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As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function. [ABSTRACT FROM AUTHOR]

Context: The purpose of the study was to develop normative ranges and standards for knee and shoulder isokinetic and anthropometric values. These standards can be qualitatively interpreted and allow practitioners to classify isokinetic and anthropometric values more objectively for university-level netball players. Design: Posttest only observational study design. All players were only evaluated once during the in-season to generate normative ranges. Methods: A total of 51 female players volunteered. Participants were evaluated on an isokinetic dynamometer at 60° per second to obtain knee-extensor and knee-flexor values as well as shoulder-flexor and shoulder-extensor values. A total of 16 anthropometric variables were collected including stature, body mass, 8 skinfolds, and 6 circumferences. Between-group differences were calculated to determine whether playing level was a differentiating factor in data. Results: Normative standards were developed for isokinetic parameters associated with the knee and shoulder joints as well as skinfolds and circumference measures. No statistically significant between-group differences were evident (χKruskal-Wallis²[2] = 3.96, P = .140). Conclusion: These standards can be used by coaches and practitioners to set attainable goals for individual players or those from secondary leagues, classify individual and team-based performances, and facilitate decision-making processes. [ABSTRACT FROM AUTHOR]

Food insecurity is highly prevalent and linked to poorer diet and worse metabolic outcomes. Food insecurity can be stressful, and could elicit chronic psychological and physiological stress. In this study, we tested whether stress could be used to identify those at highest risk for worse diet and metabolic measures from food insecurity. Specifically, we hypothesized that cortisol (a physiological marker of stress) and perceived psychological stress would amplify the link between food insecurity and hyperpalatable food intake as well as metabolic measures. In a sample of 624 Black and White women aged 36-43 who participated in the NHLBI Growth and Health Study's midlife assessment, we assessed associations between food insecurity with hyperpalatable food intake (high fat + high sodium foods; high fat + high sugar foods; and high carbohydrate + high sodium foods), and metabolic measures (fasting glucose, insulin resistance, and waist circumference). We found that food insecurity was associated with higher levels of perceived stress (R2 = 0.09), and greater intake of high fat + high sugar (hyperpalatable) foods (R2 = 0.03). In those with higher cumulative cortisol (as indexed by hair cortisol), food insecurity was associated with higher levels of fasting glucose. Neither cortisol nor perceived stress moderated any other relationships, and neither variable functioned as a mediator in sensitivity analyses. Given these largely null findings, further research is needed to understand the role stress plays in the chronic health burdens of food insecurity.

Objectives: Movement behaviors and abdominal obesity are associated with higher inflammatory biomarkers. However, the role of waist circumference as a mediating factor is still unknown. Thus, our aims were to (1) test the associations between 24-hour movement behavior variables (physical activity, sedentary behavior, and sleep), abdominal obesity, and pro- and anti-inflammatory biomarkers; and (2) investigate whether abdominal obesity had a mediating effect between the investigated associations. Methods: This multicenter cross-sectional study included 3591 adolescents (aged 12–17 y) from 4 Brazilian cities. Waist circumference (in centimeters; at half the distance between the iliac crest and at the lower costal margin), 24-hour movement behaviors (validated questionnaire), high-sensitive C-reactive protein, and adiponectin (serum plasma) were evaluated. We used multiple mediation regression models (95% confidence interval) to determine if waist circumference mediated the association between 24-hour movement behaviors and pro- and anti-inflammatory biomarkers. Results: The results revealed that screen time and moderate to vigorous physical activity were not associated with pro- or anti-inflammatory biomarkers. However, sleep duration (in hours per day) was negatively associated with pro- (C-reactive protein, β = −0.08; 95% confidence interval, −0.38 to −0.02) and anti- (adiponectin, β = −0.31; 95% confidence interval, −2.13 to −0.12) inflammatory biomarkers. Our results also showed that waist circumference mediated the association between sleep duration and high-sensitive C-reactive protein (2.7%), and adiponectin (2.8%). Conclusion: Sleep duration was inversely associated with pro- and anti-inflammatory biomarkers, and these relations were mediated by abdominal obesity. Therefore, adolescents having healthy sleep can have implications for reducing waist circumference and inflammatory indicators. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated whether anthropometric measurements and the five times sit-to-stand test could be used to identify dynapenia. The cut-off values of accurate screening tools for identifying dynapenia were also established. Materials and methods: This was a cross-sectional study conducted on individuals ≥ 60 years old (N = 529). All participants underwent handgrip strength measurement, anthropometric measurements and the five times sit-to-stand test. The participants whose handgrip strength was < 28 kg for men and < 18 kg for women were considered to have dynapenia. The association between the recorded variables and dynapenia was determined using logistic regression, and cut-off values were established by performing the Receiver Operating Characteristic curve analysis. Results: The prevalence of dynapenia was 35.42% in men and 25.61% in women. For males, both calf circumference (≤ 35.2 cm) and the five times sit-to-stand test (≥ 14.6 s) could be used as accurate tools for dynapenia. For females, only the five times sit-to-stand test (≥ 11.8 s) had sufficient accuracy to be used as a screening tool for dynapenia. Conclusions: The five times sit-to-stand test was an accurate screening tool for identifying dynapenia. The calf circumference could be only used as a screening tool in males. IMPLICATIONS FOR REHABILITATION: Calf circumference and the five times a sit-to-stand test can be used as accurate screening tools in males with dynapenia. Only the five times sit-to-stand test had sufficient accuracy in females with dynapenia. The optimal cut-off values established for older males and females are only applicable to the Asian population. [ABSTRACT FROM AUTHOR]

Background: In the Women's Health Initiative (WHI) randomized trial, dietary intervention significantly reduced breast cancer mortality, especially in women with more metabolic syndrome (MetS) components. Therefore, this study investigated the associations of MetS and obesity with postmenopausal breast cancer after long‐term follow‐up in the WHI clinical trials. Methods: A total of 68,132 postmenopausal women, without prior breast cancer and with normal mammogram, were entered into WHI randomized clinical trials; 63,330 women with an entry MetS score comprised the study population. At entry, body mass index (BMI) was determined; MetS score (0, 1–2, and 3–4) included the following: (1) high waist circumference (≥88 cm), (2) high blood pressure (systolic ≥130 mm Hg and/or diastolic ≥85 mm Hg, or hypertension history), (3) high‐cholesterol history, and (4) diabetes history. Study outcomes included breast cancer incidence, breast cancer mortality, deaths after breast cancer, and results by hormone receptor status. Results: After a >20‐year mortality follow‐up, a higher MetS score (3–4), adjusted for BMI, was significantly associated with more poor prognosis, estrogen receptor (ER)–positive, progesterone receptor (PR)–negative cancers (p =.03), 53% more deaths after breast cancer (p <.001), and 44% higher breast cancer mortality (p =.03). Obesity status, adjusted for MetS score, was significantly associated with more good prognosis, ER‐positive, PR‐positive cancers (p <.001), more total breast cancers (p <.001), and more deaths after breast cancer (p <.001), with higher breast cancer mortality only in women with severe obesity (BMI, ≥35 kg/m2; p <.001). Conclusions: MetS and obesity status have independent, but differential, adverse associations with breast cancer receptor subtypes and breast cancer mortality risk. Both represent separate targets for breast cancer prediction and prevention strategies. Metabolic syndrome and obesity status have independent, but differential, adverse associations with breast cancer receptor subtypes and breast cancer mortality risk. [ABSTRACT FROM AUTHOR]

Background: It has been reported in the literature that waist circumference (WC) was related to physical fitness in adolescents. However, the association between WC and PFI(physical fitness index), a comprehensive indicator of physical fitness, has been less studied. In addition, it is not clear whether the association between WC and PFI changes depending on altitude, ethnicity, and sex. This study further revealed the correlation between WC and PFI among adolescents in high-altitude areas and provided references for the physical and healthy development of adolescents in high-altitude areas. Methods: In this study, a total of 1705 Tajik adolescents aged 13–15 years were selected using stratified whole-population sampling. WC and physical fitness items (grip strength, standing long jump, 50 m dash, and endurance run) were assessed and a standardized method was used to calculate PFI. The association between WC and PFI was analyzed by curvilinear regression analysis. Results: The mean and standard deviation of WC and PFI for Tajik adolescents aged 13–15 years old on the Pamir Plateau in Xinjiang, China, were 68.26 ± 7.75 cm and − 2.00 ± 3.47 respectively. Comparison of PFI between groups of Tajik adolescents with different WC showed that inter-group comparisons had significant effects with effect size above 0.2. The Tajik adolescents' PFI reached its highest when WC was 61 cm for boys(-1.3207), and 60 cm for girls (-1.0556). Conclusions: The association between WC and PFI in Tajik adolescents showed an inverted "U" curve, with no sex difference. It is recommended that the WC of Tajik adolescents should be controlled between 60 and 61 cm to maintain better PFI levels. The study provides support and reference for educational policy-making and public health prevention in the Pamir Plateau in Xinjiang, China. [ABSTRACT FROM AUTHOR]

Background: Worsening renal function (WRF) is a frequent comorbidity of heart failure with preserved ejection fraction (HFpEF). However, its relationship with abdominal obesity in terms of HFpEF remains unclear. This study aimed to evaluate the value of waist circumference (WC) and body mass index (BMI) in predicting WRF and examine the correlation between abdominal obesity and the risk of WRF in the HFpEF population. Methods: Data were obtained from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. Abdominal obesity was defined as WC ≥ 102 cm for men and ≥ 88 cm for women. WRF was defined as doubling of serum creatinine concentration from baseline. Restricted cubic splines and receiver operating characteristic curves were used to evaluate the value of WC and BMI in predicting WRF. Cumulative incidence curves and cox proportional-hazards models were used to compare patients with and without abdominal obesity. Results: We included 2,806 patients with HFpEF in our study (abdominal obesity, n: 2,065). Although baseline creatinine concentrations did not differ, patients with abdominal obesity had higher concentrations during a median follow-up time of 40.9 months. Unlike BMI, WC exhibited a steady linear association with WRF and was a superior WRF predictor. Patients with abdominal obesity exhibited a higher risk of WRF after multivariable adjustment (hazard ratio: 1.632; 95% confidence interval: 1.015–2.621; P: 0.043). Conclusions: Abdominal obesity is associated with an increased risk of WRF in the HFpEF population. Trial registration: URL: https://beta.clinicaltrials.gov. Unique identifier: NCT00094302. [ABSTRACT FROM AUTHOR]

Purpose: The weight-adjusted waist index (WWI) is a recently developed index for measuring obesity. The aim of this study was to investigate the association between WWI levels and overactive bladder (OAB) in a nationally representative population. Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) database between 2007 and 2016. OAB was defined as the Overactive Bladder Syndrome Symptom Score (OABSS, score ≥ 3). The WWI index was calculated as the square root of waist circumference (WC, cm) divided by body weight (kg). We used weighted logistic regression models to assess the relationship between the WWI index and OAB in adult women. The reliability of the findings was assessed using restricted cubic spline, subgroup analysis. Results: A total of 10,563 individuals were included in the study, and the prevalence of OAB was 18.6%. Higher WWI was associated with an increased risk of overactive bladder syndrome. In model 1 with unadjusted variables (OR = 1.148; 95% CI = 1.148–1.149, p < 0.001), model 2 (OR = 1.253; 95% CI = 1.253–1.254, p < 0.001) and model 3 with fully adjusted variables (OR = 1.215; 95% CI = 1.214–1.215, p < 0.001) in which the association was significant. The results of the subgroup analyses showed that age stratification and stroke status could modify this association between WWI and OAB. Restricted cubic spline showed a nonlinear relationship between WWI and OAB (p for nonlinear < 0.05). Conclusion: Weight-adjusted waist circumference index (WWI) values are positively associated with the risk of developing OAB in adult women in the United States, but further studies are needed to elucidate the causal relationship between WWI and OAB. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of the NSW Health "Get Healthy Information and Coaching Service®"(Get Healthy) to facilitate weight loss on a population scale has been documented, but this was based on self-reported measures. Our study aims to test the effectiveness of the Get Healthy Service on objectively measured weight, BMI, waist circumference, and changes in other health behaviours, including nutrition, physical activity and alcohol intake. Methods: Men and women aged 40–70 years (n = 154) with pre-diabetes (5.7% < HbA1c < 6.5%) were referred from GP Practices to the Get Healthy Service, NSW Health. A subset (n = 98) participated in the "Zinc In Preventing the Progression of pre-Diabetes" (ZIPPeD) trial (ACTRN12618001120268). Results: The self-reported outcomes showed a statistically significant improvement from baseline to 12 months in weight (mean 2.7 kg loss, p < 0.001), BMI (mean 1 unit reduction, p < 0.001), and waist circumference (mean 4.3 cm reduction, p < 0.001). However, in the objectively measured outcomes from ZIPPeD, the differences were more modest, with point estimates of 0.8 kg mean weight loss (p = 0.1), 0.4 unit reduction in BMI (p = 0.03), and 1.8 cm reduction in waist circumference (p = 0.04). Bland-Altman plots indicated that discrepancies were due to a small number of participants who dramatically underestimated their weight or BMI. There were minimal changes in nutrition, physical activity, and alcohol. Conclusions: The potential benefits of Get Healthy should be interpreted with caution as we have shown significant differences between self-reported and objectively measured values. More valid and objective evidence is needed to determine the program's effectiveness and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Background: Elevated lipoprotein (Lp(a)) levels are associated with increased risk of atherosclerotic processes and cardiovascular events in adults. The amount of Lp(a) is mainly genetically determined. Therefore, it is important to identify individuals with elevated Lp(a) as early as possible, particularly if other cardiovascular risk factors are present. The purpose of the study was to investigate whether, in a population of children and adolescents already followed for the presence of one or more cardiovascular risk factors (elevated blood pressure (BP), and/or excess body weight, and/or dyslipidemia), the measurement of Lp(a) can be useful for better stratifying their risk profile. Methods: In a sample of 195 children and adolescents, height, body weight, waist circumference and systolic (SBP) and diastolic (DBP) BP were measured. Body Mass Index (BMI) and SBP and DBP z-scores were calculated. Plasma Lp(a), total cholesterol, high-density lipoprotein (HDL), triglycerides, glucose, insulin, uric acid and creatinine were assessed. Low-density lipoprotein (LDL) cholesterol was calculated with the Friedewald formula. High Lp(a) was defined as ≥ 75 nmol/L and high LDL cholesterol as ≥ 3.37 mmol/L. Results: Our sample of children and adolescents (54.4% males, mean age 11.5 years) had median LDL cholesterol and Lp(a) values equal to 2.54 (interquartile range, IQR: 2.07–3.06) mmol/L and 22 (IQR: 7.8–68.6) nmol/L respectively. 13.8% of children had LDL cholesterol ≥ 3.37 mmol/L and 22.6 Lp(a) values ≥ 75 nmol/L. Lp(a) values were higher in children of normal weight than in those with excess weight (p = 0.007), but the difference disappeared if normal weight children referred for dyslipidemia only were excluded from the analysis (p = 0.210). 69.4% of children had normal Lp(a) and LDL cholesterol values and only 6.2% showed both elevated Lp(a) and LDL cholesterol levels. However, 16.6% of the sample, despite having normal LDL cholesterol, had elevated Lp(a) values. Multivariable analyses showed a significant association of LDL cholesterol both with Lp(a) values, and with the presence of elevated Lp(a) levels. For each mmol/L increase in LDL cholesterol the risk of having an elevated Lp(a) value increased by 73%. There was an inverse correlation between BMI z-score and Lp(a). Neither BP z-scores, nor other biochemical parameters were associated with Lp(a). Conclusions: In our population more than one out of five children had elevated Lp(a) values, and in about 17% of children elevated Lp(a) values were present in the absence of increased LDL cholesterol. Our results suggest that Lp(a) measurement can be useful to better define the cardiovascular risk profile in children and adolescents already followed for the presence of other cardiovascular risk factors such as elevated BP, excess body weight and high LDL cholesterol. [ABSTRACT FROM AUTHOR]

Background: Central obesity was considered as a risk factor for falls among the older population. Waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI), and the Chinese visceral adiposity index (CVAI) are considered as surrogate markers for abdominal fat deposition in increasing studies. Nevertheless, the longitudinal relationship between these indices and falls among the older population remains indistinct. This study aimed to explore the association between abdominal obesity indices and falls among older community-dwellers. Methods: Our study included 3501 individuals aged ≥ 65 years from the Guangzhou Falls and Health Status Tracking Cohort at baseline in 2021 and then prospectively followed up in 2022. The outcome of interest was the occurrence of falls. The Kaplan-Meier curves and multivariable Cox regression analysis were used to explore the associations between abdominal obesity indices and falls. Moreover, the restricted cubic spline analysis (RCS) was conducted to test the non-linear relationships between abdominal obesity indices and hazards of falls incident. Results: After a median follow-up period of 551 days, a total of 1022 participants experienced falls. The cumulative incidence rate of falls was observed to be higher among individuals with central obesity and those falling within the fourth quartile (Q4) of LAP, VAI, and CVAI. Participants with central obesity and those in Q4 of LAP, VAI, and CVAI were associated with higher risk of falls, with hazard ratios (HRs) of 1.422 (HR 95%CI: 1.255–1.611), 1.346 (1.176–1.541), 1.270 (1.108–1.457), 1.322 (1.154–1.514), respectively. Each 1-SD increment in WC, LAP, VAI, and CVAI was a significant increased risk of falls among participants. Subgroup analysis further revealed these results were basically stable and appeared to be significantly stronger among those females, aged 65–69 years, and with body mass index (BMI) ≥ 28 kg/m2. Additionally, RCS curves showed an overall upward trend in the risk of falls as the abdominal indices increased. Conclusions: Abdominal obesity indices, as WC, LAP, VAI, and CVAI were significantly associated with falls among older community-dwellers. Reduction of abdominal obesity indices might be suggested as the strategy of falls prevention. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the impact of central obesity on spinal sagittal balance in adults aged 18 and older by examining correlations between waist circumference (WC) and abdominal circumference (AC) and spinopelvic alignment parameters. This prospective cohort study included 350 adults aged 18 and older. Participants underwent whole-body biplanar radiography using the EOS imaging system. Spinal and pelvic parameters were measured and correlated with body mass index, WC, and AC. Statistical analyses included one-way analysis of variance, Wilcoxon rank-sum tests for data with nonhomogeneous variances, and chi-squared tests for categorical data. Intra-rater and inter-rater reliability were assessed using intraclass correlation coefficients, with subsequent analyses to explore correlations between body measurements and spinal parameters. The study found significant correlations between increased WC and AC and changes in spinopelvic parameters. However, obesity did not uniformly influence all sagittal alignment parameters. Significant variations in spinal measurements indicate that central obesity plays a role in altering spinal stability and alignment. The findings highlight the impact of central obesity on spinal alignment and emphasize the importance of considering central obesity in clinical assessments of spinal pathologies. Further research is essential to better understand the relationship between obesity, spinal sagittal balance, and related health conditions. [ABSTRACT FROM AUTHOR]

Objective: Predisposing factors of Peyronie’s disease remain controversial. We know that obesity has extremely negative effects on erectile tissue. Therefore, in our study, we aimed to examine the relationship between Peyronie’s disease and the body shape index (ABSI), which is a new parameter for the evaluation of visceral adiposity. Materials and Methods: In this study, 55 healthy volunteers (group-1) and 50 Peyronie’s disease patients (group-2). Age, comorbidities, waist circumference (WC), height, body mass index (BMI), testosterone, fasting glucose, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, International Index of Erectile Function (IIEF), and ABSI scores of all patients were analyzed. In addition, plaque sizes, duration of symptoms, and curvature degrees of patients in group 2 were calculated. Results: The mean ages of group 1 and group 2 were 57.02±8.34 years and 56.02±10.65 years, respectively (p>0.05). Fasting glucose, WC, BMI, and ABSI values were significantly higher in group 2 (p=0.031, p<0.001, p=0.026 and p<0.001). LDL and HDLvalues were similar between both groups (p>0.05). The IIEF score was observed to be lower in group 2 (p<0.001). In terms of ABSI values, the discrimination power of Peyronie’s disease was strong. The cut-off value for the ABSI score was 0.08. For this cut-off point, classification success was determined as 88.0% sensitivity and 80.0% selectivity. Conclusion: ABSI can be a reliable independent risk factor for Peyronie’s disease and a predictor of visceral adiposity. [ABSTRACT FROM AUTHOR]

Objective: The most effective methods and entry sites for laparoscopic surgery remain a subject of ongoing investigation and discussion. The purpose of the study was to analyze and compare three umbilical entry sites for intraperitoneal access using the direct trocar insertion technique. Material and Methods: A randomized pilot study was conducted between March 2021 and January 2023, involving women eligible for laparoscopic gynecological surgery. The women were allocated to one of three equally sized groups based on trocar entry points: subumbilical, supraumbilical, or umbilical. Success and failure rates of trocar entry, factors influencing success or failure, and early and late complications were systematically evaluated and compared across groups. Results: A total of 243 patients, with a mean age of 32.93±8.33 years, were included in three groups of 81 each. Trocar entry success rates were 97.5%, 89.2%, and 89.5% in the supraumbilical, umbilical, and subumbilical groups, respectively (p>0.05). Failed trocar entry was significantly associated with age, gravidity, body mass index (BMI), waist circumference, hip circumference, and abdominal subcutaneous fat thickness (p<0.001). Regression analysis revealed that, in the subumbilical group, higher gravidity [odds ratios (OR): 0.390, 95% confidence interval (CI): 0.174-0.872, p=0.022) and greater abdominal subcutaneous fat thickness (OR: 0.090, 95% CI: 0.019-0.431, p=0.03) were associated with lower odds of successful trocar entry. In contrast, in the umbilical group, a higher waist circumference was associated with lower odds of successful trocar entry (OR: 0.673, 95% CI: 0.494-0.918, p=0.012). None of the covariates were significant in the supraumbilical group. Conclusion: The study highlighted the importance of selecting the appropriate trocar entry site in laparoscopic gynecological surgery. Surgeons should consider factors such as age, gravidity, BMI, waist circumference, hip circumference, and abdominal subcutaneous fat thickness, as these factors significantly influence the success of trocar entry. [ABSTRACT FROM AUTHOR]

The present study aimed to assess the relationship between body shape, physical activity (PA), and systolic blood pressure (SBP) and diastolic blood pressure (DBP). A novel visualization method was used to examine the effects of body shape combined with physical activity on hypertension. Data from 54,303 participants were obtained from the China Health and Nutrition Survey (CHNS) and analyzed using logistic regression models and standardized regression coefficients of linear models. These models were used to explore factors and effects of body shape indices and other parameters on SBP and DBP. The logistic regression model revealed that compared to transport‐related PA, the aggregated variables (weight and waist) were associated with a 2.44‐fold and 1.65‐fold increase in the risk of hypertension, respectively (p <.05). The average aggregated standardized coefficient of the linear model, based on 1000 bootstrap resamples, indicated that the Base Shape group had the strongest explanatory power for hypertension, followed by the Habits group. However, the explanatory power of the PA group was around 10 and 22 times lower than that of the Base Shape group for DBP and SBP, respectively (p <.05). These results demonstrate that increasing physical activity, with emphasizing a healthy body shape, and adopting positive lifestyle habits can effectively contribute to the prevention and control of hypertension. [ABSTRACT FROM AUTHOR]

Objectives: We describe studies determining the association between testosterone therapy (TTh) and mortality. Materials & methods: We used a registry database of 737 men with adult‐onset testosterone deficiency defined as presenting with low serum total testosterone (TT) levels ≤12.1 nmol/L and associated symptoms over a near 10‐year follow‐up. We compared associations between testosterone undecanoate (TU), cardio‐metabolic risk factors and mortality using non‐parametric statistics followed by separate Cox regression models to determine if any association between TU and morality was independent of age and cardio‐metabolic risk factors. Finally, the association between TU and mortality was studied in men stratified by cardio‐metabolic risk. Results: During a median follow‐up interquartile range (IQR) of 114 (84–132) months, 94 of the 737 men died. TU (ref: non‐treatment) was associated with mortality; hazard ratio = 0.23, 95% confidence intervals = 0.14–0.40. Cox's regression models showed the above association to be independent of baseline age, waist circumference, hemoglobin A1c, lipids, blood pressure, smoking, and type 2 diabetes. These variables remained associated with mortality. We finally stratified the men by the high‐risk baseline variables and established that the association between mortality and TU was only evident in men at higher risk. A possible explanation could lie with the "law of initial value," where greater improvements are evident following treatment in patients with worse baseline values. Conclusions: This study with long follow‐up confirms that TTh is associated with lower mortality in men with adult‐onset TD. This association was evident only in men with greater cardio‐metabolic risk factors who demonstrated greater benefit. [ABSTRACT FROM AUTHOR]

Summary: Semaglutide is found to be efficient for weight loss in patients with overweight or obesity with diabetes mellitus (DM). With a wide range of adverse events reported, the efficacy and safety of once‐weekly subcutaneous semaglutide in individuals without DM, with overweight or obesity, is unclear. We conducted a comprehensive meta‐analysis of randomized studies on once‐weekly semaglutide in this patient population. We identified nine studies with 11,641 patients in the semaglutide group and 10,479 in the placebo group. We observed that semaglutide resulted in significant benefits, including change in body weight (%): mean difference (MD) of −11.49% (p < 0.0001), change in absolute body weight: MD of −11.74 kg (p < 0.0001), and change in waist circumference: MD of −9.06 cm (p < 0.0001). Gastrointestinal side effects are predominant including nausea: odds ratio (OR) of 4.06 (p < 0.0001), vomiting: OR of 4.43 (p < 0.0001), diarrhea: OR of 2.10 (p < 0.0001), constipation: OR of 2.43 (p < 0.0001), gallbladder disorders: OR of 1.26 (p = 0.010), and cholelithiasis: OR of 2.06 (p = 0.04). Serious adverse events were not statistically significant: OR of 1.06 (p = 0.82). However, the percentage of participants discontinuing due to adverse events and gastrointestinal side effects was statistically significant: ORs of 2.22 (p < 0.0001) and 3.77 (p < 0.0001), respectively. This study shows that in patients with overweight or obesity without DM, once‐weekly subcutaneous semaglutide can significantly decrease body weight without risk of serious adverse events when compared with a placebo. However, gastrointestinal side effects are predominant with semaglutide, which can result in medication discontinuation. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations of body mass index (BMI), waist circumference (WC) and the weight‐adjusted waist index (WWI) with the impairment of activities of daily living (ADL) in older Chinese people. Methods: A total of 13 260 participants aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey were included in this cross‐sectional study. BMI, WC and the WWI were calculated from measurements of height, weight and WC. Binary logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Non‐linear correlations were investigated using restricted cubic spline curves. Results: In multivariate logistic regression fully adjusted for confounding variables, our analyses revealed significant associations between WC and WWI and ADL impairment, with adjusted ORs (95% CI) of 1.01 (1.00, 1.01) and 1.08 (1.03, 1.12), respectively. Meanwhile, participants with a high WWI had a higher risk of ADL impairment compared with those with a low WWI, with an adjusted OR (95% CI) of 1.12 (1.02, 1.23). Subgroup analyses showed that only the association between WWI and ADL impairment did not differ in any of the different populations. In addition, we found that BMI, WC and WWI were non‐linearly associated with ADL impairment. Conclusions: There are significant associations between WC and WWI and ADL impairment in older Chinese people. The findings show the ability of the WWI to serve as a comprehensive and effective indicator of obesity in older Chinese people and emphasize the importance of assessing WWI in screening and preventing ADL impairment in older people. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between thyroid function and weight regain in patients with obesity after metabolic surgery. Methods: This retrospective study enrolled 162 patients who underwent metabolic surgery. Correlations between decreases in thyroid hormone levels and changes in weight, waist circumference (WC) and the Chinese visceral adiposity index (CVAI) were assessed. Binary logistic regression and receiver operating characteristic (ROC) curves were used to identify predictors and clinically useful cut‐off values, respectively. Results: The levels of thyroid‐stimulating hormone (TSH) and free triiodothyronine (FT3) decreased markedly at 1 year after surgery, as did weight, body mass index (BMI), triglycerides, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, WC and CVAI. Decreases in TSH and FT3 after metabolic surgery were associated with changes in weight, BMI and CVAI. Binary logistic regression and ROC curve analyses confirmed that decreases in TSH can predict good weight loss after metabolic surgery to some extent. Finally, binary logistic regression and ROC curve analyses confirmed that changes in TSH can predict weight regain after metabolic surgery. Conclusions: Changes in TSH and FT3 after metabolic surgery were correlated with changes in weight and CVAI. Changes in thyroid hormones can predict weight regain in patients with obesity who underwent metabolic surgery. [ABSTRACT FROM AUTHOR]

Summary: Objective: This study identified metabolite modules associated with adiposity and body fat distribution in childhood using gold‐standard measurements. Methods: We used cross‐sectional data from 329 children at mid‐childhood (age 5.3 ± 0.3 years; BMI 15.7 ± 1.5 kg/m2) from the Genetics of Glucose regulation in Gestation and Growth (Gen3G), a prospective pre‐birth cohort. We quantified 1038 plasma metabolites and measured body composition using the gold‐standard dual‐energy x‐ray absorptiometry (DXA), in addition to skinfold, waist circumference, and BMI. We applied weighted‐correlation network analysis to identify a network of highly correlated metabolite modules. Spearman's partial correlations were applied to determine the associations of adiposity with metabolite modules and individual metabolites with false discovery rate (FDR) correction. Results: We identified a 'green' module of 120 metabolites, primarily comprised of lipids (mostly sphingomyelins and phosphatidylcholine), that showed positive correlations (all FDR p < 0.05) with DXA estimates of total and truncal fat (ρadjusted = 0.11–0.19), skinfold measures (ρadjusted = 0.09–0.26), and BMI and waist circumference (ρadjusted = 0.15 and 0.18, respectively). These correlations were similar when stratified by sex. Within this module, sphingomyelin (d18:2/14:0, d18:1/14:1)*, a sphingomyelin sub‐specie that is an important component of cell membranes, showed the strongest associations. Conclusions: A module of metabolites was associated with adiposity measures in childhood. [ABSTRACT FROM AUTHOR]

The obesity prevalence in South Korea in 2021 stood at 38.4%. South Korea faces unique challenges in providing essential and emergency guidelines for weight management because of stepping into an aging society. We aimed to determine the daily diet patterns among the general Korean population and to investigate the association between such patterns and different obesity. Longitudinal prospective cohort study. A total of 6539 adult participants (mean age 50.8 years, 52.9% male) with normal-weight adults were included from the Ansan-Ansung cohort of 10,030 Korean adults aged 40 or older and followed for an average of 11 years. Obesity was defined according to the criteria from the Korean Society for The Study of Obesity. Baseline dietary intake was assessed using a validated 103-item food frequency questionnaire. Dietary patterns were derived from k-means cluster analysis. In the multivariate analysis, referring to white rice + baechu kimchi, participants from multigrain rice + baechu kimchi showed lower HR for obesity development (waist circumference defined-obesity; HR: 0.87, 95% CI: 0.79, 0.95; body fat percentage defined-obesity; HR: 0.89, 95% CI: 0.80, 0.98). Further analysis documented that except for body fat percentage defined-obesity, consuming milk or dairy products was linked to a reduced incidence of the other three obesity (body mass index defined-obesity; HR: 0.84, 95% CI: 0.72, 0.99; waist circumference defined-obesity; HR: 0.82, 95% CI: 0.71, 0.94; waist-to-hip ratio defined-obesity; HR: 0.75, 95% CI: 0.61, 0.91). Following a diet that includes multigrain rice, fermented baechu kimchi, and dairy products is linked to a decreased risk of obesity in Korean adults. Public health programs and policies could incorporate these dietary recommendations, targeting specific population groups such as schoolchildren, adults, and the elderly. Additionally, further research is needed to explore the synergistic effects of various foods and their interactions within dietary patterns on obesity outcomes. [ABSTRACT FROM AUTHOR]

Objective: The triglyceride glucose (TyG) index and obesity are significantly closely related to the incidence of nonalcoholic fatty liver disease (NAFLD). The study aimed to investigate the relationship among the TyG index and its related parameters [TyG-waist circumference (WC) and TyG-body mass index (BMI)] with NAFLD. Methods: This was a cross-sectional study involving 8401 subjects who underwent a health examination in Karamay, Xinjiang Province, China. TyG, TyG-WC, TyG-BMI were calculated with the established formula. NAFLD was diagnosed and classified by ultrasonography. Results: The prevalence of NAFLD was markedly increased with increasing levels of TyG, TyG-WC and TyG-BMI. Logistic regression analysis suggested that WC, BMI, TyG, TyG-WC and TyG-BMI were independent risk factors for NAFLD. In receiver operating characteristic (ROC) analysis, TyG-BMI showed the largest area under the ROC curve (AUC) for the detection of NAFLD (0.856, 95% confidence interval: 0.848 ~ 0.865), and the results of sex analysis were consistent. TyG-BMI values of 176.69 (sensitivity: 86.9%, specificity: 68.1%), 193.02 (sensitivity: 73.8%, specificity: 73.6%) and 167.73 (sensitivity: 86.3%, specificity: 74.4%) were the optimal cutoff points to predict NAFLD in all participants, males and females, respectively. Conclusions: This study demonstrated that TyG and its related parameters are significantly correlated with NAFLD. TyG-BMI is an effective predictor or clinical marker for identifying NAFLD. [ABSTRACT FROM AUTHOR]

Aims: To determine risk factors for 1‐year postpartum weight retention (PPWR) and glucose intolerance (prediabetes + diabetes) in women with a previous history of gestational diabetes (GDM) and prediabetes in early postpartum. Methods: In this exploratory analysis of the MELINDA randomized controlled trial, we report data of 167 women with prediabetes at the 6–16 weeks (early) postpartum oral glucose tolerance test after a recent history of GDM. Results: Of all participants, 45% (75) had PPWR >0 kg at 1‐year postpartum. Compared to women without PPWR, women with PPWR had higher gestational weight gain [10.5 ± 6.4 vs. 6.5 ± 4.5 kg, p < 0.001], higher BMI (p < 0.01) and a worse metabolic profile (higher waist circumference, worse lipid profile and more insulin resistance) (all p < 0.05) both in early and late postpartum. Of all women with PPWR, 40.0% developed metabolic syndrome, compared to 18.9% of women without late PPWR (p = 0.003). The only independent predictor for late PPWR was weight retention in early postpartum (p < 0.001). Of all participants, 55.1% (92) had glucose intolerance (84 prediabetes, 8 diabetes) 1‐year postpartum. Independent predictors for late postpartum glucose intolerance were lower gestational age at start insulin therapy in pregnancy and delivery by caesarean section (resp. p = 0.044 and 0.014). Conclusions: In women with a previous history of GDM and prediabetes in early postpartum, PPWR in early postpartum was a strong independent predictor for late PPWR, while earlier start of insulin therapy during pregnancy and delivery by caesarean section were independent predictors of glucose intolerance in late postpartum. [ABSTRACT FROM AUTHOR]

Aims: To determine the effect of a 16-week fitness program (strength vs. aerobic) on different indicators of body composition and components of health-related physical fitness in youths with Down syndrome. Methods and procedures outcomes: Fifty adolescents (19 girls and 31 boys; average age, 18.33 ± 1.42 years) with Down syndrome were recruited and randomized to two groups (strength group vs. aerobic group). Adolescents allocated in the aerobic group carried out a physical activity program three times a week for 16 weeks meanwhile adolescents allocated in the strength group performed a fitness program three times a week for 16 weeks. Results: The exercise group had significant improvements in all health-related physical fitness variables (p <.05) but not on body composition. Conclusions and implications: A sixteen week fitness program consisting of three sessions of 60 min is able to increase levels of health-related physical fitness but not on body composition in youths with Down syndrome. The aerobic program does not seem to show significant differences. [ABSTRACT FROM AUTHOR]

Background: The relationship between waist circumference and nocturia has not been previously studied. This study investigated the association between waist circumference and the occurrence of nocturia in adults. Methods: We analyzed data from the National Health and Nutrition Examination Survey covering 2005–2020, encompassing 6287 adults aged ≥20. Nocturia was defined as the need to urinate two or more times during the night. First, we compared baseline characteristics between the nocturia and non‐nocturia groups. Subsequently, we used multivariate logistic regression analysis to investigate the relationship between waist circumference and nocturia prevalence. We also employed restricted cubic spline analysis to study the potential nonlinear correlation between waist circumference and the prevalence of nocturia. Recognizing the baseline data's heterogeneity based on nocturia prevalence, we conducted subgroup analyses according to age, sex, body mass index (BMI), and ethnicity. Results: Our findings indicated that females, individuals aged ≥50, citizens, Non‐Hispanic Black, those with lower education levels (high school or less), higher BMIs, lower family income‐to‐poverty ratios, higher waist circumference, hypertension, and diabetes were more likely to experience nocturia. Compared with individuals in the lowest waist circumference quartile (Q1), those in the higher quartiles (Q4) exhibited an increased risk of nocturia in Model 1 (Q4, OR:2.00, 95% CI:1.64, 2.45, p < 0.0001). These results remained consistent after adjusting for covariates in models 2 and 3. A restricted cubic spline analysis suggested a linear association between waist circumference and nocturia (P for nonlinearity = 0.066). Subgroup analyses based on age, sex, BMI, and ethnicity revealed no significant differences in the interaction tests between waist circumference and nocturia (P for interaction = 0.437, 0.331, 0.121, and 0.889, respectively), indicating that these baseline characteristics did not influence the association. Conclusions: Our findings indicated an association between increased waist circumference and a higher prevalence of nocturia. Knowledge of this association reinforces the importance of lifestyle modifications in maintaining a healthy waist circumference and informs public health strategies to address other potential risk factors for nocturia. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is an important risk factor for secondary hypogonadism in men. Several studies evaluated the impact of bariatric surgery on gonadal function in men, proving an improvement in testosterone levels, without yet a global consensus on the impact of different surgical approaches. Objectives of the study are: to estimate the prevalence of obesity-associated gonadal dysfunction among men with severe obesity; to evaluate the response to bariatric surgery in terms of resolution of this condition, distinguishing between restrictive and restrictive-malabsorptive surgery. Methods: We conducted a retrospective evaluation of 413 males with severe obesity (BMI 44.7 ± 8.3 kg/m2). A subgroup of them (61.7%) underwent bariatric surgery. Anthropometric assessment (weight, BMI, waist and hip circumference), metabolic (glyco-lipidic asset and urate) and hormonal (morning gonadotropin and total testosterone) assessments were carried out at baseline and 3–6 months post-surgery. Results: Using a TT threshold of 2.64 ng/ml, 256 out of 413 (62%) patients were categorized as having biochemical hypogonadism. At multivariate analysis, the only parameter significantly associated with biochemical hypogonadism, was BMI value (p = 0.001). At 3–6 months after surgery, during the acute weight loss phase, only 20.1% of patients still had biochemical hypogonadism. At multivariate analysis, which included age, presurgical BMI, pre-surgical TT, surgical approach and %EWL, presurgical TT levels (p = 0.0004), %EWL (p = 0.04), and mixed restrictive-malabsorptive surgery (p = 0.01), were independently associated with the recovery of gonadal function. Conclusions: The results of this study underscore the potential reversibility of obesity-associated gonadal dysfunction through bariatric surgery, highlighting the importance of considering surgical approach. [ABSTRACT FROM AUTHOR]

Pulmonary function is influenced by factors such as age, sex, height, and weight. This study investigated the relationship between obesity, body composition, and pulmonary function measures (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], and the FEV1-to-FVC ratio) of Korean adults aged 40 years and older. Using the fifth Korea national health and nutrition examination survey in 2010 and 2011, multiple regression analyses were performed to identify factors associated with pulmonary function, stratified by sex. Independent variables were waist circumference (WC) and an additional measure of obesity/muscularity (weight in model 1, body mass index [BMI] in model 2, and fat-free mass index [FFMI] in model 3). Among 3918 adults, the mean FFMI was 17.7 and 15.0 kg/m2 for men and women, respectively. Weight and BMI were positively associated with only FEV1 (B = 0.003 and B = 0.006, respectively, p < 0.01) and the FEV1-to-FVC ratio (B = 0.001, p < 0.01) in women. FFMI was positively associated with FEV1 and FVC in both sexes (B = 0.019, p < 0.05 for FEV1 and B = 0.020, p < 0.01 for FVC in men; B = 0.025, p < 0.0001 for FEV1 and B = 0.022, p < 0.0001 for FVC in women). WC was inversely associated with FEV1 and FVC in men and FEV1 in women, respectively. Weight and BMI behaved as indicators of body size based on their positive associations with pulmonary function. In conclusion, FFMI can be an important and consistent predictor of pulmonary function in both men and women. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder affecting 5–15% of women of reproductive age, characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology. PCOS is associated with metabolic disturbances such as dyslipidemia, insulin resistance (IR), and an increased risk of type 2 diabetes (T2DM) and cardiovascular disease. Objective: The aim of this study is to apply new anthropometric indices [body adiposity index (BAI), visceral adiposity Index (VAI), lipid accumulation product (LAP), body roundness index (BRI), a body shape index (ABSI)] and new atherogenic indices [Castelli index-I, Castelli index-II, atherogenic risk of plasma (AIP), atherogenic coefficient (AC), lipoprotein combined index (LCI), triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio, metabolic score for insulin resistance (METS-IR), triglyceride glucose (TyG) index, triglyceride glucose-dody mass (TyG-BMI) index, triglyceride glucose-waist circumference (TyG-WC) index] metabolic score of insulin resistance to patients with PCOS. Methods: A retrospective analysis was conducted on 248 women diagnosed with PCOS based on the 2003 Rotterdam criteria. Anthropometric measurements, biochemical parameters, and atherogenic indices were collected from patient records. Statistical analyses were performed using Statistical Package for the Social Sciences software version 28.0. Results: Significant correlations were found between fasting glucose and various anthropometric indices, such as Body mass index (BMI), waist-height ratio (WHtR), and BAI, indicating a link between adiposity and glucose metabolism in PCOS. Atherogenic indices like Castelli's risk indices, AIP, and AC showed positive correlations with glucose and insulin levels, reinforcing their role in assessing cardiovascular risk. Novel indices such as METS-IR and TyG demonstrated strong correlations with both glucose and insulin profiles, highlighting their potential as reliable markers for IR and cardiometabolic risk. Conclusion: The study underscores the importance of using a range of anthropometric and atherogenic indices for comprehensive metabolic assessment in women with PCOS. Indices like METS-IR and TyG offer valuable insights into insulin sensitivity and cardiovascular risk, potentially aiding in better management and prognosis of PCOS. [ABSTRACT FROM AUTHOR]

Purpose: The causal relationship between life course adiposity with metabolic dysfunction-associated steatotic liver disease (MASLD) is ambiguous. We aimed to investigate whether there is an independent genetic causal relationship between body size at various life course and MASLD. Methods: We performed univariable and multivariable Mendelian randomization (MR) to estimate the causal effect of body size at different life stages on MASLD (i.e., defined by the clinical comprehensive diagnosis from the electronic health record [HER] codes [ICD9/ICD10] or diagnostic phrases), including birthweight, childhood body mass index (BMI), adult BMI, waist circumference (WC), waist-to-hip ratio (WHR), body fat percentage (BFP). Results: In univariate analyses, higher genetically predicted lower birthweight (ORIVW = 0.61, 95%CI, 0.52 to 0.74), Childhood BMI (ORIVW = 1.37, 95%CI, 1.12 to 1.64), and adult BMI (ORIVW = 1.41, 95%CI, 1.27 to 1.57) was significantly associated with subsequent risk of MASLD after Bonferroni correction. The MVMR analysis demonstrated compelling proof that birthweight and adult BMI had a direct causal relationship with MASLD. However, after adjusting for birthweight and adult BMI, the direct causal relationship between childhood BMI and MASLD disappeared. Conclusion: For the first time, this MR elucidated new evidence for the effect of life course adiposity on MASLD risk, providing lower birthweight and duration of obesity are independent risk factors for MASLD. Our findings indicated that weight management during distinct time periods plays a significant role in the prevention and treatment of MASLD. [ABSTRACT FROM AUTHOR]

Background: Previous studies have revealed the effects of different physical activity (PA) types on visceral adipose tissue (VAT) accumulation in individuals with overweight/obesity. However, the independent association (especially the dose–response relationship) between PA and VAT in individuals with and without overweight/obesity remains less explored. Visceral adiposity index (VAI), calculated from waist circumference, body mass index (BMI), triglyceride and high-density lipoprotein cholesterol, is a novel indicator of VAT. This study aims to elucidate the association between PA and VAI in participants with and without overweight/obesity. Methods: Participants who are overweight or obese and with complete data on VAI, PA, and other essential covariates from the National Health and Nutrition Examination Survey (NHANES) database (2015–2018) were included in this study. PA was evaluated by the PA questionnaire and converted into metabolic equivalent task (MET) hours per week (MET-h/wk) based on the suggested MET scores. Multivariate linear regression models were used to identify the association between PA and VAI. Subgroup analyses, combined with interaction tests and restricted cubic spline (RCS) regression analyses, were utilized to explore the stability and nonlinearity of PA-VAI association, respectively. Results: A total of 4, 312 participants with complete data on PA and VAI was included in this study, with 3, 441 of them being overweight or obese. After adjusting for all potential covariates, increased PA was found to be significantly associated with remarkable lower level of VAI in all participants (β = -0.0004, P = 0.003), participants with (β = -0.0013, P = 0.012) and without (β = -0.0004, P = 0.003) overweight/obesity. Subgroup analyses and interaction tests revealed that the PA-VAI association was not modified by other covariates in individuals with overweight/obesity. Furthermore, RCS analyses revealed that PA was significantly, linearly and negatively associated with VAI in all participants, participants with and without overweight/obesity (all P < 0.05, all P for nonlinearity > 0.05). Noteworthily, as opposed to individuals without overweight/obesity, PA was significantly associated with lower VAI in participants with overweight/obesity after exceeding the threshold of 150 MET-h/wk. Conclusion: Increased PA was significantly associated with lower level of VAI, but a higher level of PA (> 150 MET-h/wk) was needed to obtain significantly lower level of VAI in individuals with overweight/obesity. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to evaluate the relationship between core endurance tests and physical activity level, balance, ergonomics and pain in office workers. Methods. The study included 57 office workers who had been employed for at least 1 year. Core endurance was assessed using McGill core endurance tests. Physical activity, balance, pain and ergonomic risks were evaluated with the international physical activity questionnaire (IPAQ), timed up and go (TUG), visual analog scale (VAS) and rapid office strain assessment (ROSA), respectively. Results. A significant correlation was found between balance and static core endurance tests. However, no significant correlation was found between ergonomics and physical activity level and core endurance tests except for trunk extension and prone bridge tests. In addition, there was a significant difference in core endurance tests for patients with and without regular exercise habits. Waist circumference and hip circumference measurements were found to be significantly negatively associated with static core tests. Conclusion. Core endurance was found to be associated with exercise habits, balance, hip and waist circumference and ergonomics in office workers. Improving core endurance may be beneficial for preventing musculoskeletal risks in office workers. [ABSTRACT FROM AUTHOR]

Reference growth curves are viable tools for monitoring somatic growth. Therefore, the objective of this study was to develop reference growth curves for body mass, height, body mass index (BMI), waist circumference (WC) and waist‐to‐height ratio (WHtR) in Brazilian children and adolescents aged 7–14 years. The reference growth curves were constructed from a cross‐sectional panel study using data from four surveys conducted in 2002, 2007, 2012/2013 and 2018/2019, with 9675 children and adolescents aged 7–14 years, of both sexes from Florianopolis, Southern Brazil. Growth curves were constructed using the LMS method, based on anthropometric indicators and indices (body mass, height, BMI, WC and WHtR), measured according to standardised norms. There was an increase in body mass, height, BMI and WC values with increasing age in both sexes and percentiles (P5, P10, P25, P50, P75, P85 and P95). The girls presented higher values of body mass, BMI and WC in the analysed percentiles, compared to the boys. Regarding height, there was a higher value from 10 to 11 years old in girls and from 12 to 14 years old in boys. WHtR decreased with increasing age in both sexes and analysed percentiles. Region‐specific reference growth curves can enable the monitoring of somatic growth of particular paediatric populations, expanding discussions in different regions of the world. [ABSTRACT FROM AUTHOR]

Summary Introduction Objective Methods Results Conclusions Hair cortisol concentration (HCC) is a biomarker of long‐term stress. Higher HCC is associated with higher adiposity in adults; however, associations are not well characterized in adolescents.To examine cross‐sectional associations of HCC with adiposity in late adolescence.Amongst 336 non‐Hispanic White participants (48.5% female, mean 17.7 years) in Project Viva, we used multivariable linear regression models, overall and sex‐stratified, to estimate associations of HCC with body mass index (BMI), bioelectric impedance (BIA) percent body fat, waist circumference (WC) and dual X‐ray absorptiometry‐measured percent and total fat or trunk fat mass. We adjusted models for age and known predictors of adiposity.Median (interquartile range) HCC was 2.1 pm/mg (1.0–4.5) and mean (SD) BMI was 23.1 kg/m2 (3.9), BIA %body fat 20.2% (9.9) and WC 80.6 cm (10.9). In adjusted models, higher HCC (per doubling) was associated with higher BMI (β = 0.19 kg/m2; 95%CI 0.00, 0.37) and BIA percent body fat (β = 0.41%; 95%CI 0.04, 0.77). We observed no evidence of effect modification by sex.Higher HCC was associated with greater adiposity in late adolescence. Further research is needed to disentangle the relationship between HCC and adolescent adiposity, including the temporal direction of the relationship and sex‐specific associations. [ABSTRACT FROM AUTHOR]

Introduction: Earlier studies reported inconsistent findings for the association of childhood obesity with the risk of dental caries. In this systematic review and meta-analysis, we aimed to summarize earlier studies on the association of overweight and obesity with risk of dental caries in children. Methods: Relevant studies published up to December 2023 were identified through searches in PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar, using suitable keywords. All observational studies, including cross-sectional or cohort or case-control studies, about the association of each obesity index with risk of dental caries in children which reported odds ratio (OR), hazard ratio (HR), or relative risk (RR) and 95% CIs, were included. Studies involving adults, randomized clinical trials, studies on animals or pregnant women, and studies on other dental disorders were excluded. Risk of bias was assessed using standard methods for observational studies. A total of 22 studies including 40673 participants were included. Studies were pooled using the random-effect model, and results were synthesized with subgroup analyses and assessments of heterogeneity. Limitations included potential publication bias and heterogeneity among study designs. The quality of the included studies was assessed using the Newcastle–Ottawa scale (NOS). Results: Children at the highest category of BMI were 44% more likely to have early childhood caries (ECC) than those at the bottom (OR: 1.44; 95% CI: 1.16 to 1.78). Moreover, combined analysis also showed no significant association between waist circumference (WC) and risk of dental caries in children. However, significant linear and non-linear associations were found between BMI and risk of childhood dental caries. No publication bias was found for the relationship between BMI and the risk of ECC based on visual inspection of a funnel plot and Egger's test. Conclusions: This study showed a significant direct association between BMI and the risk of dental caries in children. Non-linear analysis showed higher risk of dental caries in children with higher BMI and also among underweight children. Further prospective studies are required to expand current knowledge in this issue. Impact statement: The findings of this study have significant implications for public health and dental care, suggesting association between BMI and the risk of dental caries in children. This comprehensive meta-analysis is among the first to summarize earlier publications on the association of obesity with risk of dental caries in children, highlighting the need for more accurate methods of obesity assessment and further research to understand this relationship better. These findings can help inform public health policies and interventions to reduce the prevalence of childhood obesity and dental caries. [ABSTRACT FROM AUTHOR]

Background: While body mass index (BMI) defines obesity as a well-established risk factor for cardiovascular disease, the paradoxical theory of BMI suggests that obesity may indeed have a favorable impact on the prognosis of cardiovascular disease. Therefore, this study aims to assess the correlation between body shape index (ABSI), which is a novel measure of obesity, and coronary heart disease (CHD) among obese individuals in the United States. Methods: The data from the National Health and Nutrition Examination Survey (NHANES) were evaluated by us for 5046 patients. We assessed the exposure variable ABSI, which includes waist circumference (WC), height, and BMI. The outcome variable was CHD. Results: The cross-sectional study included a total of 5046 obese adults aged over 20 years, with an average age (standard deviation: SD) of 49.86 (16.24) years and a male proportion of 44.57%.The odds ratio (OR) values for CHD in Model 1, Model 2, 3 were found to be 2.45 (95%CI: 2.12, 2.83), 1.53 (95%CI:1.30, 1.81) and 1.31 (95%CI:1.09, 1.56) per SD increase in ABSI, respectively. In the fully adjusted model, we designated participants in the T1 group as the reference group. Our findings indicate a significant increase in the prevalence of CHD (OR:1.82, 95%CI: 1.07–3.10) only within the T3 group. Although there is an increased prevalence of CHD (OR:1.32, 95%CI: 0.77–2.29) in the T2 group, no statistically significant difference was observed. Conclusions: The increase in ABSI is strongly associated with the rise in CHD prevalence among obese individuals in the United States. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion This study aimed to assess the effects of web‐based education on blood glucose control, self‐care and quality of life in patients with type 2 diabetes.A single‐blinded randomized controlled trial was conducted in accordance with the Consolidated Standards of Reporting Trials (CONSORT) checklist at a university hospital in Turkey. The study included 89 patients with type 2 diabetes who were randomly divided into an intervention group (44) and a control group (45). Participants in the intervention group participated in a 3‐month web‐based education programme.The findings indicated that there were no significant differences in sociodemographic characteristics and illness features between the intervention and control groups, and both were homogeneous. A statistically significant decrease of 0.71 was observed in the HbA1c (%) level of the intervention group following web‐based education. Following web‐based education, there was a significant difference in body mass index (kg/m2) and waist circumferences (cm) between the intervention and control groups. The intervention group displayed significantly improved self‐care and quality of life over the 3‐month period (p < 0.05).This study suggests that web‐based education can enhance the self‐care and quality of life of patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective: The accurate diagnosis of thyroid nodules is crucial for effective management and the detection of malignancy. Fine-needle aspiration biopsy (FNAB) and fine-needle non-aspiration biopsy (FNNAB) are widely used techniques for evaluating thyroid nodules. In this study, we aimed to investigate the impact of anthropometric parameters and sonographic characteristics on the choice between FNAB and FNNAB in terms of diagnostic yield. Material and Methods: This retrospective and cross-sectional analysis involved 188 cases with a total of 225 thyroid nodules. Each nodule initially underwent either FNAB or FNNAB and if the initial biopsy did not yield a diagnostic result, the nodule was re-biopsied using the alternate technique. Ultrasound was used to evaluate the nodules, with a focus on echogenicity, calcifications, size, vascularity, and the presence of a halo sign. Both FNAB and FNNAB were performed using a 25-gauge needle, with the only difference being the application of suction. Results: FNAB demonstrated a higher diagnostic rate for nodules with a taller-than-wide shape (anteroposteriorto-transverse ratio ≥1), nodules sized 10–40 mm, nodules with volumes <0.5 cc, and hypoechoic nodules (P < 0.001 for all). FNAB also outperformed FNNAB in the assessment of the right-sided, inferior, and posterior nodules (P < 0.001), nodules with and without calcification (P = 0.041 and P = 0.020, respectively), and nodules with type 1 and type 2 vascularity patterns (P = 0.006 and P = 0.017, respectively). FNAB was effective in obese individuals (Body mass index ≥40 kg/m2), males with a waist circumference of <94 cm, females with a waist circumference of ≥80 cm, and females with a neck circumference of ≥34 cm (P = 0.011, P = 0.044, P = 0.029, and P = 0.008, respectively). Conclusion: Anthropometric parameters and sonographic characteristics influenced the diagnostic yield of FNAB and FNNAB, with FNAB generally demonstrating superior results. Given the importance of obtaining an accurate diagnostic result from fine-needle biopsy, clinicians should consider both the sonographic features of the nodule and the anthropometric measurements of the patient when selecting a biopsy technique. [ABSTRACT FROM AUTHOR]

Summary Background Objective Methods Results Conclusions Calcium intake has been associated with lower adiposity, but few studies explored the longitudinal relation of calcium from different sources and cardiometabolic markers in young population.Prospectively estimate the association between dairy and non‐dairy calcium intake at 4, 7, and 10 years (y) of age and cardiometabolic risk at 13 y.The sample included 4017 participants from the Generation XXI birth cohort. Dietary data were collected from a 3‐day food diary. Cardiometabolic clusters at 13 y were estimated by a probabilistic Gaussian mixture model (z‐score of waist circumference [WC], HOMA‐IR; HDL cholesterol, triglycerides, and systolic blood pressure [BP]). Multivariable linear and logistic regression models were used to estimate associations.Calcium intake (/100 mg), after adjustment for confounders, was negatively and significantly associated with body mass index (BMI) (β = −0.02, 95% CI: −0.04; −0.01), WC (cm) (β = −0.23, 95% CI: −0.36; −0.11), and diastolic BP (mmHg) (β = −0.14, 95% CI: −0.26; −0.03). After additional adjustment for total energy intake, associations lose statistical significance. Calcium intake from milk at 7 y was inversely associated with WC (β = −0.25, 95% CI: −0.48; −0.03) and from yogurt at 10 y was associated with higher BMI (β = 0.08, 95% CI: 0.03; 0.13) and WC (β = 0.54, 95% CI: 0.12; 0.96). Calcium from vegetables at 4, 7, 10 y reduces later cardiometabolic risk (OR = 0.71; OR = 0.84; OR = 0.98, respectively).This study supports a protective effect of calcium on adolescents' cardiometabolic health, especially from vegetables. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionPrevious observational studies have indicated a potential association between metabolic syndrome (MetS) and asthma, though the causal nature of this connection is still uncertain. Our study used Mendelian randomization (MR) to examine the causal relationship between metabolic syndrome (MetS) and its components with asthma.This study utilized single nucleotide polymorphisms (SNPs) related to MetS and its components, sourced from publicly available genome-wide association studies (GWAS) data, in combination with asthma data from the FinnGen database. Statistical analyses were conducted using the inverse variance weighted method (IVW), MR-Egger, and weighted median method. The robustness of the findings was confirmed through various sensitivity analyses.The IVW analysis indicated that MetS was associated with an increased risk of asthma (OR = 1.0781, 95% CI = 1.0255-1.1333, p = 0.0032). Among the components of MetS, waist circumference (WC) showed a strong association with asthma (OR = 1.4777, 95% CI = 1.3412-1.6281, p = 2.8707 × 10−15). Conversely, high-density lipoprotein cholesterol (HDL-C) was found to be inversely related to the risk of asthma (OR = 0.9186, 95% CI = 0.8669-0.9734, p = 0.0041).The findings of this study support that MetS and its specific components, particularly abdominal obesity, are linked to a higher risk of asthma, while HDL-C might offer protective effects against asthma. These findings provide a foundation both for further research and possible therapeutic interventions. [ABSTRACT FROM AUTHOR]

Objective To analyze the association of 11 anthropometric indicators (AIs) with gastric cancer and precancerous lesions in people aged 40 - 69 years in Yangzhong City. Methods Using the cluster sampling method, 10 698 residents aged 40 - 69 years who participated in upper gastrointestinal cancer screening in Yangzhong City from November 2017 to December 2022 were selected for questionnaire survey, physical examination, endoscopy and pathological diagnosis. Multivariate logistic regression was used to analyze the association between AIs [body mass index (BMI), waist circumference (WC), waist - to - hip ratio (WHR), waist - to - height ratio (WHtR), body fat percentage (BF%), conicity index (CI), body adiposity estimator (BAE), a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI) and abdominal volumetric index (AVI) ] and gastric cancer and precancerous lesions. Results The prevalence of gastric cancer and precancerous lesions was 39. 37% among 10 115 residents. The results of multivariate logistic regression showed that compared with those in quartile 1 (QI), the Q3 and Q4 populations of BMI had an 11. 1% (OR = 0. 889, 0. 791 - 0. 999) and 12. 4% (OR = 0.876, 0.779 - 0.984) lower risk of gastric cancer and precancerous lesions, respectively. The Q2, Q3 and Q4 populations of BF% had 14. 2% (OR = 0. 858,0.756 -0. 974),17.4% (OR =0. 826, 0. 689 -0. 991) and 26. 6% (OR = 0. 734, 0. 603 - 0. 893) lower risk of gastric cancer and precancerous lesions risk, respectively. The Q2 and Q4 populations of the BAE had reduced the risk of gastric cancer and precancerous lesions by 13.2% (OR = 0. 868, 0. 766 - 0. 983) and 21. 3% (OR = 0. 787, 0. 648 - 0. 957). The risk of gastric cancer and precancerous lesions in BAI's Q2 and Q3 populations was reduced by 13. 7% (OR = 0. 863, 0. 767 - 0. 970) and 13. 1% (OR = 0. 869, 0. 769 - 0. 983), respectively. Stratified analysis showed that BMI, BF%, BAE and BAI were associated with a reduced risk of non - cardia gastric cancer and precancerous lesions (all P < 0. 05). However, only the Q2 level of BAE was associated with a reduced risk of cardia gastric cancer and precancerous lesions compared to the QI (P <0. 05), Conclusion Increased levels of BMI, BF%, BAE, and BAI among residents aged 40 - 69 years in Yangzhong City are associated with a reduced risk of gastric cancer and precancerous lesions. However, most of this association apply to non - cardia but not cardia. [ABSTRACT FROM AUTHOR]

Background: The Lipid Accumulation Product (LAP) is a measure that indicates excessive fat accumulation in the body. LAP has been the focus of research in epidemiological studies aimed at forecasting chronic and metabolic diseases. This study aimed to evaluate the association between LAP and type 2 diabetes mellitus (T2DM) among adults in western Iran. Methods: The study involved 9,065 adults who participated in the initial phase of the Ravansar non-communicable diseases study (RaNCD) cohort. To investigate the association between LAP and T2DM, multiple logistic regressions were employed. Additionally, the receiver operating characteristic (ROC) curve was used to evaluate LAP's predictive ability concerning T2DM. Results: The participants had an average age of 47.24 ± 8.27 years, comprising 49.30% men and 50.70% women. The mean LAP was 53.10 ± 36.60 for the healthy group and 75.51 ± 51.34 for the diabetic group (P < 0.001). The multiple regression analysis revealed that the odds of T2DM in the second quartile of LAP were 1.69 (95% CI: 1.25, 2.29) times greater than in the first quartile. Furthermore, the odds in the third and fourth quartiles were 2.67 (95% CI: 2.01, 3.55) and 3.73 (95% CI: 2.83, 4.92) times higher, respectively. The ROC analysis for predicting T2DM showed that the LAP index had an area under the curve (AUC) of 0.66 (95% CI: 0.64, 0.68). Conclusion: A strong association was identified between elevated LAP levels and T2DM in the adult population of western Iran. LAP is recommended as a potential tool for screening diabetes susceptibility. [ABSTRACT FROM AUTHOR]

Background and objectives: Low handgrip strength (HGS) and abdominal obesity (AO) have been reported to be linked to an increased all-cause mortality risk in older adults. However, the combined impact of AO with low HGS and/or HGS asymmetry on mortality risk remains unclear. Therefore, this study aimed to investigate the synergistic effects of AO and abnormal HGS on mortality risk among Chinese older adults. Methods: Baseline data of the China Health and Retirement Longitudinal Study in 2011, along with mortality outcomes obtained in 2018 were used for the analysis. Low HGS was identified as HGS <18 kg in women or <28 kg in men, while HGS asymmetry is defined as an HGS of either hand > 10% stronger than the other. AO was characterized by a waist circumference ≥90 cm in men and ≥85 cm in women. Logistic regression analysis was used to evaluate the relationship between AO, abnormal HGS and mortality risk. Results: A total of 5186 subjects aged 60 years or older were enrolled, 50.6% of whom were male. The proportions of participants with only AO, only low HGS, only HGS asymmetry, low HGS with asymmetry, both AO and low HGS, both AO and asymmetric HGS, and AO with both low HGS and asymmetry were 20.0%, 6.1%, 16.6%, 8.3%, 3.2%, 13.4%, and 3.9%, respectively. Over the course of a 7-year follow-up interval, 970 of these individuals died, with 13.4%, 12.4%, 13.6%, 15.5%, 4.1%, 10.1% and 6.9% of deaths in the above groups, respectively. The adjusted logistic regression analysis model confirmed that only low HGS (OR = 1.897, 95%CI: 1.386–2.596, p<0.001), low HGS with asymmetry (OR = 1.680, 95%CI: 1.265–2.231, p<0.001), and AO combined with both low HGS and asymmetry (OR = 2.029, 95%CI: 1.381–2.981, p<0.001) were associated with a higher risk of mortality. Conclusions: Low HGS, with or without asymmetry, is associated with increased mortality risk in older Chinese adults without AO, and the combination of low HGS and HGS asymmetry further elevates mortality risk in those with AO. [ABSTRACT FROM AUTHOR]

The aim of this research was to determine the influence of a 12-week program of aerobics mix on the parameters of body composition in healthy adult women. The research has been performed in a sample of 64 women participants, and it is divided into two groups, an experimental group (E), made of 34 women participants (age 32 ± 1.8 years), and a control one (C), made of 30 women participants (age 33 ± 0.5 years). Their anthropometric and body composition were evaluated using the following respective parameters: body height, body weight, body fat percentage, muscle mass percentage, skinfold-back (KNL), skinfold-upper arm (KNN), skinfold-stomach (KNT), and skinfold-thigh (KNNK). After mix aerobics realization, among the women of the E group, there is a reduction of body mass by -2.5% and waist size by -3.39%, while muscle mass increased by 2.26%. With all skinfolds within the participants of the E group, there is a statistically important gained reduction of p < 0.05 at the final measuring, compared with the initial one (upper arm -21.10%, stomach -14.36%, back -20.58%, and upper leg -13.98%). The reduction of body mass percentage was -10.59%, and that of body mass index was -2.5%. Based on the gained results, it can be concluded that the mix program was efficient in the reduction of the subcutaneous fat tissue and visceral fat and also influential on the increase of muscle mass. [ABSTRACT FROM AUTHOR]

Introduction: Waist circumference (WC) and fasting plasma glucose (FPG) have been demonstrated as risk factors for type 2 diabetes mellitus (T2DM). Evidence is limited regarding the association of the combination of WC and FPG (WyG) with the risk of T2DM. The primary aim of the study was to investigate the relationship between WyG and T2DM. Research design and methods: The current study was a population-based cohort study using data from the NAGALA database. Participants were divided into tertiles based on WyG. Cox proportional hazard regression model was applied to identify the association of WyG with T2DM. Results: During a median follow-up of 6.19 years in the normoglycemia group and 5.58 years in the prediabetes group, respectively, 88 and 285 individuals in the two groups received a diagnosis of T2DM. After full adjustment, risk of T2DM increased in step-wise fashion with increasing tertiles of WyG. For a per-SD increase in WyG, the hazard ratios for T2DM were 3.05 (95% CI 2.64 - 3.51) in all populations, 1.94 (95% CI 1.46 - 2.58) in the normoglycemia group and 1.63 (95% CI 1.40 - 1.90) in the prediabetes group. The interaction between WyG and fatty liver on T2DM was statistically significant in the prediabetes group (P for interaction = 0.034). Conclusions: Elevated WyG was independently associated with incident T2DM in Japan. Baseline WyG help identify individuals at high risk of T2DM and implement effective preventive measures. [ABSTRACT FROM AUTHOR]

Introduction: Filipino Americans (FAs) are at high risk for developing type 2 diabetes despite other Asian phenotypes. Evidence suggests that pro-inflammatory interleukin-18 (IL-18) and anti-inflammatory adiponectin biomarkers associated with visceral adipose tissue (VAT) may explain this risk. Objectives: This study aimed to quantify the biomarkers in relation to standard ranges of VAT or typical circulating concentration ranges reported in the literature of IL-18 and adiponectin, examine relationships of these markers, and determine if they were different among those participants without diabetes, prediabetes, and diabetes. Methods: A cross-sectional study was used to enroll FAs without diabetes, prediabetes, or diabetes. VAT was measured using the InBody 570© Body Composition Analyzer. Blood samples were obtained to assess plasma concentrations of IL-18 and adiponectin using enzyme-linked immunosorbent assay. All analyses were conducted using a 5% type I error rate. Mean ±SD and percentages were used to describe the sample and data where appropriate. Pearson's correlations (R) were calculated to determine the relationships between VAT and IL-18 in each group. Analysis of variance was used to determine differences in VAT, IL-18, and adiponectin among groups. Further, nonparametric procedures examined the differences in adiponectin among those within groups. Results: Seventy-five participants were enrolled. Biomarkers above the typical concentration range were observed for VAT, IL-18, and adiponectin. Adiponectin significantly differed among groups with lower values in the diabetes group vs. the nondiabetes group. Conclusions: The findings indicate that while inflammation-related biomarkers, such as adiponectin, correlate with VAT and may serve as indicators of increased risk of type 2 diabetes in FAs, correlation alone does not establish causality. [ABSTRACT FROM AUTHOR]

The current systematic review and meta‐analysis was conducted to evaluate the effects of kiwifruit intake on anthropometric indices and key cardiometabolic parameters. Related articles were found by searching PubMed, ISI Web of Science, and Scopus to detect relevant Randomized Clinical Trials (RCTs) and novel systematic reviews relating to kiwi consumption in adults, up to August 2023. The weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated using a random‐effects model. Heterogeneity, sensitivity analysis, and publication bias were assessed and reported using standard methods. Six RCTs were included in the meta‐analysis. Analyzing overall effect sizes demonstrated a significant reduction in low‐density lipoprotein cholesterol (LDL) levels (WMD: −9.30 mg/dL; 95% CI: −17.56 to −1.04, p = .027), whereas no significant alterations of triglycerides (TG) (WMD: −12.91 mg/dL; 95% CI: −28.17 to 2.34, p = .097), total cholesterol (TC) (WMD: −7.66 mg/dL; 95% CI: −17.85 to 2.52, p = .141), high‐density lipoprotein cholesterol (HDL) (WMD: 2.87 mg/dL; 95% CI: −0.36 to 6.11, p = .141), fasting blood glucose (FBG) (WMD: 1.06 mg/dL; 95% CI: −1.43 to 3.56, p = .404), C‐reactive protein (CRP) (WMD: 0.15 mg/dL; 95% CI: −0.40, 0.70, p = .0598), body weight (BW) (WMD: 0.85 kg; 95% CI: −1.34 to 3.04, p = .448), body mass index (BMI) (WMD: 0.04 kg/m2; 95% CI: −0.75 to 0.83, p = .920), and waist circumference (WC) (WMD: 0.18 cm; 95% CI: −1.81 to 2.19, p = .855) were found. Our findings suggest that consuming kiwifruit does not have a significant impact on anthropometric indices and cardiometabolic factors, except for LDL‐C levels. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusions The purpose of this study is to investigate the prevalence and risk factor of cognitive frailty in patients undergoing maintenance hemodialysis.Systematically searched PubMed, EmBase, Web of Science, Cochrane Library, SinoMed, China Knowledge Resource Integrated Database, Wanfang Database, and Weipu Database from inception until January 1, 2024. Two researchers were independently screened and cross‐checked. Stata 15.1 software was used to perform the meta‐analysis.A total of 15 articles were included, including 5398 patients. The results showed that the prevalence of cognitive frailty in patients undergoing maintenance hemodialysis was 24%. Among them, age (odds ratio [OR] = 1.33, 95% CI [1.16, 1.53]), waist circumference (OR = 1.05, 95% CI [1.03, 1.08]), malnutrition (OR = 2.91, 95% CI [1.94, 4.35]), comorbidities (OR = 1.93, 95% CI [1.47, 2.54]), stroke history (OR = 2.94, 95% CI [1.72, 5.03]), and depression (OR = 3.26, 95% CI [1.91, 5.57]) were the main risk factors for cognitive frailty in patients undergoing maintenance hemodialysis. Education level (OR = 0.48, 95% CI [0.31, 0.73]) was protective factors for cognitive frailty in patients undergoing maintenance hemodialysis.Current evidence showed that the prevalence of cognitive frailty in patients undergoing maintenance hemodialysis was high, and there were many risk factors. Therefore, early identification and intervention of cognitive frailty in maintenance hemodialysis patients should be carried out, which may be helpful to reduce the prevalence rate and occurrence of adverse events and improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Background: Although triglyceride-glucose (TyG) index is a reliable indicator of insulin resistance and cardiometabolic disease, its effectiveness in predicting mortality risk has not been adequately validated. We aimed to investigate the association between the TyG-related indices and all-cause and cause-specific mortality in the general population. Methods: A total of 27,642 individuals were included from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. Three indicators were constructed, including the TyG index, TyG combined with waist-to-height ratio (TyG-WHtR), and TyG combined with waist circumference (TyG-WC). Mortality data was acquired through the linkage of NHANES data with National Death Index records. Weighted Cox proportional hazards models were used to estimate the independent association between the TyG-related indices and mortality. Nonlinear associations were explored using restricted cubic splines. Results: Multivariable adjusted models showed a progressive increase in all-cause and cause-specific mortality across quartiles of the TyG-related indices. Compared with the lowest quartile of the TyG index, the highest quartile had adjusted hazard ratios of 1.26 (95% CI 1.04–1.52) for all-cause mortality, 1.38 (1.04–1.74) for cardiovascular mortality, and 1.23 (1.01–1.50) for non-cardiovascular mortality, respectively. For the TyG-WHtR index, the corresponding hazard ratios were 1.60 (1.25–2.05), 1.86 (1.26–2.50), and 1.48 (1.10–1.99), respectively. For the TyG-WC index, the corresponding hazard ratios were 1.42 (1.11–1.75), 1.48 (1.04–1.96), and 1.38 (1.05–1.72), respectively. The associations between the three TyG-related indices and all-cause, cardiovascular and non-cardiovascular mortality were J-shaped. Interaction tests revealed significant effect modification by age, low-density lipoprotein cholesterol (LDL-C) level, and statin use (all P values < 0.05). Conclusions: The TyG-related indices were independent predictors of all-cause and cause-specific mortality in the general population. Young individuals should be particularly vigilant, whereas low LDL-C levels and statin use are potentially protective. [ABSTRACT FROM AUTHOR]

Background: Coaching on Lifestyle (CooL) is a two-year healthcare intervention for people with overweight or obesity, stimulating weight reduction by promoting sustained healthier behavior. The objective of this study is to investigate the effects of CooL on participants' anthropometrics, personal factors and behavioral factors over the two-year timeframe of CooL. Methods: A descriptive case series study, using a broad set of routinely collected data on anthropometrics, personal factors and behavioral factors of adults living across the Netherlands. The data were collected between November 2018 and December 2021 among participants of CooL (N = 746) at three moments during the intervention: at baseline (T0), at 8 months (T1) after completion of phase 1 and at 24 months (T2) after ending CooL. Changes over time were analyzed using paired t-tests comparing baseline to T1 and baseline to T2. In addition, potential differences on outcomes in subgroups based on education level, weight status and group size were examined using paired t-tests and ANOVA-tests. Results: The results showed positive changes on all outcomes at 24 months compared to baseline. The largest effects were on perceived health, attentiveness towards meal size and meal composition (large effect size). Mean weight loss was 4.13 kg (SD 7.54), and mean waist circumference decreased with 4.37 centimeters (SD 8.59), indicating a medium to large effect size. Changes were consistent across subgroups varying in educational level, BMI at baseline and group size. Conclusion: The study demonstrated sustained weight-related effects of CooL over 24 months supporting its two-year duration. The results indicate that CooL, though not for every individual, is in general appropriate and effective for different group sizes and for a wide variety of participants regardless of level of education, or BMI at baseline. Trial registration: Dutch Trial Register NTRNL6061 (13-01-2017). Registered at Overview of Medical Research in the Netherlands (OMON), via https://www.onderzoekmetmensen.nl/. [ABSTRACT FROM AUTHOR]