Body Mass Index Scores Research Articles

Temporalis and masseter muscle thickness as predictors of post-stroke dysphagia after endovascular thrombectomy

PurposePost-stroke dysphagia (PSD) is a common sequela of stroke. Given the association between dysphagia and sarcopenia, we aimed to investigate the association between PSD and temporal muscle thickness (TMT) and masseter muscle thickness (MMT) following endovascular thrombectomy (EVT) in patients with large-vessel occlusion (LVO). MethodsThis retrospective cohort study included hospitalized patients with LVO stroke who underwent EVT between January 1, 2018, and October 31, 2022. TMT and MMT were measured using brain computed tomography (CT) angiography. The correlation between relevant clinicodemographic factors and both TMT and MMT was examined. The relationship between each of two parameters (TMT and MMT) and PSD, which was defined as the retention of the nasogastric (NG) tube at 4 and 12 weeks, was evaluated in adjusted logistic regression models. ResultsAmong the 148 participants, the mean TMT and MMT was 5.9 ± 1.6 and 11.2 ± 2.3 mm, respectively. Lower age, male sex, higher body mass index (BMI), higher albumin levels, and a lower initial National Institute of Health Stroke Scale (NIHSS) score were associated with higher TMT and MMT (p < 0.05). In the logistic regression analysis adjusted for age, sex, BMI, serum albumin, and NIHSS score, lower TMT and MMT significantly correlated with PSD at weeks 4 and 12 (p < 0.001). ConclusionTMT and MMT are associated with age, sex, BMI, albumin, and the initial NIHSS score. Both TMT and MMT are independent indicators of post-EVT PSD in stroke patients and serve as reliable predictors of NG removal.

Strengths-Based Factors Related to Post-Traumatic Stress Problems in Black Youth with High Body Weights.

Black youth with high body weights [BYHW; Body Mass Index (BMI)≥95th percentile] endure unique stressors (e.g., exposure to discrimination due to race and size) that may contribute to psychopathology. Factors that decrease mental health problems associated with these stressors have been underexamined in BYHW. The current study assessed how multisystemic resilience, weight-related quality of life (QOL), and discrimination were associated with post-traumatic stress problems in BYHW from the perspective of youth and their caregivers. A total of 93 BYHW and one of their primary caregivers were recruited from a Midsouth children's hospital. Youth ranged in age from 11 to 17 years (Mage=13.94, SD = 1.89), were mostly girls (61.3%), and had CDC-defined BMI scores above the 95th percentile. Nearly all caregivers were mothers (91.4%; Mage=41.73 years, SD = 8.08). Youth and their caregivers completed measures of resilience, discrimination, weight-related QOL, and post-traumatic stress problems. Utilizing linear regression modeling, the youth model was significant [F(3, 89)=31.63, p<.001, Adj. R2=.50], with higher resilience (β=-.23; p=.01) and lower discrimination (β=.52; p<.001) associated with fewer post-traumatic stress problems. The caregiver regression model was also significant [F(2, 90)=10.45, p<.001, Adj. R2=.17], with higher weight-related QOL associated with lower post-traumatic stress problems (β=-.37; p<.001). Findings illustrate differences in youth and caregiver perceptions of factors related to post-traumatic stress problems in BYHW. Youth emphasized both internal and external contributors to stress, while caregivers focused on internal variables. Such knowledge could be harnessed to develop strengths-based interventions that address health and well-being among BYHW.

Comparison of mortality rate and septic and aseptic revisions in total hip arthroplasties for osteoarthritis and femoral neck fracture: an analysis of the German Arthroplasty Registry

BackgroundIndications for total hip arthroplasties (THA) differ from primary osteoarthritis (OA), which allows elective surgery through femoral neck fractures (FNF), which require timely surgical care. The aim of this investigation was to compare mortality and revisions in THA for primary OA and FNF.MethodsData collection for this study was performed using the German Arthroplasty Registry (EPRD) with analysis THA for the treatment of FNF and OA. Cases were matched 1:1 according to age, sex, body mass index (BMI), cementation, and the Elixhauser score using Mahalanobis distance matching.ResultsOverall 43,436 cases of THA for the treatment of OA and FNF were analyzed in this study. Mortality was significantly increased in FNF, with 12.6% after 1 year and 36.5% after 5 years compared with 3.0% and 18.7% in OA, respectively (p < 0.0001). The proportion for septic and aseptic revisions was significantly increased in FNF (p < 0.0001). Main causes for an aseptic failure were mechanical complications (OA: 1.1%; FNF: 2.4%; p < 0.0001) and periprosthetic fractures (OA: 0.2%; FNF: 0.4%; p = 0.021). As influencing factors for male patients with septic failure (p < 0.002), increased BMI and Elixhauser comorbidity score and diagnosis of fracture (all p < 0.0001) were identified. For aseptic revision surgeries, BMI, Elixhauser score, and FNF were influencing factors (p < 0.0001), while all cemented and hybrid cemented THA were associated with a risk reduction for aseptic failure within 90 days after surgery (p < 0.0001).ConclusionIn femoral neck fractures treated with THA, a significant higher mortality, as well as septic and aseptic failure rate, was demonstrated compared with prosthesis for the therapy of osteoarthritis. Increased Elixhauser comorbidity score and BMI are the main influencing factors for development of septic or aseptic failure and can represent a potential approach for prevention measures.Level of evidence: Level III, Prognostic.

Gene-Environment Interplay in the Development of Overweight

PurposeOverweight in youth is influenced by genes and environment. Gene-environment interaction (G×E) has been demonstrated in twin studies and recent developments in genetics allow for studying G×E using individual genetic predispositions for overweight. We examine genetic influence on trajectories of overweight during adolescence and early adulthood and determine whether genetic predisposition is attenuated by higher socioeconomic status and having physically active parents. MethodsLatent class growth models of overweight were fitted using data from the TRacking Adolescents’ Individual Lives Survey (n = 2720). A polygenic score for body mass index (BMI) was derived using summary statistics from a genome-wide association study of adult BMI (N = ∼700,000) and tested as predictor of developmental pathways of overweight. Multinomial logistic regression models were used to examine effects of interactions of genetic predisposition with socioeconomic status and parental physical activity (n = 1675). ResultsA three-class model of developmental pathways of overweight fitted the data best (“non-overweight”, “adolescent-onset overweight”, and “persistent overweight”). The polygenic score for BMI and socioeconomic status distinguished the persistent overweight and adolescent-onset overweight trajectories from the non-overweight trajectory. Only genetic predisposition differentiated the adolescent-onset from the persistent overweight trajectory. There was no evidence for G×E. DiscussionHigher genetic predisposition increased the risk of developing overweight during adolescence and young adulthood and was associated with an earlier age at onset. We did not find that genetic predisposition was offset by higher socioeconomic status or having physically active parents. Instead, lower socioeconomic status and higher genetic predisposition acted as additive risk factors for developing overweight.

#4287 GASTROINTESTINAL SYMPTOMS IN PATIENTS RECEIVING HEMODIALYSIS: PREVALENCE, SEVERITY AND ASSOCIATED FACTORS

Abstract Background and Aims Gastrointestinal (GI) symptoms are common among patients with chronic renal failure, especially in those treated with maintenance hemodialysis (HD), and may adversely affect patients'' quality of life. A variety of GI symptoms has been reported, but previous studies present conflicting results regarding their association with age, sex, comorbidities, concomitant medications and dialysis modality. This study aimed to assess the prevalence and severity of GI symptoms in the maintenance HD population and explore possible associated factors. Method A total of 188 stable patients (55.3% male, 53.7% ≥65 years of age, age range 24–85, 30.9% with diabetes, 19.9% smokers) from three HD centres were enrolled in this observational cross-sectional study. Gastrointestinal symptoms were assessed by the self-administered Gastrointestinal Symptoms Rating Scale (GSRS). The scale includes 15 items graded by a 7-point Likert scale that can be grouped into five dimensions: abdominal pain syndrome, reflux syndrome, indigestion syndrome, diarrhoea syndrome, and constipation syndrome. A dimension score is calculated as the mean value of the items belonging to the specific syndrome, and the final score is the mean of dimension scores. Standard blood analyses, Kt/V, body mass index (BMI) and malnutrition-inflammation score (MIS) were determined in all patients. Other relevant demographic and clinical data were obtained from the patient's medical records. The results were analyzed with SPSS software, version 22 (IBM Corporation, New York, USA). Results The average BMI was 25.04±4.29. Half of the patients (50.3%) were overweight, 45.3% had normal weight, and 4.3% were underweight. The average MIS was 5.64±2.87. The average number of symptoms per patient was 4.01±3.20 (range 0 – 15). At least one GI symptom was reported by 84.6% of patients (33.0% reported 1 – 3 symptoms, and 49.5% reported 4 or more symptoms). The mean GSRS scores for eating dysfunctions were 1.59±1.08 for reflux, 1.74±0.98 for abdominal pain, 1.75±1.14 for constipation, 1.94±1.01 for indigestion, and 1.38±0.90 for diarrhoea. Total GSRS was 1.70±0.61. Elderly patients had a significantly lower overall number of GI symptoms (3.49±2.83 vs 4.57±3.51; p = 0.023), lower abdominal pain score (1.60±0.96 vs 1.91±1.09; p = 0.031), and indigestion score (1.74±0.85 vs 2.18±1.15; p = 0.005), but higher constipation (1.94±1.27 vs 1.54±0.96;p = 0.017) score than individuals under 65 years of age. Patients smoking cigarettes and those longer on HD had a significantly higher overall number of GI symptoms (3.44±0.56 vs 3.10±0.25; p = 0.035 and 3.78±2.99 vs 2.46±2.23; p = 0.016 respectively). Average abdominal pain score was significantly higher in non-diabetic (1.87±1.04 vs 1.44±0.75; p = 0.002) and underweight (2.62±1.51 vs 1.71±0.94 vs 1.65±0.90; p = 0.023) compared to diabetic, normal weight and overweight patients respectively. Patients taking ASA or NSAIDs had significantly higher total GSRS scores (1.84±0.72 vs 1.60±0.50; p = 0.016 and 1.88±0.64 vs 1.65±0.59; p = 0.044 respectively). Sex, dialysis adequacy and malnutrition-inflammation status were not significantly related to any of the GSRS dimensions. Conclusion The present study demonstrates a high prevalence of GI symptoms in maintenance HD patients and identifies age, cigarette smoking, diabetes, dialysis vintage, and certain medications as important elements to consider when addressing specific groups of GI symptoms in this population.

Associations between combinations of 24-h movement behaviors and physical fitness among Chinese adolescents: Sex and age disparities.

To analyze the relationship between 24-h movement behaviors and adolescents' physical fitness, with sex difference and age disparity explored specifically. A total of 135 852 Chinese adolescents aged 13-22 years were included in this cross-sectional study. Self-reported 24-h movement behavioral times, including moderate to vigorous physical activity (MVPA), recreational screen, and sleep, were identified as meeting guidelines based on Canadian recommendations. Physical fitness indicator (PFI) was calculated through sex- and age-specific z scores of body mass index, forced vital capacity, 50 m dash, sit-and-reach, standing long jump, body muscle strength, and endurance running, and then classified as: low level (<20th), middle level (20th-80th), and high level (>80th). Mixed effect logistic regression was applied to analyze the association, and interaction terms were constructed to prove the sex and age disparities. Only 12.4% of adolescents aged 13-22 years met all three recommendations. The number of meeting guidelines exhibited a typical dose-response relationship with high level PFI (OR = 1.22 [95% CI: 1.19-1.25]), and in detail, meeting MVPA + recreational screen (OR = 2.29 [95% CI: 2.09-2.51]) or MVPA-only (OR = 2.16 [95% CI: 1.93-2.41]) guidelines were better associated with high-level PFI. Besides, meeting MVPA-only guideline was proved with stronger association with high-level PFI for boys (p-interaction = 0.005). The dose-response relationship in boys of the number of guidelines met with PFI was stronger in 19- to 22-year-olds (p-interaction <0.001) and 16- to 18-year-olds (p-interaction = 0.001) than that in 13- to 15-year-olds. The prevalence of meeting 24-h movement behaviors guidelines among Chinese adolescents aged 13-22 years was relatively low. It was associated with adolescents' physical fitness, with meeting MVPA + recreational screen or MVPA-only guidelines bringing greater benefits, and sex difference and age disparity existing.

Psychological factors and symptom duration are associated with exercise-based treatment effect in people with hypermobile shoulders: A secondary analysis of a randomised controlled trial

BackgroundShoulder symptoms are common in patients with hypermobility spectrum disorders (HSD), but few studies focus on identifying factors associated with treatment effects. AimTo identify baseline and clinical characteristics associated with a better outcome 16 weeks after starting an exercise-based treatment in patients with HSD and shoulder symptoms. DesignExploratory secondary analysis of data from a randomised controlled trial. MethodSelf-reported treatment outcome was reported as change between baseline and follow-up after 16 weeks of high-load or low-load shoulder strengthening. Multiple linear and logistic regressions were used to investigate associations of patient expectations of treatment effect, self-efficacy, fear of movement, and symptom duration with change in shoulder function, shoulder pain, quality of life, and patient reported health change. All regression models were performed firstly with adjustments for covariates (age, sex, body mass index, hand dominance, treatment group, and baseline score of the outcome variable) and secondly with additional adjustments for exposure variables. ResultsExpectations of complete recovery were associated with an increased odds of perceiving an important improvement in physical symptoms after a 16-week exercise-based treatment program. Higher self-efficacy at baseline seemed to be associated with improved shoulder function, shoulder pain and quality of life. A higher fear of movement seemed to be associated with increased shoulder pain and decreased quality of life. A longer symptom duration was associated with decreased quality of life. ConclusionExpectations of complete recovery, higher self-efficacy, lower fear of movement and shorter symptom duration seem to be important for better treatment outcomes.

Cardiovascular risk factors among Jordanian patients with rheumatoid arthritis: A cohort study.

To determine the frequency of risk factors for cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) in Jordan. During this study, 158 patients with RA were enlisted from the outpatient rheumatology clinic at King Hussein Hospital of the Jordanian Medical Services, from 1 June 2021, to 31 December 2021. Demographic data and disease duration were recorded. After 14 h of fasting, venous blood samples were drawn to determine the levels of cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein. History of smoking, diabetes mellitus, and hypertension was recorded. Body mass index and Framingham's 10-year risk score (FRS) were calculated for each patient. Disease duration was noted. The mean age of the male population was 49.29 years and that of the female population was 46.06 years. Most of the study population were female (78.5%) and 27.2% of the study population had one modifiable risk factor. The most frequent risk factors observed in the study were obesity (38%) and dyslipidemia (38%). Diabetes mellitus was the least frequent risk factor, with a frequency of 14.6%. The FRS differed significantly between the sexes, with the risk score of men being 9.80, whereas that of women was 5.34 (p < .00). Regression analysis revealed that age increased the odds ratio of diabetes mellitus, hypertension, obesity, and a high-to-moderate FRS by 0.7%, 10.9%, 0.33%, and 10.3%, respectively. Rheumatoid arthritis patients have increased chances of developing cardiovascular risk factors leading to cardiovascular events.

Combined associations of a healthy lifestyle and body mass index on colorectal cancer recurrence and survival: A cohort study.

3609 Background: Colorectal cancer (CRC) risk is associated with modifiable lifestyle factors including smoking, physical inactivity, Western diet, and excess body weight. The impact of lifestyle factors on survival is less known. A cohort study was conducted to investigate the combined effects of a pre-diagnostic healthy lifestyle and body mass index (BMI) on prognosis following CRC diagnosis. Methods: Treatment and follow-up data were collected from the patient files of 1098 participants from the Swedish Colorectal cancer low-risk study cohort including stage I-III CRC patients. A healthy lifestyle and BMI (HL) score was computed using self-reported data on smoking status, physical activity, adherence to a Mediterranean diet pattern, and BMI five years before diagnosis, and divided into four categories ranging from least to most healthy. Survival analyses were performed to assess recurrence-free survival and overall survival across categories of exposure, using the Kaplan-Meier method and Cox proportional hazards model, the latter adjusted for age, sex, and educational level. Results: Among 1098 participants with stage I-III CRC, 233 (21.2%) had an HL score of 0-1 (least healthy), 354 (32.2%) HL score of 2, 357 (32.5%) HL score of 3 and 154 (14.0) HL score of 4 (most healthy). Participants missing follow-up data (n = 29) or relapsing ≤ 6 months (n = 29) were excluded from the recurrence-free survival analysis. 221 events of cancer recurrence were observed among 1040 participants during a median follow-up time of 4.3 years, and 542 deaths among 1098 participants during a median follow-up time of 6.3 years. Patients with the healthiest lifestyle had an improved recurrence-free survival (HL 4 vs HL0-1, HRadj 0.51 (95% CI 0.31-0.83) and overall survival (HL 4 vs HL 0-1, HRadj 0.52 (95% CI 0.38-0.70)). Stratifying these results for cancer stage (I-III) and tumor site (colon/rectum) did not alter estimated HR:s or 95% CI:s. Avoidance of smoking and being physically active were independently associated with improved recurrence-free survival and overall survival: non-smoking vs smoking HRadj 0.62 (95% CI 0.43-0.90), high vs low levels of physical activity HRadj 0.71 (95% CI 0.54-0-94)). Conclusions: Our study indicates that pre-diagnostic adherence to a healthy lifestyle may increase the recurrence-free and overall survival of patients with stage I-III CRC. Avoidance of smoking and being physically active were the strongest risk-reducing factors for these outcomes. [Table: see text]

Health change awareness and its association with weight loss following bariatric surgery.

Patients' ability to judge health change over time has important clinical implications for treatment, but is understudied in longitudinal contexts with meaningful health change. We assess patients' awareness of health change for 5 years following bariatric surgery, and its association with weight loss. Participants were part of the Longitudinal Assessment of Bariatric Surgery (N = 2,027). Perceived health change for each year was assessed by comparing it to self-reports of health on the SF-36 health survey. Participants were categorized as concordant when perceived and actual self-reported health change corresponded, and as discordant when they did not correspond. Year-to-year concordance between perceived and actual self-reported health change occurred less than 50% of the time. Discordance between perceived and actual health was associated with weight loss following surgery. Discordant-positive participants who perceived their health change as more positive than was warranted lost more weight post-surgery and thus had lower body mass index scores than concordant participants. Conversely, discordant-negative participants who perceived their health as worse than what was warranted lost less weight post-surgery and thus had higher body mass index scores. These results suggest that recollection of past health is generally poor and can be biased by salient factors during recall. Clinicians are advised to use caution when retrospective judgments of health are utilized. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Polygenic Risk Associations with Clinical Characteristics and Recurrence of Dupuytren Disease.

Dupuytren disease (DD) is a common complex trait, with varying severity and incompletely understood cause. Genome-wide association studies (GWAS) have identified risk loci. In this article, we examine whether genetic risk profiles of DD in patients are associated with clinical variation and disease severity and with patient genetic risk profiles of genetically correlated traits, including body mass index (BMI), triglycerides, high-density lipoproteins, type 2 diabetes mellitus, and endophenotypes fasting glucose and glycated hemoglobin. The authors used a well-characterized cohort of 1461 DD patients with available phenotypic and genetic data. Phenotype data include age at onset, recurrence, and family history of disease. Polygenic risk scores (PRSs) of DD, BMI, triglycerides, high-density lipoprotein, type 2 diabetes, fasting glucose, and hemoglobin A1c using various significance thresholds were calculated with PRSice using the most recent GWAS summary statistics. Control data from LifeLines were used to determine P value cutoffs for PRS generation explaining most variance. The PRS for DD was significantly associated with a positive family history for DD, age at onset, disease onset before the age of 50, and recurrence. We also found a significant negative correlation between the PRSs for DD and BMI. Although GWAS studies of DD are designed to identify genetic risk factors distinguishing case/control status, we show that the genetic risk profile for DD also explains part of its clinical variation and disease severity. The PRS may therefore aid in accurate prognostication, choosing initial treatment and in personalized medicine in the future. Risk, III.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients presenting sepsis-induced immunosuppression: The GRID randomized controlled trial

PurposeSeptic shock is associated in some patients with a profound immunosuppression. We hypothesized that GM-CSF would reduce the occurrence of ICU-acquired infections in immunosuppressed septic patients. MethodsRandomized double-blind trial conducted between 2015 and 2018. Adult patients, admitted to ICU, with severe sepsis or septic shock presenting with sepsis-induced immunosuppression defined by mHLA-DR < 8000 ABC (antibodies bound per cell) at day 3 were included. Patients were randomized to receive GM-CSF 125 μg/m2 or placebo for 5 days at a 1:1 ratio. The primary outcome was the difference in the number of patients presenting≥1 ICU-acquired infection at day 28 or ICU discharge. ResultsThe study was prematurely stopped because of insufficient recruitment. A total of 98 patients were included, 54 in the intervention group and 44 in the placebo group. The two groups were similar except for a higher body mass index and McCabe score in the intervention group. No significant difference was observed between groups regarding ICU-acquired infection (11% vs 11%, p = 1.000), 28-day mortality (24% vs 27%,p = 0.900), or the number or localization of the ICU infections. ConclusionGM-CSF had no effect on the prevention of ICU-acquired infection in sepsis immunosuppression, but any conclusion is limited by the early termination of the study leading to low number of included patients.

Integrative multiomics analysis of infant gut microbiome and serum metabolome reveals key molecular biomarkers of early onset childhood obesity

Evidence supports a complex interplay of gut microbiome and host metabolism as regulators of obesity. The metabolic phenotype and microbial metabolism of host diet may also contribute to greater obesity risk in children early in life. This study aimed to identify features that discriminated overweight/obese from normal weight infants by integrating gut microbiome and serum metabolome profiles. This prospective analysis included 50 South Asian children living in Canada, selected from the SouTh Asian biRth cohorT (START). Serum metabolites were measured by multisegment injection-capillary electrophoresis-mass spectrometry and the relative abundance of bacterial 16S rRNA gene amplicon sequence variant was evaluated at 1 year. Cumulative body mass index (BMIAUC) and skinfold thickness (SSFAUC) scores were calculated from birth to 3 years as the total area under the growth curve (AUC). BMIAUC and/or SSFAUC >85th percentile was used to define overweight/obesity. Data Integration Analysis for Biomarker discovery using Latent cOmponent (DIABLO) was used to identify discriminant features associated with childhood overweight/obesity. The associations between identified features and anthropometric measures were examined using logistic regression. Circulating metabolites including glutamic acid, acetylcarnitine, carnitine, and threonine were positively, whereas γ-aminobutyric acid (GABA), symmetric dimethylarginine (SDMA), and asymmetric dimethylarginine (ADMA) were negatively associated with childhood overweight/obesity. The abundance of the Pseudobutyrivibrio and Lactobacillus genera were positively, and Clostridium sensu stricto 1 and Akkermansia were negatively associated with childhood overweight/obesity. Integrative analysis revealed that Akkermansia was positively whereas Lactobacillus was inversely correlated with GABA and SDMA, and Pseudobutyrivibrio was inversely correlated with GABA. This study provides insights into metabolic and microbial signatures which may regulate satiety, energy metabolism, inflammatory processes, and/or gut barrier function, and therefore, obesity trajectories in childhood. Understanding the functional capacity of these molecular features and potentially modifiable risk factors such as dietary exposures early in life may offer a novel approach for preventing childhood obesity.

Comparison of Makorin Ring Finger Protein 3 Levels Between Obese and Normal Weight Patients with Central Precocious Puberty.

Genetic studies of familial central precocious puberty (CPP) have suggested that makorin ring finger protein 3 (MKRN3) is the primary inhibitor of gonadotropin-releasing hormone (GnRH) secretion. Obesity in girls can cause early puberty by affecting the hypothalamic-pituitary-gonadal (HPG) axis. This study evaluated the serum MKRN3 level of patients with CPP and its relationship with body mass index (BMI). The study included 92 CPP and 86 prepubertal healthy controls (HC) aged 6-10 years. The CPP and HC groups were divided into obese and non-obese subgroups to evaluate whether BMI affects MKRN3. Patients' presenting complaints, chronological age, height age, bone age, Tanner stage, standard deviation scores for weight, height, and BMI, levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and MKRN3, and pelvic ultrasonography findings were recorded. The serum MKRN3 levels were lower in the CPP group and lowest in the CPP-obese subgroup. There were significant differences in MKRN3 levels between the CPP-obese and CPP-normal weight (p=0.02), CPP-obese and HC-obese (p<0.001), and CPP-obese and HC-normal weight (p=0.03) groups. MKRN3 and BMI were negatively correlated in all cases (r=-0.326, p<0.001). The negative correlation between BMI and MKRN3, and lower MKRN3 levels in CPP-obese patients, suggests that adipose tissue has a role in the onset of puberty. More comprehensive studies are needed to determine the relationship between MKRN3 and adipose tissue.

Liver steatosis in patients with rheumatoid arthritis treated with methotrexate is associated with body mass index.

Methotrexate (MTX) is the usual first-line treatment for rheumatoid arthritis (RA). Long-term use of MTX has been associated with liver steatosis (LS) and liver fibrosis (LF). To determine if LS in patients treated with MTX for RA is associated with MTX cumulative dose (MTX-CD), metabolic syndrome (MtS), body mass index (BMI), the male sex, or LF. A single-center, prospective study of patients receiving MTX for RA was performed from February 2019 to February 2020. The inclusion criteria were patients aged 18 years or older diagnosed with RA by a rheumatologist and being treated with MTX (without limitation on the duration of treatment). The exclusion criteria were previous diagnosis of liver disease (hepatitis B or C virus infection, known nonalcoholic fatty liver disease), alcohol consumption greater than 60 g/d in males or 40 g/d in females, human immunodeficiency virus infection on antiretroviral therapy, diabetes mellitus, chronic renal failure, congestive heart failure, or BMI greater than 30 kg/m². Patients receiving leflunomide in the 3 years prior to the study were also excluded. Transient elastography (FibroScan, Echosens®, Paris, France) was used for fibrosis determination (LF > 7 KpA) and computer attenuation parameter (CAP) for LS (CAP > 248 dB/m). Demographic variables, laboratory data, MTX-CD (> 4000 mg), MtS criteria, BMI (> 25), transient elastography, and CAP scores were collected from all patients. Fifty-nine patients were included. Forty-three were female (72.88%), and the mean age was 61.52 years (standard deviation: 11.73). When we compared MTX-CD ≤ 4000 mg (26 patients; 14 with LS and 12 without) with > 4000 mg (33 patients; 12 with LS and 21 without), no statistical differences were found (P = 0.179). We compared CAP scores stratified by MtS, BMI, sex, and LF. There were no significant differences in CAP scores based on the presence of MtS [CAP/MtS: 50 no MtS (84.75%); 9 MtS (15.25%); P = 0.138], the male sex (CAP/sex: 8 male/18 female LS; 8 male/25 female no LS; P = 0.576), or LF [CAP/fibrosis: 53 no LF (89.83%); 6 LF (10.17%); P = 0.239]. LS determined by CAP was significantly associated with BMI > 25 (CAP/BMI: 22 BMI ≤ 25 (37.29%); 37 BMI > 25 (62.71%); P = 0.002]. LS in patients with RA treated with MTX was not associated with MTX-CD, LF, the male sex, or MtS. However, BMI was significantly related to LS in these patients.

Estimated dietary intake of polyphenols from cereal foods and associated lifestyle and demographic factors in the Melbourne Collaborative Cohort Study

Cereal foods are consumed globally and are important sources of polyphenols with potential health benefits, yet dietary intakes are unclear. We aimed to calculate the dietary intakes of polyphenols from cereal foods in the Melbourne Collaborative Cohort Study (MCCS), and describe intakes by demographic and lifestyle factors. We estimated intakes of alkylresorcinols, lignans and phenolic acids in n = 39,892 eligible MCCS participants, using baseline dietary data (1990–1994) from a 121-item FFQ containing 17 cereal foods, matched to a polyphenol database developed from published literature and Phenol-Explorer Database. Intakes were estimated within groups according to lifestyle and demographic factors. The median (25th–75th percentile) intake of total polyphenols from cereal foods was 86.9 mg/day (51.4–155.8). The most consumed compounds were phenolic acids, with a median intake of 67.1 mg (39.5–118.8), followed by alkylresorcinols of 19.7 mg (10.8–34.6). Lignans made the smallest contribution of 0.50 mg (0.13–0.87). Higher polyphenol intakes were associated with higher relative socio-economic advantage and prudent lifestyles, including lower body mass index (BMI), non-smoking and higher physical activity scores. The findings based on polyphenol data specifically matched to the FFQ provide new information on intakes of cereal polyphenols, and how they might vary according to lifestyle and demographic factors.

Safety and feasibility of robotic surgery for old rectal cancer patients.

Robotic surgery is widely utilized for rectal cancer. Older patients are associated with comorbidity and diminished cardiopulmonary reserve, resulting in uncertainty and reluctance to perform robotic surgery in older patients. The aim of the study was to assess the safety and feasibility of robotic surgery in older rectal cancer patients. We collected the data of patients diagnosed with rectal cancer and operated at our hospital from May 2015 to January 2021. All patients undergoing robotic surgery were classified into two groups: the old group (≥ 70years) and young group (< 70years). Perioperative outcomes were analyzed and compared between the two groups. Risk factors related to postoperative complications were also explored. A total of old N = 114 and young N = 324 rectal patients were enrolled in our study. Older patients were prone to exhibit comorbidity than the young and had lower body mass index and higher scores of American Society of Anesthesiologists than the young. No statistical difference was found in operative time, estimated blood loss, lymph nodes retrieved, tumor size, pathological TNM stage, hospital stay after surgery and total hospital cost between the two groups. The incidence of postoperative complications did not show difference between the two groups. On multivariate analyses, male sex and longer operative time could predict postoperative complications, whereas old age was not an independent factor for postoperative complications. After careful preoperative evaluation, robotic surgery is a technically feasible and safe procedure for older rectal cancer patients.

Trends of cardiovascular health in Asian American individuals: A national health and nutrition examination survey study

ObjectiveOversampling of Asian American individuals in the National Health and Nutrition Examination Survey (NHANES) provides a unique opportunity to assess the population-level cardiovascular health (CVH) in the fastest-growing racial group in the US. MethodsThe Life's Essential 8 (LE8) score and its components were calculated in self-reported Asian American individuals ≥20 years of age and free of cardiovascular disease in the NHANES cycles from 2011-March 2020. Multivariable adjusted linear and logistic regression models were used for analysis. ResultsAmong 2,059 Asian American individuals, the weighted mean LE8 score was 69.1 (0.4) with US-born [69.0 (0.8)] and foreign-born individuals [69.1 (0.4)] having similar CVH. From 2011 to March 2020, CVH in the overall population [69.7 (0.8) to 68.1 (0.8); Ptrend: 0.009] and foreign-born individuals [69.7 (0.8) to 67.7 (0.8); Ptrend: 0.005] declined. Decreasing trends were noted in the body mass index score irrespective of stratification and in the blood pressure scores in the overall population and foreign-born Asian American individuals. Compared with US-born individuals, the odds of ideal levels of smoking [ORadj:<5 years: 2.23 (95%CI: 1.45–3.44); 5–15 years: 1.97 (95%CI: 1.27–3.05); 15–30 years: 1.61 (95%CI: 1.11–2.34); ≥30 years: 1.69(95%CI:1.20–2.36)] and diet [ORadj: <5 years: 1.87 (95%CI: 1.26–2.79); 5–15 years: 2.00 (95%CI: 1.38–2.89); 15–30 years: 1.74 (95%CI: 1.14–2.68)] were higher in foreign-born individuals. Foreign-born individuals had lower odds of ideal physical activity levels [ORadj: 5–15 years: 0.55 (95%CI: 0.39–0.79); 15–30 years: 0.68 (95%CI: 0.49–0.95)] and ideal cholesterol levels [ORadj: 5–15 years: 0.59 (95%CI: 0.42–0.82); 15–30 years: 0.54 (95%CI :0.38–0.76); ≥30 years: 0.52 (95%CI: 0.38–0.76)]. ConclusionThe CVH in Asian American individuals declined from 2011 to March 2020. The odds of ideal CVH decreased with increasing duration of stay in the US, with foreign-born individuals residing in the US for ≥30 years having ∼28% lower odds of ideal CVH compared with US-born individuals.

Weight management treatment modalities in patients with overweight or obesity: A retrospective cohort study of administrative claims data

BackgroundThe purpose of this study was to describe demographic and clinical characteristics among patients who have medical encounters for weight management treatments and to investigate the association of those characteristics with treatment modality. MethodsThis was a retrospective database study using medical claims, pharmacy claims, and enrollment information from commercial and Medicare Advantage with Part D members in the Optum Research Database from 01/01/2011−2/29/2020. Adult patients with a claim for a weight management treatment from 01/01/2012−2/28/2019 were categorized into cohorts according to the highest intensity intervention received. To examine the association between patient characteristics and treatment modality received, a multinomial logit model was performed. ResultsCohorts by increasing intensity included lifestyle intervention (LSI, n = 67,679), weight reduction pharmacotherapy (WRRx) with an anti-obesity medication (AOM, n = 6,905), weight reduction procedure (WRP, n = 1,172), and weight reduction surgery (WRS, n = 18,036). Approximately 32.1% and 16.6% of patients who received WRS or WRP had an LSI during the 12-month baseline, and only 0.6% and 0.4% had treatment with long-term AOMs. In a multinomial logit model, patients with type 2 diabetes (not including WRRx cohort), respiratory disorders, cardiovascular risk factors, pain disorders, and mental health conditions had increased odds of treatment with higher intensity intervention versus LSI. Patients who were male, received an intervention more recently (2016-2019), or had a Charlson comorbidity score of 1 (compared to 0) had decreased odds of treatment with higher intensity interventions. ConclusionIn this study, age, sex, body mass index, obesity-related complications, and Charlson comorbidity score appeared to influence the type of weight management treatment modality received. This study improves understanding of weight management treatment utilization and identifies gaps and opportunities to improve obesity care with the appropriate use of different treatment modalities.

The Relationship Between Eating Behaviors and Functional Status in Female Patients Diagnosed with Fibromyalgia

Aim. To evaluate whether eating behaviors of female patients with fibromyalgia syndrome differ from those of the healthy population, what factors affect these behaviors, and whether eating behaviors are effective on patients’ life quality and functional status.&#x0D; Materials and Methods. This cross-sectional and observational study included 55 female fibromyalgia patients and 55 healthy female volunteers. All participants were assessed using demographic data, body mass index (BMI), and the Three-Factor Eating Questionnaire (TFEQ) (Uncontrolled Eating, Cognitive Restraint, Emotional Eating, and Hunger Susceptibility). Fibromyalgia patients were assessed using the Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ).&#x0D; Results. BMI, Uncontrolled Eating, and Hunger Susceptibility scores differed significantly between fibromyalgia patients and healthy volunteers (p &lt; 0.05). In fibromyalgia patients, the TFEQ subscores were not correlated with the FIQ (p &gt; 0.05). There was a positive correlation between the Cognitive Restraint score and age, rest and night pain scores in fibromyalgia patients (p&lt; 0.05). Increasing age was an independent predictor of Cognitive Restraint in fibromyalgia patients (p=0.003).&#x0D; Conclusions. The proportion of overweight/obese patients, BMI, Uncontrolled Eating, and Hunger Susceptibility were significantly higher among fibromyalgia patients. Fibromyalgia patients’ eating behaviors were not associated with their quality of life and functional status. Increasing age appeared to be a predictor of Cognitive Restraint degree.