalance in caloric intake and expenditure leads to a loss of muscle mass, reduced insulin sensitivity, and accumulation of the visceral fat. Organokines (adipokines, myokines, hepatokines, etc.) serve in the organism for inter-organ communication. However, human studies focused on the exercise-related changes in plasma levels of certain myokines have produced contradictory results. In the present study, we verified a hypothesis that myokine irisin, which is expected to increase in response to physical activity, induces brain-derived neurotrophic factor (BDNF) production and by this way mediates the beneficial effect of exercise on several brain functions. Subjects and Methods. Women (n=27) and men (n=10) aged 44.5±12.0 years, who were sedentary and overweight/obese (men ≥25%, women ≥28% body fat), participated in the study. The effect of an 8-week intensive lifestyle intervention (150 minutes of moderate physical activity per week, diet modification, and reduction of caloric intake) on the selected organokines (irisin, BDNF) in the context of an expected improvement in cardiometabolic status was examined. Results. The 8-week lifestyle intervention resulted in a significant (p<0.05) reduction in body mass index, body fat, blood pressure, insulin resistance, lipid and liver parameters, and irisin levels (p<0.001). However, BDNF increase in the whole group did not reach statistical significance. After the improvement of cardiometabolic parameters, a significant decrease in irisin and increase in BDNF levels were also observed in the subgroup with unsatisfactory (≤5%) body weight reduction. Neither relationship between irisin and BDNF levels, nor effect of age or sex on their levels was observed. Conclusions. We cannot confirm the hypothesis that exercise-induced irisin may increase the BDNF levels, whereas, the organokine levels in the periphery may not completely reflect the processes in the brain compartments. The observed decrease in irisin levels after 8-week intensive lifestyle intervention program, which was in contrary to its supposed mechanisms of action and dynamics, suggests the presence of several yet undiscovered impacts on the secretion of irisin.

Factors affecting blood sugar changes in diabetic patients using a three-level model in analysis of longitudinal data.

Diabetes, a currently threatening disease, has severe consequences for individuals' health conditions. The present study aimed to investigate the factors affecting the changes in the longitudinal outcome of blood sugar using a three-level analysis with the presence of missing data in diabetic patients. A total of 526 diabetic patients were followed longitudinally selected from the annual data collected from the rural population monitored by Tonekabon health centers in the North of Iran during 2018-2019 from the Iranian Integrated Health System (SIB) database. In analyzing this longitudinal data, the three-level model (level 1: observation (time), level 2: subject, level 3: health center) was carried out with multiple imputations of possible missing values in longitudinal data. Results of fitting the three-level model indicated that every unit of change in the body mass index (BMI) significantly increased the fasting blood sugar by an average of 0.5 mg/dl (p=0.024). The impact of level 1 (observations) was insignificant in the three-level model. Still, the random effect of level 3 (healthcare centers) showed a highly significant measure for health centers (14.62, p<0.001). The BMI reduction, the healthcare centers' socioeconomic status, and the health services provided have potential effects in controlling diabetes.

Reliability of the New Index of Global Food Quality and its relationship with sociodemographic variables and physical activity levels in the Chilean population.

surveys play a crucial role in evaluating the quality of food in populations, especially in healthcare settings, helping identify important characteristics of food descriptions and improving efficiency in the collection and management of data in dietary surveys. the primary aim of this study was to analyze the internal consistency of the New Index of Global Food Quality (NIGFQ) instrument and assess its applicability to sociodemographic variables and levels of physical activity (IPAQ-S) in a specific region of Chile. a descriptive, comparative, and correlational study that utilizes the online platform of Google Forms for data collection using the New Index of Global Food Quality (NIGFQ) and IPAQ-S instruments, in addition to considering sociodemographic variables, in a sample of 1,331 participants from the metropolitan region of Chile. the study shows an improvement in the reliability of the GQIN (Cronbach's alpha: 0.63 to 0.71). Findings reveal significant inverse correlations between fruits (r = -0.31; p ≤ 0.05) and legumes (r = -0.34; p ≤ 0.05) with body mass. it is concluded that values above 52.5 points are considered healthy on the new evaluation scale of the index, supported by statistical reliability tests. Similarly, the components of the adjusted New Index of Global Food Quality, particularly fruits and vegetables in greater proportion, show a beneficial relationship with daily consumption in reducing body mass index and body weight.

The effect of water-soluble tomato concentrate on elevated serum cholesterol in the middle-aged and elderly Chinese individuals.

Water-soluble tomato concentrate (WSTC) has demonstrated beneficial effect on blood flow in healthy populations. The prospective, randomized, double-blind, and placebo-controlled clinical trial was conducted to explore the impact of WSTC on individuals with elevated cholesterol levels. Sixty participants aged 35-65 with high cholesterol were enrolled and evenly divided into a treatment group (FFG) and a placebo group (PCG). Over a 60-day period comprising a 45-day treatment phase followed by a 15-day observational follow-up. Participants in the FFG received 300 mg daily of Fruitflow tablets, while the PCG were received placebos. The study showed that there were no significant differences in baseline parameters between the FFG and PCG (p > 0.05). Post-intervention, the FFG exhibited significant reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 4.2% (SBP, p < 0.001) and 3.8% (DBP, p = 0.015), respectively, compared to the PCG (p = 0.041). These reductions were sustained during the follow-up period. In contrast, the PCG showed no significant changes in SBP and DBP (p > 0.05). Stratified analysis by hypertension status revealed a significant SBP reductions both hypertensive and non-hypertensive FFG subjects (p < 0.05), with a trend towards DBP reduction. No significant changes in SBP and DBP were observed in the PCG. Moreover, the FFG group showed a significant increase in high-density lipoprotein (HDL) cholesterol (p < 0.05), along with a marked reduction in both weight and body mass index (BMI) (p < 0.05). The FFG also showed decreased levels of homocysteine, high-sensitivity C-reactive protein, and fasting blood glucose compared to the PCG (p < 0.05). In conclusion, WSTC has the potential to lower blood pressure and cardiovascular risk profiles in hypercholesterolemic individuals, presenting a viable non-harmacological option for enhancing cardiovascular health. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=27052, identifier ChiCTR1800015904.

Meta-analysis of the clinical efficacy of liraglutide in treating type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease.

This study aimed to systematically evaluate the efficacy of liraglutide in treating type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) by comparing liraglutide with placebo or other drugs (mainly insulin). The PubMed, Web of Science, and National Library of Medicine databases were systematically searched from their inception until December 1, 2023. A meta-analysis was performed using Stata 15.1 software. A total of 12 studies with 13 outcome measures were included. The meta-analysis results revealed that liraglutide significantly reduced body mass index (mean difference [MD] = -1.06, 95%CI: -1.41, -0.70, p < 0.001), triglycerides (MD = -0.35, 95%CI: -0.61, -0.09, p = 0.0009), visceral adipose tissue (MD = -21.06, 95%CI: -34.58, -7.55, p = 0.002), and subcutaneous adipose tissue (MD = -20.53, 95%CI: -29.15, -11.90, p < 0.001) levels in patients with T2DM and NAFLD. Of the 11 studies, 2 reported the occurrence of adverse reactions, which were primarily gastrointestinal. Compared with placebo and other drugs (e.g., insulin), liraglutide may improve glucose metabolism, lipid and liver function parameters, and visceral and subcutaneous fat in patients with T2DM and NAFLD, thus constituting an effective treatment for these patients.

Effect of Punching Bag Exercises on Body Mass Index (BMI)

Background: The increasing global prevalence of obesity and overweight conditions necessitates effective physical activity interventions for weight management. Punching bag exercises, utilized in martial arts and boxing, offer a combination of aerobic and strength training, which could be beneficial for Body Mass Index (BMI) reduction. This study aims to investigate the impact of a structured punching bag exercise regimen on BMI among young adults. Objective: The primary objective of this study was to assess the effectiveness of a six-week punching bag exercise program in reducing the BMI of university students. Methods: The study was designed as a six-week experimental intervention, involving 30 undergraduate students (37% male, 63% female) with an average age of 24.42 ± 0.631 years, randomly selected from various institutions. Participants engaged in a punching bag exercise regimen on alternating days. Each session comprised four rounds of three-minute exercises with one-minute breaks between each round, totaling 15 minutes per session. BMI was measured weekly throughout the program. Data were analyzed using SPSS-21 software, with descriptive statistics and paired t-tests applied for statistical evaluation. Results: The study commenced with an average BMI of 25.67 kg/m^2. Week-by-week analysis revealed a consistent decrease in BMI: 25.63 kg/m^2 in the second week, 25.22 kg/m^2 in the third week, 25.13 kg/m^2 in the fourth week, 24.36 kg/m^2 in the fifth week, and 24.11 kg/m^2 in the sixth week. Statistically significant reductions in BMI were observed in the fifth (p = 0.038) and sixth weeks (p = 0.011), compared to the baseline. Conclusion: The six-week punching bag exercise regimen resulted in a significant reduction in BMI, particularly notable in the final weeks of the intervention. These findings suggest the potential efficacy of punching bag exercises in BMI management and weight reduction strategies among young adults.

Estimated-Adult BMI Versus BMI for Monitoring Childhood Obesity

A child or an adult is considered obese (wasted), when the incumbent has excess (lesser) mass-for-height. BMI (body-mass index) is, universally, employed to estimate status of obesity (wasting). The name was given by Ancel Keys (1904-2004) and co-workers, replacing the earlier name ‘Quetelet index’ (1832) after the Belgian astronomer, mathematician and statistician, Adolphe Quetelet (1796-1874). To compute BMI of an individual, one should divide the incumbent’s mass (in kg — kilograms) by square of height (in m — meters). This index has its weak as well as its strong points. It is not able to account for factors like size of body frame as well as muscularity. Further, it is based on incorrect assumptions about body fat and lean mass distribution. As the person attains mature age, a decrease in height occurs, which results in BMI reduction, although the mass is not altered. Further, BMI is not able to establish a universal threshold for conditions of overweight and underweight as well as inter- and intra-region variations in body compositions of different communities, the later one appears by the presence of different ethnic groups within the same region. For children, the BMI range, which is routinely employed for estimating statuses for adults, is not applicable. BMI tables are needed to interpret childhood obesity-and-malnutrition.

Editorial

Editorial

Clinical Evaluation of a Novel, Patented Green Coffee Bean Extract (GCB70®), Enriched in 70% Chlorogenic Acid, in Overweight Individuals

Objective Obesity and overweight are challenging health problems of the millennium that lead to diabetes, hypertension, dyslipidemia, nonalcoholic fatty liver disease (NAFLD), and atherosclerosis. Green coffee bean exhibited significant promise in healthy weight management, potentiating glucose-insulin sensitization and supporting liver health. The safety and efficacy of a novel, patented water-soluble green coffee bean extract (GCB70® enriched in 70% total chlorogenic acid and <1% caffeine) was investigated in 105 participants for 12 consecutive weeks. An institutional review board and Drugs Controller General (India) (DCGI) approvals were obtained, and the study was registered at ClinicalTrials.gov. Method Body weight, body mass index (BMI), waist circumference, lipid profile, plasma leptin, glycosylated hemoglobin (HbA1c), and total blood chemistry were assessed over a period of 12 weeks of treatment. Safety was affirmed. Results GCB70 (500 mg BID) supplementation significantly reduced body weight (approximately 6%; p = 0.000**) in approximately 97% of the study population. About a 5.65% statistically significant reduction (p = 0.000**) in BMI was observed in 96% of the study volunteers. Waist circumference was significantly reduced by 6.77% and 6.62% in 98% of the male and female participants, respectively. Plasma leptin levels decreased by 13.6% in 99% of the study population as compared to the baseline value. Upon completion of 12 weeks’ treatment, fasting glucose levels decreased by 13.05% (p = 0.000**) in 79% of the study population. There was a statistically significant decrease in HbA1c levels in both male and female participants (p = 0.000**), while 86.7% of the study participants showed a statistically significant decrease in thyroid-stimulating hormone (TSH) levels (p = 0.000**). The mean decrease in TSH levels on completion of the treatment was 14.07% in the study population as compared to baseline levels. Total blood chemistry analysis exhibited broad-spectrum safety. Conclusions This investigation demonstrated that GCB70 is safe and efficacious in healthy weight management.

Exploring the Effectiveness of Self-Management Interventions in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.

Chronic diseases are a leading cause of global morbidity and mortality. In response to this challenge, self-management interventions (SMIs) have emerged as an essential tool in improving patient outcomes. However, the diverse and complex nature of SMIs pose significant challenges in measuring their effectiveness. This work aims to investigate the comparative effectiveness of SMIs on Type 2 diabetes mellitus (T2DM) outcomes. A rigorous analytical framework was employed to assess the relative effectiveness of different SMIs, encompassing both pairwise and network meta-analysis (NMA), as well as component network meta-analysis (CNMA). Various outcomes were considered, including glycated hemoglobin (HbA1c) control, body mass index (BMI) reduction and low-density lipoprotein (LDL) cholesterol. Visualization tools were also utilized to enhance the interpretation of results. SMIs were found promising in improving clinical outcomes and patient-reported measures. However, considerable heterogeneity and inconsistency across studies challenged the validity of NMA results. CNMA along with various visualization tools offered insights into the contributions of individual SMI components, highlighting the complexity of these interventions. SMIs represent a valuable approach to managing chronic conditions, but their effectiveness is context-dependent. Further research is needed to elucidate the contextual factors influencing SMI outcomes. This work contributes to a comprehensive understanding of SMIs' role in T2DM management, aiming to aid decision-makers, clinicians, and patients in selecting tailored interventions.

Timing Matters: Optimizing the Timeframe for Preoperative Weight Loss to Mitigate Postoperative Infection Risks in Total Knee Arthroplasty

BackgroundWe explore the incidence of periprosthetic infections post-total knee arthroplasty (TKA) in morbidly obese patients who achieved weight loss. Current American Academy of Orthopaedic Surgeons guidelines suggest a preoperative body mass index (BMI) below 40 for TKA. This study assesses infection risks in patients initially who had a BMI of 40-50 who reduced their BMI to under 35 at varying intervals prior to surgery. MethodsWe reviewed a national, all-payer database, PearlDiver, for patients undergoing primary TKA. Patients were stratified based on initial BMI of 40 to 50 and reduction of BMI to less than 35 at 3 months (n = 1,932), 3 to 6 months (n = 794), 6 to 9 months (n = 2,233), and 9 to 12 months (n = 1,194) prior to TKA, as well as patients who had a BMI between 40 to 50 (n = 41,632) on the day of surgery. The nonobese group comprised of patients who had a BMI between 20 and 30 (n = 33,294). Multivariate analyses were performed at one-year follow-up. ResultsWe found an increased risk of PJI for patients who had achieved BMI reduction less than nine months prior to TKA, compared to the BMI 20 to 30 cohort at the one-year follow-up (P < .001). Patients who achieved BMI reduction nine to twelve months prior to TKA showed no significant difference in PJI risk compared to the matching nonobese cohort at one-year follow-up (P = .400). ConclusionsIn conclusion, our results suggest that weight loss should be achieved at least nine months before TKA to decrease infection risks. These findings have significant implications for surgical considerations in obese patients undergoing TKA.

Obesity Variants in the GIPR Gene Are not Associated With Risk of Fracture or Bone Mineral Density.

It is not clear if antagonizing the GIP (glucose-dependent insulinotropic polypeptide) receptor (GIPR) for treatment of obesity is likely to increase the risk of fractures, or to lower bone mineral density (BMD) beyond what is expected with rapid weight loss. The objective of this study was to investigate the risk of fracture and BMD of sequence variants in GIPR that reduce the activity of the GIP receptor and have been associated with reduced body mass index (BMI). We analyzed the association of 3 missense variants in GIPR, a common variant, rs1800437 (p.Glu354Gln), and 2 rare variants, rs139215588 (p.Arg190Gln) and rs143430880 (p.Glu288Gly), as well as a burden of predicted loss-of-function (LoF) variants with risk of fracture and with BMD in a large meta-analysis of up to 1.2 million participants. We analyzed associations with fractures at different skeletal sites in the general population: any fractures, hip fractures, vertebral fractures and forearm fractures, and specifically nonvertebral and osteoporotic fractures in postmenopausal women. We also evaluated associations with BMD at the lumbar spine, femoral neck, and total body measured with dual-energy x-ray absorptiometry (DXA), and with BMD estimated from heel ultrasound (eBMD). None of the 3 missense variants in GIPR was significantly associated with increased risk of fractures or with lower BMD. Burden of LoF variants in GIPR was not associated with fractures or with BMD measured with clinically validated DXA, but was associated with eBMD. Missense variants in GIPR, or burden of LoF variants in the gene, are not associated with risk of fractures or with lower BMD.

Evaluating the Clinical Effectiveness and Safety of Semaglutide in Individuals with Uncontrolled Type2 Diabetes. Real-World Evidence from Saudi Arabia: The Observational, Multicenter, 15-Month EVOLUTION Study.

This study aimed to assess the safety and effectiveness of semaglutide, administered either by weekly subcutaneous (SC) injection or orally, in real-life practice in Saudi Arabia in individuals with type2 diabetes mellitus (T2DM). A retrospective chart review study was conducted at 18 Saudi Arabia centers. An accredited centralized institutional review board approved the study. Medical records were included for individuals of any age ≥ 18years with uncontrolled T2DM. The primary outcome measure was the laboratory glycated hemoglobin (HbA1c) level.Secondary measures included fasting blood glucose (FBG), weight, and hypoglycemia. All variables were checked after 6 and 12months of semaglutide initiation. The analysis of this study included 1223 patients with uncontrolled T2DM (HbA1c > 7%). The mean (SD) baseline HbA1c was 10.02% (1.17). HbA1c was reduced by an average of 3.02% (0.84) and 3.17% (0.84) at 6 and 12months, respectively. Results of a repeated measure analysis of variance (ANOVA) indicated significant differences in HbA1c (pvalue < 0.001). HbA1c levels at 6 and 12months were significantly lower, 7.00% (0.70) and 6.85% (0.69), than at baseline, 10.02% (1.17). About 193 patients (56.4%) of the 295 patients having HbA1c < 9% achieved HbA1c of 5.7% or less. The frequency of hypoglycemia events was 4.60 (1.10) in the 3months before semaglutide was initiated. The frequency of hypoglycemia events in the last 3months was 2.30 (0.80) events and 0.80 (0.50) events at 6-month and 12-month follow-up visits, respectively. The percent reduction in body mass index (BMI) was an average of 13.07% (1.53) and 19.89% (4.07) at 6 and 12months, respectively. Lipid profile and blood pressure were improved at 6 and 12months. Semaglutide, administered either by SC injection or orally, provided substantial glycemic and weight-loss benefits in adults with T2DM.

The effectiveness of an mHealth intervention ondiabetes risk factors and body composition.

Early identification and lifestyle intervention is beneficial for people with risk for diabetes. The aim of this study was to evaluate the risk of type 2 diabetes (T2D) in healthy overweight or obese women using the FINDRISC score and a twelve-week long mobile app-based lifestyle intervention.Fifty-four subjects were involved and forty-eight were analysed, n = 28 in the intervention group (online group: OG) and n = 20 in the control group (CG). Body composition was assessed using the InBody 720 device and diabetes risk was evaluated with the Finnish Diabetes Risk Questionnaire. The calorie intake and macronutrients were evaluated by a 3-day diary. Group differences and pre- and post-results were analysed using student t-tests by TIBCO Statistica 13.40.14.Significantly decreased body mass index (28.0 ± 2.5 kg m-2 vs 25.8 ± 4.3 kg m-2, P = 0.00), body fat percentage (37.5 ± 6.3% vs 34.1 ± 5.9%, P = 0.03), waist circumference (100.8 ± 7.2 cm vs 94.7 ± 8.2 cm, P= 0.00) and visceral fat (124.0 ± 29.2 cm³ vs 109.0 ± 24.6 cm³, P = 0.04) were found in the OG. By the end of the programme, both groups showed significant decrease in food consumption, daily calorie intake (OG: 2,348.6 ± 348.0 vs 1,483.1 ± 114.4, CG: 2,372.4 ± 464.2 vs 1,654.1 ± 201.3 kcal day-1, P = 0.00), fibre(OG: 19.5 ± 3.7 vs 26.1 ± 3.4, CG: 17.8 ± 3.9 vs 22.0 ± 4.8 g day-1, P = 0.00) and cholesterol consumption (OG: 365.2 ± 58.9 vs 266.2 ± 65.8, CG: 377.4 ± 72.1 vs 269.2 ± 42.7 mg day-1, P = 0.00). OGhad a more significant reduction in body mass index (P = 0.03) and body fat percentage (P = 0.04) values at the end of the programme compared to the control group.In this study, it was found that mHealth intervention is a useful and effective method in the Hungarian female population. Further studies are needed to investigate modifications of this intervention to achieve more health-related effects.

Fasting mimicking diet cycles versus a Mediterranean diet and cardiometabolic risk in overweight and obese hypertensive subjects: a randomized clinical trial

Abnormalities in the vascular endothelium such as impaired vasodilation can contribute to atherosclerosis and hypertension. Here we have performed a single-center randomized clinical trial to evaluate the efficacy of 4 months of a continuous Mediterranean diet (MD) regimen as compared to 4 cycles of fasting mimicking diet (FMD) administered for only 5 days/month on endothelial function, measured as reactive hyperemia index (RHI) and large/small-resistance artery compliance (AC1/AC2), and on other cardiometabolic risk factors, in hypertensive patients with obesity/excess weight [both sexes, body mass index (BMI) ≥ 28, RHI ≤ 2.0, and/or small-resistance artery compliance (AC2) ≤ 5.0]. At the end of the intervention period, FMD but not MD decreased RHI (p = 0.0023) compared to baseline with no increase in the portion of patients with abnormal RHI. Both FMD and MD improved PULS cardiac test score; evaluating the risk of cardiovascular events. FMD and MD did not show any significant change in either AC1 or AC2 compared to baseline. Both FMD and MD led to comparable decreases in weight, waist circumference, BMI, body fat mass and % body fat, total cholesterol, and leptin. FMD decreased HbA1c (p = 0.0059) and IGF-1 (p = 0.0427), while MD decreased glucose (p = 0.0488), HOMA-IR (p = 0.0476), and HDL-C (p = 0.0419). None of the parameters were significantly different between the FMD vs. MD group at the end of the intervention period. During the 3-month follow-up period, the FMD and MD groups continued to display weight and BMI reduction; however, the MD group also lost fat free mass (FMD vs. MD, p = 0.0498). In summary, both MD and FMD reduced a range of cardiometabolic risk factors, but FMD also decreased RHI, a change associated with either impaired functional integrity of vascular endothelial cells but also with vascular rejuvenation, with the latter being more likely considering the improved cardiometabolic profile, reduced PULS cardiac score and calculated heart age, and unaltered arterial compliance in the FMD group. MD but not FMD cycles caused loss of lean body mass.