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Background: Obesity represents a significant risk factor for the development of metabolic abnormalities. However, it is not inevitable that all individuals with obesity will develop these disorders. Selenium has been demonstrated to play a role in maintaining metabolic homeostasis in vivo, with the ability to regulate relevant signaling pathways involved in glucose and lipid metabolism processes. Previous studies have indicated that selenium concentrations in obese individuals are higher than those reported in the general population. These findings the question of whether altered selenium concentrations may act as important triggers for accelerating metabolic imbalances in the obese population. The aim of this study was to examine the potential correlation between serum selenium concentrations and the risk of developing metabolic abnormalities in individuals with obesity. Methods: The present study included 6,125 participants from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) who were aged between 20 and 80 years, with a body mass index (BMI) of 30 kg/m² or greater, and met the inclusion and exclusion criteria. Weighted generalized linear regression analyses were conducted to evaluate the associations between serum selenium concentrations and the conversion of metabolically healthy obesity (MHO) to metabolically unhealthy obesity (MUO). A generalized additive model (GAM) and a two-piecewise linear regression model were employed to investigate the saturation threshold effect between selenium and MUO. The correlation between different selenium concentration intervals and metabolic diseases was evaluated by categorizing selenium concentrations according to the saturation threshold. Furthermore, this study investigated the correlation between serum selenium and lipid concentrations in obese females and between serum selenium and blood pressure in obese males. Results: The weighted prevalence of MUO in the study population was 48.35%. After rigorous adjustment for sociodemographic, physical, and laboratory test covariates, the weighted odds ratio (OR) of MUO increased by 44% for every 1 µM increase (approximately 78.74 µg) in the serum selenium concentration (weighted OR=1.44; 95% CI=1.09 - 1.91; P=0.018). Second, GAM analysis and saturation threshold analyses revealed an inverted U-shaped relationship between serum selenium and metabolic abnormalities in males, with a corresponding inflection point (K) of 2.82 µM. When the serum selenium concentration was below the K-value, the effects of serum selenium were mainly on blood pressure, especially diastolic blood pressure (DBP) (weighted β: 3.34; 95% CI= 0.25 - 6.44; P=0.038). Conversely, the correlation between the serum selenium concentrations and metabolic homeostasis imbalance in females was linear. When the selenium concentration exceeded 2.12 µM, the increase in selenium content was accompanied by increases in total cholesterol (TC, weighted β=0.54, 95% CI=0.32 - 0.76; P=0.000) and triglyceride (TG, weighted β=0.51, 95% CI=0.27 - 0.75; P=0.000) concentrations. Conclusions: The findings of our study indicate that selenium supplementation strategies for individuals with obesity should be tailored to the sex of the individual. In females, serum selenium concentration above the saturation threshold primarily facilitates the transition from MHO to MUO by influencing alterations in serum lipid metabolism. Maintaining selenium concentrations below the threshold levels is highly important for preventing the conversion of MHO to MUO. In males, serum selenium concentrations above the threshold were found to be effective in preventing an elevation in blood pressure, particularly in improving systolic blood pressure (SBP). Nevertheless, serum selenium concentrations below the threshold are linked to an increased risk of hypertension in obese individuals, particularly those with elevated diastolic blood pressure (DBP). Further research is needed to elucidate the optimal serum selenium concentration that exerts deleterious effects on blood pressure. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between the occupational history as a wildland firefighter (WFF) and clinical indicators of cardiovascular health. Methods: Among 2862 WFFs, we evaluated associations between the number of total days assigned on fire and high-risk categories of three clinically measured cardiovascular indicators. Results: Almost one-third (32%) of WFFs had one or more clinicalmeasures that would place them in high-risk categories for body mass index, blood pressure, and total cholesterol. WFF work history was associated with some of these measures: odds ratio (and 95% confidence interval) for highest versus lowest tertile of days on fire were 1.4 (1.2, 1.8) and 1.2 (1.0, 1.5) for high-risk categories of body mass index and cholesterol, respectively. Conclusion: More frequent screening and targeted health promotion programs for WFFs are warranted to increase awareness of cardiovascular risk and prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Steroids, the mainstay of treatment for nephrotic syndrome in children, have multiple adverse effects including growth suppression. Methods: Anthropometric measurements in children < 18 years enrolled in the Nephrotic Syndrome Study Network (NEPTUNE) were collected. The longitudinal association of medication exposure and nephrotic syndrome characteristics with height z-score and growth velocity was determined using adjusted Generalized Estimating Equation regression and linear regression. Results: A total of 318 children (57.2% males) with a baseline age of 7.64 ± 5.04 years were analyzed. The cumulative steroid dose was 216.4 (IQR 61.5, 652.7) mg/kg (N = 233). Overall, height z-scores were not significantly different at the last follow-up compared to baseline (− 0.13 ± 1.21 vs. − 0.23 ± 1.71, p = 0.21). In models adjusted for age, sex, and eGFR, greater cumulative steroid exposure (β − 7.5 × 10−6, CI − 1.2 × 10−5, − 3 × 10−6, p = 0.001) and incident cases of NS (vs. prevalent) (β − 1.1, CI − 2.22, − 0.11, p = 0.03) were significantly associated with lower height z-scores over time. Rituximab exposure was associated with higher height z-scores (β 0.16, CI 0.04, 0.29, p = 0.01) over time. Conclusion: Steroid dose was associated with lower height z-score, while rituximab use was associated with higher height z-score. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis prevalence is increased in Crohn's disease (CD). Its pathogenesis in these patients is incompletely understood. Objectives: To identify factors associated with decreased bone mineral density (BMD) status in CD patients on a time-line course. Methods: A retrospective study was performed that followed CD patients who underwent at least two bone mineral density scans (DEXAs). Follow-up began one year prior to the first DEXA test and lasted at least one year after a second test. Possible correlations between baseline and follow-up variables and changes in BMD status were examined. Change in BMD was defined as a transition from one bone density category to another (normal vs. osteopenia vs. osteoporosis). Binary variables were assessed using the Cochrane–Armitage test. Categorical variables were assessed using the chi-squared test. A multivariate analysis was performed. Results: The study included 141 patients. At baseline, 33 patients (23.4%) had normal BMD, 75 (53.2%) had osteopenia, and 33 (23.4%) had osteoporosis. Patients with low BMD had a lower baseline BMI compared to those with normal BMD (p < 0.0001). After a median follow-up of 48 months (IQR 29–71), BMD status worsened in 19 (13.5%) patients, whereas in 95 (67.3%) and 27 (19.1%) patients, BMD remained unchanged or improved, respectively. On the multivariate analysis, elevated median CRP throughout follow-up (OR = 0.8, 95% CI: 0.68–0.93) and low baseline BMI (OR = 0.9, 95% CI: 0.83–0.98) were associated with a lack of BMD status improvement. Conclusions: Persistently elevated CRP and low BMI are associated with a lack of improvement in BMD. These findings underscore the importance of effective inflammation control and nutritional support to maintain and improve bone health. [ABSTRACT FROM AUTHOR]

Background: Obesity, characterized by excess fat accumulation, is associated with heightened inflammation and infection risk. However, the relationship between body mass index (BMI) and wound healing remains unclear. Objective: The study aimed to explore the relationship between BMI and wound infection incidence, pathogenic bacterial strains in wounds, and wound healing promotion using different BMI values in conventional medical dressings. Methods: The study included 120 patients with traumatic and orthopedic wound infections and 40 patients with vertebral fractures to assess dressing efficacy and the influence of BMI index on healing outcomes. Wound infection incidence rates, pathogenic bacteria distribution within groups, and antibiotic resistance were identified, and their association with BMI was evaluated. Factors contributing to wound infection were analyzed. Results: The wound infection incidence rate was 30.36% without statistically significant correlation with BMI (p>0.05). A weak correlation (0.3Conclusions: BMI exhibited a weak correlation with pathogenic bacteria distribution and negatively correlated with the degree of wound healing. [ABSTRACT FROM AUTHOR]

Background: Unhealthy weight control behaviors (UWCBs) involve weight control strategies to reduce or maintain weight, such as fasting, taking diet pills, and vomiting or taking laxatives. UWCBs in teenagers can escalate into severe health issues such as eating disorders. Understanding the trends of UWCBs and their association with risk behaviors in teenagers is crucial, as early intervention and prevention strategies are pivotal. Methods: This study utilized eight waves of the youth risk behavior surveillance system (YRBSS) data from 1999 to 2013. Our primary outcome was UWCBs engagement. We used multinomial logistic models to analyze the association between UWCBs and risk behaviors among adolescents including driving after alcohol consumption, suicide attempts, smoking, alcohol use, and sexual intercourse. Results: Among 109,023 participants, UWCBs prevalence was 16.64%. Body Mass Index (BMI) was significantly associated with UWCBs risk. In addition, we found the intention of weight management confounded the relationship between BMI and UWCBs. The unadjusted logistic regression indicated a monotone-increasing association between BMI and the risk of UWCBs. In contrast, the adjusted logistic regression indicated a U-shaped curve with the lowest (BMI < 17 kg/m2) and highest (BMI > 30 kg/m2) BMI groups having significantly higher odds of engaging in UWCBs compared to the reference BMI group (18.5 ≤ BMI ≤ 24.9 kg/m2). Conclusions: The intention of weight management confounded the relationship between Body Mass Index (BMI) and the risk of UWCBs. These findings suggest that healthcare interventions for weight management behaviors should be tailored to adolescents with BMI ≥ 25 and BMI < 18.5. Plain English Summary: This study looked at unhealthy weight control behaviors (UWCBs) in American teenagers, such as fasting, taking diet pills, or vomiting to control weight. These behaviors can lead to serious health problems, including eating disorders. The research analyzed data from over 100,000 teenagers between 1999 and 2013 to understand the connection between UWCBs and other risky behaviors like drinking alcohol, smoking, and attempting suicide. While previous research suggested that teens with higher body weight were more likely to engage in UWCBs, our findings showed a shift in this relationship after considering the teens' intentions to manage weight. Specifically, teens with very low body weight (BMI < 17) and a strong desire to lose weight had an increased risk of UWCBs. This highlights the need for healthcare providers to focus on the mental health and weight management goals of these teens to prevent harmful behaviors. Additionally, reconsidering the removal of UWCB-related questions from national surveys like YRBSS is important to continue monitoring these behaviors. [ABSTRACT FROM AUTHOR]

Background: Dupilumab is a monoclonal antibody used for the treatment of moderate/severe atopic dermatitis (AD). In recent years, several studies have confirmed the positive association between AD and overweight/obesity, and a report demonstrated the effect of weight reduction on the improvement of AD symptoms. Methods: The weight of 170 patients under treatment with dupilumab was recorded at baseline and after 48 weeks (T48). Clinical monitoring was mainly conducted using the Eczema Area and Severity Index (EASI). The study aimed to assess a possible correlation between the clinical outcome of dupilumab therapy and BMI. Results: Although not statistically significant, patients with a BMI < 25 have a higher EASI percentage improvement than patients with a BMI ≥ 25 at any time point, and the percentage of overweight and obese patients that does not reach EASI-75 at T48 is higher compared to normal-weight patients (13.5% vs. 5.9%). Despite this, in the multivariate regression analysis, no baseline characteristic, including BMI, appears to increase the risk of not reaching EASI-75. In addition, the results show no differences in BMI between baseline and T48 in any age/sex group. Conclusions: The results suggest that overweight and obese patients have a lower response to dupilumab when considering the EASI score, but this difference does not appear to be clinically significant. Furthermore, dupilumab treatment does not seem to impact weight. [ABSTRACT FROM AUTHOR]

Aim/Introduction: This historical cohort study sought to research the relationship between eating behaviors and the incidence of type 2 diabetes in a large, long‐term cohort of Japanese subjects. Materials and Methods: Panasonic Corporation employees who had no history of diabetes and attended yearly health surveys between 2008 and 2018 were included in this study. The main outcome measure was diabetes onset. Results: This study included 128,594 participants and 6,729 participants who developed type 2 diabetes in the study period. Skipping breakfast, fast eating, snacking after dinner, and eating meals before sleeping were linked with the risk of the incidence of type 2 diabetes. In individuals with a BMI < 25 kg/m2, fast eating (hazard ratio [HR]: 1.61, 95% confidence interval [CI]: 1.37–1.90), and eating meals before sleeping (HR: 1.09, 95% CI: 1.02–1.17) were likewise associated with an increased risk of incident type 2 diabetes. Nevertheless, fast eating (HR: 1.08, 95% CI: 0.89–1.30) and meals before sleeping (HR: 0.94, 95% CI: 0.88–1.01) were not related to the occurrence of type 2 diabetes in individuals with a BMI ≥25 kg/m2 (P value for interaction = 0.0007 [fast eating] and 0.007 [meals before sleeping], respectively). No significant interaction effect between sex and eating behavior was found. Conclusions: With respect to Japanese people, especially in people with a BMI < 25 kg/m2, eating behaviors may be a risk factor for the occurrence of type 2 diabetes. [ABSTRACT FROM AUTHOR]

• Obesity is associated with lower rates of Obstetrics anal sphincter injuries (OASIS). • Obesity is linked to lower episiotomy rates. • Clinics may opt for a more cautious approach to episiotomy in obese patients. Prevalence of obesity in reproductive age and pregnant women has been on the rise during the past several decades. The relationship between body mass index (BMI) and obstetric anal sphincter injuries (OASIS) or episiotomy has not yet been thoroughly investigated. The objective of this study was to shed light on this issue. This retrospective cohort study was performed using electronic database of an obstetrics department at a university-affiliated tertiary medical center. All spontaneous singleton vaginal deliveries at term between January 2015 and December 2021 were included. The primary outcome was the incidence of OASIS (third- and fourth-degree perineal tears) and obesity. These were compared across three BMI categories: normal (BMI below 25 kg/m2), overweight (BMI 25.0–29.9 kg/m2), and obesity (BMI of 30 kg/m2 and over). Of the overall 13,932 spontaneous vaginal deliveries identified, 34.7 % had BMI in the normal range, 43.1 % were overweight, and 25.4 % were obese. Multivariate analysis demonstrated lower rates of OASIS in obese (OR 0.2, 95 %CI 0.04–0.9) and in overweight (OR 0.3, 95 %CI 0.1–0.99) women, as compared to the normal-weight cohort. In addition, lower rates of episiotomy were noted in the obese cohort (OR 0.7, 95 %CI 0.6–0.8). Decreased incidence of OASIS was noted in women with obesity, in conjunction with lower use of episiotomy. These findings imply that obstetrics clinics might consider a more conservative approach to episiotomy in obese patients. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery procedure in China. However, its cost-effectiveness in Chinese patients is currently unknown. Objectives: This study aims to assess the cost-effectiveness of LSG vs no surgery in Chinese patients with severe and complex obesity, taking into account both healthcare expenses and the potential improvement in health-related quality of life (HRQoL). Methods: A retrospective cohort study was conducted, encompassing 135 Chinese patients who underwent LSG between January 3, 2022 and December 29, 2022, at a major bariatric center. The study evaluated the cost-effectiveness from a healthcare service perspective, employing the incremental cost-effectiveness ratio (ICER) for quality-adjusted life years (QALYs) gained. The analyses compared LSG with the alternative of not undergoing surgery over a 1-year period, using actual data, and extended to a lifetime horizon by projecting costs and utilities at an annual discount rate of 3.0%. Subgroup analyses were undertaken to explore cost-effectiveness variations across different sex, age and BMI categories, and diabetes status, employing a one-way analysis of variance (ANOVA). To ensure the reliability of the findings, one-way and probabilistic sensitivity analyses were executed. Results: The results indicated that 1-year post-LSG, patients achieved an average total weight loss (TWL) of (32.7 ± 7.3)% and an excess weight loss (EWL) of (97.8 ± 23.1)%. The ICER for LSG compared to no surgery over a lifetime was $4,327/QALY, significantly below the willingness-to-pay (WTP) threshold for Chinese patients with severe and complex obesity. From a lifetime perspective, LSG proved to be cost-effective for all sex and age groups, across all BMI categories, and for both patients with and without diabetes. Notably, it was more cost-effective for younger patients, patients with higher BMI, and patients with diabetes. Conclusions: LSG is a highly cost-effective intervention for managing obesity in Chinese patients, delivering substantial benefits in terms of HRQoL improvement at a low cost. Its cost-effectiveness is particularly pronounced among younger individuals, those with higher BMI, and patients with diabetes. [ABSTRACT FROM AUTHOR]

Background: Patients with multiple sclerosis (MS) have many potential factors (disease duration, spasticity, immobilization, or glucocorticoid use) that can deteriorate their nutritional status and impact both the progression and prognosis of the disease. Body mass index (BMI), the most widely used nutritional status assessment tool, has important limitations because it does not provide any data on body composition. Aim: This study aimed to assess the interrelationship between nutritional status assessment by both body mass index (BMI) and body composition using bioelectrical impedance analysis (BIA) and the consistency of diagnosis for underweight/underfat, normal weight/healthy, overweight/overfat, and obesity/obese MS patients. Methods: Anthropometric [BMI and waist-to-height ratio (WHtR)] and body composition (BIA) data were evaluated in 176 patients with MS. Patients were categorized into four nutritional status subgroups (underweight, normal weight, overweight, obese according to BMI, and underfat, healthy, overfat, and obese according to fat mass% by BIA). The median Expanded Disability Status Scale score was 4.5. Patients were then divided according to EDSS score as mild (EDSS 1.0-4.0) or moderate (EDSS 4.5-6.5) disability subgroups. Results: Based on BIA assessment, there was a significantly higher prevalence of overfat than of overweight based on BMI [n = 50 (28.41%) vs. n = 38 (21.59%); p < 0.05]. However, the prevalence of obesity did not differ significantly regardless of the mode of diagnosis and was not significantly lower when assessed using BIA [n = 26 (14.77%) vs. n = 30 (17.05%), respectively]. The overall compatibility rates (CR) of diagnoses made using both BMI and BIA were 75.6, 77.0, and 70.1% for all patients with MS and the mild and moderate subgroups, respectively. The lowest CR was observed in the overweight group. Adiposity significantly underestimated BMI in all subgroups. In the moderate MS subgroup, BMI significantly overcategorized patients with MS as having a normal weight (p < 0.05). Stratification for abdominal obesity (WHtR > 0.5) showed that BMI significantly underestimated the prevalence of MS in overweight and obese vs. overfat and obese patients, as assessed using BIA (60.5 vs. 67%; p < 0.05). Clinical status (EDSS and ΔEDSS) was more closely related to the nutritional status categorized by FAT% assessed using BIA than using BMI cutoff points. However, the relationship was not statistically significant. Conclusion: Using the BMI cutoff point for nutritional status assessment in patients with MS is associated with a significant underestimation of excess fat mass. BIA-based FAT% based on BIA have a better relationship with abdominal obesity and disability status than with BMI in patients with MS. The highest rate of false-negative diagnoses was based on the BMI in patients with MS and moderate disability. Adiposity assessment using BIA appears to be a useful method for proper nutritional status assessment in the patients group. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the association of Body Mass Index (BMI) and age of epilepsy onset, in patients with epilepsy associated with temporal encephaloceles (TEs). Methods: A comprehensive PubMed literature review was conducted using the keywords "temporal encephaloceles" and "epilepsy" for identifying articles for the analysis. Inclusion criteria encompassed all evidence levels reporting patients with TE-related epilepsy and documented BMI. Logistic regression analyses were performed to examine the effect of BMI on predicting epilepsy onset after the 25th year of age. Spearman's correlation assessed the relationship between BMI with epilepsy onset. Finally, the association between BMI and postsurgical outcomes, distinguishing between more favourable outcomes (Engel Class I and II) and less favourable outcomes (Engell Class III and IV) was explored. Results: Of the initially identified 88 articles, nine were included in the analysis, involving 127 patients with TE-related epilepsy and reported BMI. The mean age of epilepsy onset was 24.9 years (SD = 14.8 years), with a mean BMI of 28.0 kg/m2 (SD = 7.4 kg/m2). A significant positive correlation was observed between BMI and age of epilepsy onset (rho = 0.448, p < 0.001). Female patients had higher BMI compared to male patients (30.1 kg/m2, SD = 8.7 kg/m2 and 26.5 kg/m2, SD = 5.3 kg/m2 respectively, p = 0.008). However, the epilepsy onset did not differ significantly between male and female patients (p = 0.26). The bivariate logistic regression showed that patients with increased BMI were more likely to have an epilepsy onset after the 25th year of age, adjusted for the confounder sex (OR = 1.133, 95%-CI [1.060, 1.211], p < 0.001). Finally, a potential trend indicated a higher average BMI among patients with more favourable postsurgical outcomes than less favourable postsurgical outcomes (27.3 kg/m2, SD = 7.7 kg/m2 and 24.8 kg/m2, SD = 2.2 kg/m2 respectively, p = 0.076). Significance: The occurrence of TEs has already been associated with increased BMI and idiopathic intracranial hypertension. The current analysis indicates a significant correlation between elevated BMI and delayed epilepsy onset in cases of TE-related epilepsy. This finding suggests the presence of unique underlying pathomechanisms among epilepsy patients with higher BMI and TEs, supporting the hypothesis of a potential gradual influence of BMI on TE formation. Consequently, this may lead to a milder, more gradual progression of epileptogenesis compared to individuals with a normal BMI. [ABSTRACT FROM AUTHOR]

Abstract Background Unhealthy weight control behaviors (UWCBs) involve weight control strategies to reduce or maintain weight, such as fasting, taking diet pills, and vomiting or taking laxatives. UWCBs in teenagers can escalate into severe health issues such as eating disorders. Understanding the trends of UWCBs and their association with risk behaviors in teenagers is crucial, as early intervention and prevention strategies are pivotal. Methods This study utilized eight waves of the youth risk behavior surveillance system (YRBSS) data from 1999 to 2013. Our primary outcome was UWCBs engagement. We used multinomial logistic models to analyze the association between UWCBs and risk behaviors among adolescents including driving after alcohol consumption, suicide attempts, smoking, alcohol use, and sexual intercourse. Results Among 109,023 participants, UWCBs prevalence was 16.64%. Body Mass Index (BMI) was significantly associated with UWCBs risk. In addition, we found the intention of weight management confounded the relationship between BMI and UWCBs. The unadjusted logistic regression indicated a monotone-increasing association between BMI and the risk of UWCBs. In contrast, the adjusted logistic regression indicated a U-shaped curve with the lowest (BMI 30 kg/m2) BMI groups having significantly higher odds of engaging in UWCBs compared to the reference BMI group (18.5 ≤ BMI ≤ 24.9 kg/m2). Conclusions The intention of weight management confounded the relationship between Body Mass Index (BMI) and the risk of UWCBs. These findings suggest that healthcare interventions for weight management behaviors should be tailored to adolescents with BMI ≥ 25 and BMI

Abstract Objective The objective of this study is to independently assess skeletal muscle index (SMI) and body mass index (BMI) as prognostic determinants for renal cell carcinoma (RCC) and investigate their correlation with surgical outcomes. Patients and methods A retrospective cohort study of 524 RCC patients diagnosed between August 2010 and July 2018 was conducted using data from the Zealand University Hospital Renal Cancer Database in Denmark. Patient information was extracted from electronic patient records and the National Cancer Registry and encompassed demographics, clinical factors, tumour characteristics and surgical details. SMI was calculated from a single third lumbar vertebra (L3) axial computed tomography (CT) image via CoreSlicer software and classified into high using gender‐specific thresholds. Primary outcomes focused on complications within 90 days as well as survival outcomes, and their relation with both SMI and BMI. Multivariable analysis assessed SMI's independent prognostic significance in RCC. Results Among 524 patients, 18.5% experienced complications, with high SMI correlating significantly (p = 0.018) with a 72% higher complication risk. High SMI patients had a 22.7% complication rate compared to 14.5% in the low SMI group. High SMI was also linked to prolonged survival (110.95 vs. 94.87 months; p = 0.001), whereas BMI showed no significant survival differences (p = 0.326). Multivariable analysis (n = 522) revealed high SMI associated with improved survival (hazard ratio [HR] = 0.738; 95% CI, 0.548–0.994; p = 0.046). Advanced T‐stage significantly impacted mortality (T2: HR = 2.057; T3: HR = 4.361; p

ABSTRACT Aim/Introduction This historical cohort study sought to research the relationship between eating behaviors and the incidence of type 2 diabetes in a large, long‐term cohort of Japanese subjects. Materials and Methods Panasonic Corporation employees who had no history of diabetes and attended yearly health surveys between 2008 and 2018 were included in this study. The main outcome measure was diabetes onset. Results This study included 128,594 participants and 6,729 participants who developed type 2 diabetes in the study period. Skipping breakfast, fast eating, snacking after dinner, and eating meals before sleeping were linked with the risk of the incidence of type 2 diabetes. In individuals with a BMI

Abstract Objective This study investigates the association of Body Mass Index (BMI) and age of epilepsy onset, in patients with epilepsy associated with temporal encephaloceles (TEs). Methods A comprehensive PubMed literature review was conducted using the keywords “temporal encephaloceles” and “epilepsy” for identifying articles for the analysis. Inclusion criteria encompassed all evidence levels reporting patients with TE-related epilepsy and documented BMI. Logistic regression analyses were performed to examine the effect of BMI on predicting epilepsy onset after the 25th year of age. Spearman’s correlation assessed the relationship between BMI with epilepsy onset. Finally, the association between BMI and postsurgical outcomes, distinguishing between more favourable outcomes (Engel Class I and II) and less favourable outcomes (Engell Class III and IV) was explored. Results Of the initially identified 88 articles, nine were included in the analysis, involving 127 patients with TE-related epilepsy and reported BMI. The mean age of epilepsy onset was 24.9 years (SD = 14.8 years), with a mean BMI of 28.0 kg/m2 (SD = 7.4 kg/m2). A significant positive correlation was observed between BMI and age of epilepsy onset (rho = 0.448, p

Population-level surveillance of student weight status (particularly monitoring students with a body mass index (BMI) ≥95th percentile) remains of public health interest. However, there is mounting concern about objectively measuring student BMI in schools. Using data from the nations largest school district, we determined how closely students self-reported BMI approximates objectively-measured BMI, aggregated at the school level, to inform decision-making related to school BMI measurement practices. Using non-matched data from n = 82,543 students with objective height/weight data and n = 7676 with self-reported height/weight from 84 New York City high schools (88% non-white and 75% free or reduced-price meal-eligible enrollment), we compared school-level mean differences in height, weight, BMI, and proportion of students by weight status, between objective and self-reported measures. At the school-level, the self-reported measurement significantly underestimated weight (-1.38 kg; 95% CI: -1.999, -0.758) and BMI (-0.38 kg/m2; 95% CI: -0.574, -0.183) compared to the objective measurement. Based on the objective measurement, 12.1% of students were classified as having obesity and 6.3% as having severe obesity (per CDC definition); the self-report data yielded 2.5 (95% CI: -1.964, -0.174) and 1.4 (95% CI: -2.176, -0.595) percentage point underestimates in students with obesity and severe obesity, respectively. This translates to 13% of students with obesity and 21% of students with severe obesity being misclassified if using self-reported BMI. School-level high school students self-reported data underestimate the prevalence of students with obesity and severe obesity and is particularly poor at identifying highest-risk students based on BMI percentile.

Background: Aerobic exercise plays an influential role in improving mental health. Aerobics, as a form of efficient aerobic exercise, is suitable for various individuals and promotes the mental health of college students. Objectives: The purpose of this study was to explore whether aerobic exercise has a positive effect on the mental health and Body Mass Index (BMI) of obese college students. Methods: Sixty obese college students with a BMI ≥ 28 were selected and divided into two groups. Each group consisted of 30 students, 15 boys and 15 girls. The experimental group received aerobic exercise training three times a week for 12 weeks, while the control group received prescribed aerobic training. Data before and after the experiment were recorded. Results: The BMI of the experimental group decreased from 30.19 ± 0.73 before the experiment to 27.32 ± 0.84 after the experiment, with a change range of 2.86 ± 0.11. The experimental group showed significant differences before and after the experiment (P < 0.01). The BMI of the control group decreased from 30.16 ± 0.73 before the experiment to 28.62 ± 0.89 after the experiment, with a change range of 1.54 ± 0.84. The control group also showed significant differences before and after the experiment (P < 0.05). The experimental group had a better effect. The 12 dimensions of the mental health test changed in both the experimental group and the control group, and the results were statistically significant (P < 0.05), with the experimental group showing better improvement. Conclusions: The statistically significant impact of aerobics on the mental health of obese college students holds practical significance. Notably, the observed reduction in anxiety and depression symptoms, coupled with notable enhancements in self-esteem and self-confidence, underscores the tangible benefits of incorporating aerobics into the lifestyle of this demographic. [ABSTRACT FROM AUTHOR]

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Objective: To study the prevalence of obesity among children aged 5 to 14 years in the Republic of Tajikistan (RT) from 2017 to 2021 Methods: The clinical data used for research was obtained from the Republican Center of Medical Statistics and Information of the Ministry of Health and Social Protection of the Population of the RT. The data covered the period from 2017 to 2021 and included obese children between the ages of 5 and 14. Descriptive statistical methods were used to analyze the results, including data aggregation and trend line derivation. The range of values and their 95% confidence intervals were also calculated. For this purpose, absolute values were converted into rates per 10,000 children aged 5 to 14 Results: : According to the study results, the prevalence of obesity among children aged between 5 and 14 years has increased between 2017 and 2021. In 2017, there were approximately 28 obese children per 10,000, while by the end of 2021, this number had risen to 102 per 10,000 children. The study also found a significant increase in the number of obese children in the capital city of Dushanbe and the Sughd region. The number of obese children was higher in urban than rural areas. However, there is also a noticeable increase in the number of children with obesity in rural areas; at the same time, in urban areas, obesity is more prevalent in girls than in boys. Conclusion: The study showed a rapid increase in childhood obesity rates, particularly in urban areas. To mitigate this issue, it is essential to utilize specialized programs.

Abstract Background BMI has been reported to be a major risk factor for the increased burden of several diseases. This study explores the burden of cancer linked to high body mass index (BMI) in Gulf Cooperation Council (GCC) countries and assesses the correlation with Socio-demographic Index (SDI). Method Using Global burden of disease (GBD) 2019 data, the authors quantified cancer burden through mortality, DALYs, age standardized mortality rate (ASMR), and age standardized DALYs rate (ASDR) across sexes, countries, cancer types, and years. Spearman’s correlation tested ASMR against SDI. The authors estimated 95% uncertainty limits (UIs) for population attribution fraction (PAFs). Results Between 1990 and 2019, all six GCC countries showed increased number of the overall cancer-related deaths (398.73% in Bahrain to 1404.25% in United Arab Emirates), and DALYs (347.38% in Kuwait, to 1479.35% in United Arab Emirates) reflecting significant increasing in deaths, and burden cancer attributed to high BMI. In 2019, across GCC countries, pancreatic, uterine, and kidney cancer accounted for 87.91% of the total attributable deaths associated with high BMI in females, whereas in male, colon and rectum cancer alone accounted for 26% of all attributable deaths associated with high BMI. Conclusion The study highlights the significant impact of high BMI on cancer burden in GCC countries. Moreover, the study identifies specific cancers, such as pancreatic, uterine, and kidney cancer in females, and colon and rectum cancer in males, as major contributors to attributable deaths, urging targeted prevention strategies at reducing weight and encouraging physical activity could greatly lessen the impact of diseases in the GCC countries.

Abstract Background The proportion of patients with breast cancer and obesity is increasing. While the therapeutic landscape of breast cancer has been expanding, we lack knowledge about the potential differential efficacy of most drugs according to the body mass index (BMI). Here, we conducted a systematic review on recent clinical drug trials to document the dosing regimen of recent drugs, the reporting of BMI and the possible exclusion of patients according to BMI, other adiposity measurements and/or diabetes (leading comorbidity of obesity). We further explored whether treatment efficacy was evaluated according to BMI. Methods A search of Pubmed and ClinicalTrials.gov was performed to identify phase I-IV trials investigating novel systemic breast cancer treatments. Dosing regimens and exclusion based on BMI, adiposity measurements or diabetes, documentation of BMI and subgroup analyses according to BMI were assessed. Results 495 trials evaluating 26 different drugs were included. Most of the drugs (21/26, 81%) were given in a fixed dose independent of patient weight. BMI was an exclusion criterion in 3 out of 495 trials. Patients with diabetes, the leading comorbidity of obesity, were excluded in 67/495 trials (13.5%). Distribution of patients according to BMI was mentioned in 8% of the manuscripts, subgroup analysis was performed in 2 trials. No other measures of adiposity/body composition were mentioned in any of the trials. Retrospective analyses on the impact of BMI were performed in 6 trials. Conclusions Patient adiposity is hardly considered as most novel drug treatments are given in a fixed dose. BMI is generally not reported in recent trials and few secondary analyses are performed. Given the prevalence of patients with obesity and the impact obesity can have on pharmacokinetics and cancer biology, more attention should be given by investigators and study sponsors to reporting patient’s BMI and evaluating its impact on treatment efficacy and toxicity.

Background: Depression has become a multifaceted global health issue, with complex connections to obesity. Weight-adjusted-waist index (WWI) can effectively evaluate central obesity, but the relationship between WWI and depression has not been well studied. The study aims to investigate the potential correlation between these two health parameters. Methods: According to the data from National Health and Nutrition Examination Survey, this cross-sectional study used multiple regression analysis, subgroup analysis, and smooth curve fitting to explore the relationship between WWI and depression. The assessment ability of WWI was evaluated and compared to other obesity indicators using the receiver operating characteristic (ROC) curve. Results: This study analyzed 38,154 participants. Higher WWI is associated with higher depression scores (β = 0.41; 95% CI, 0.36–0.47). After adjusting for various confounding factors, the positive correlation between WWI and depression remained significant (P for trend < 0.0001). Nonlinear positive correlation was detected with a breakpoint of 11.14. ROC analysis shows that compared to other obesity indicators (ROCWWI = 0.593; ROCBMI = 0.584; and ROCWC = 0.581), the correlation between WWI and depression has better discrimination and accuracy. DII mediated 4.93%, SII mediated 5.08%, and sedentary mediated 0.35% of the total association between WWI and depression. Conclusion: WWI levels were related to an increased likelihood of depression and showed a stronger relationship than BMI and waist circumference. Our findings indicated that WWI may serve as a simple anthropometric index to evaluate depression.

Background: Extensive research has been conducted on the correlation between adipose tissue and the risk of malignant lymphoma. Despite numerous observational studies exploring this connection, uncertainty remains regarding a causal relationship between adipose tissue and malignant lymphoma. Methods: The increase or decrease in adipose tissue was represented by the height of BMI. The BMI and malignant lymphoma genome-wide association studies (GWAS) used a summary dataset from the OPEN GWAS website. Singlenucleotide polymorphisms (SNPs) that met the criteria of P <5e-8 and LD of r2 = 0.001 in the BMI GWAS were chosen as genetic instrumental variants (IVs). Proxy SNPs with LD of r2 > 0.8 were identified, while palindromic and outlier SNPs were excluded. Mendelian randomization (MR) analysis used five methods, including inverse-variance weighted (IVW) model, weighted median (WM), MREgger, simple mode, and weighted mode. Sensitivity assessments included Cochran's Q test, MR-Egger intercept test, and leave-one-out analysis. Participants randomly selected by the National Center for Health Statistics (NHANSE) and newly diagnosed HL patients at Fujian Medical University Union Hospital were used for external validation. Results: The results of the MR analysis strongly supported the causal link between BMI and Hodgkin's lymphoma (HL). The research demonstrated that individuals with lower BMI face a significantly increased risk of developing HL, with a 91.65% higher risk (ORIVW = 0.0835, 95% CI 0.0147 - 0.4733, P = 0.005). No signs of horizontal or directional pleiotropy were observed in the MR studies. The validation results aligned with the results from the MR analysis (OR = 0.871, 95% CI 0.826 - 0.918, P< 0.001). And there was no causal relationship between BMI and non-Hodgkin's lymphoma (NHL). Conclusions: The MR analysis study demonstrated a direct correlation between lower BMI and HL. This suggested that a decrease in adipose tissue increases the risk of developing HL. Nevertheless, further research is essential to grasp the underlying mechanism of this causal association comprehensively. [ABSTRACT FROM AUTHOR]

Background: About 10-20% of pancreas allografts are still lost in the early postoperative period despite the identification of numerous detrimental risk factors that correlate with graft thrombosis. Methods: We conducted a multicenter study including 899 pancreas transplant recipients between 2000 and 2018. Early pancreas failure due to complete thrombosis, long-term pancreas, kidney and patient survivals were analyzed and adjusted to donor, recipient and perioperative variables using a multivariate cause-specific Cox model stratified to transplant centers. Results: Pancreas from donors with history of hypertension (6.7%), as well as with high body mass index (BMI), were independently associated with an increased risk of pancreas failure within the first 30 post-operative days (respectively, HR= 2.57, 95% CI from 1.35 to 4.89 and HR= 1.11, 95% CI from 1.04 to 1.19). Interaction term between hypertension and BMI was negative. Donor hypertension also impacted long-term pancreas survival (HR= 1.88, 95% CI from 1.13 to 3.12). However, when pancreas survival was calculated after the postoperative day 30, donor hypertension was no longer a significant risk factor (HR= 1.22, 95% CI from 0.47 to 3.15). A lower pancreas survival was observed in patients receiving a pancreas from a hypertensive donor without RAAS (Renin Angiotensin Aldosterone System) blockers compared to others (50% vs 14%, p < 0.001). Pancreas survival was similar among non-hypertensive donors and hypertensive ones under RAAS blockers. Conclusion: Donor hypertension was a significant and independent risk factor of pancreas failure. The well-known pathogenic role of renin-angiotensin-aldosterone system seems to be involved in the genesis of this immediate graft failure. [ABSTRACT FROM AUTHOR]

Objective To explore the impact of body mass index (BMI) on the cell composition of the stromal vascular fraction (SVF) obtained from human subcutaneous adipose. Methods In this study, abdominal subcutaneous adipose tissue was collected from 61 patients undergoing liposuction, following which SVF was isolated for flow cytometry. Based on BMI, patients were categorized into lean groups (BMI＜25 kg/m²) and overweight or obese groups (BMI≥ 25 kg/m²). Results Flow cytometry results revealed significant reductions in relative percentages of ADSCs, adipose precursor cells, endothelial cells, M2 macrophages, and CD34+ cell subsets of adipose tissue SVF in overweight and obese groups compared to the lean group (P＜0.05). However, there was no significant difference in relative percentages of endothelial progenitor cells, hematopoietic stem cells, monocytes, and pericytes between both groups (P＞0.05). Notably, the M1/M2 macrophage ratio significantly increased in the overweight and obese group (P＜0.05). Conclusion The cell composition of adipose tissue SVF varies significantly among different BMI groups. The proliferation, adipogenesis, angiogenesis, and regenerative functions of SVF in overweight and obese adipose tissues are impaired, which may further lead to adipose tissue dysfunction and affect the efficacy of SVF in clinical application. [ABSTRACT FROM AUTHOR]

Purpose: Obesity and preeclampsia share similar patho-mechanisms and can both affect placental pathology. We aimed to investigate pregnancy outcomes in correlation with placental pathology among pregnancies complicated by preeclampsia in three different maternal body mass index (BMI, kg/m2) groups. Methods: In this retrospective cohort study, medical and pathological records of patients with preeclampsia and a singleton pregnancy delivered between 2008 and 2021 at a single tertiary medical center were reviewed. Study population was divided into three BMI groups: BMI < 22.6 kg/m2 (low BMI group), 22.7 ≤ BMI ≤ 28.0 kg/m2 (middle-range BMI group), and BMI > 28.0 kg/m2 (high BMI group). Data regarding maternal characteristics, neonatal outcomes, and placental histopathological lesions were compared. Results: The study groups included a total of 295 patients diagnosed with preeclampsia—98, 99, and 98 in the low, middle-range, and high BMI groups respectively. Neonatal birth weight was significantly decreased in the low maternal BMI group compared to both middle and high BMI groups (p = 0.04) with a similar trend seen in placental weight (p = 0.03). Villous changes related to maternal malperfusion were more prevalent in the low and high BMI groups compared to middle-range BMI group (p < 0.01) and composite maternal vascular malperfusion lesions were also more prevalent in the groups of BMI extremities compared to the middle-range BMI group (p < 0.01). Conclusion: Maternal BMI might influence neonatal outcomes and placental pathology in pregnancies complicated by preeclampsia. Both extremes of BMI were associated with higher rates of placental maternal vascular malperfusion. Balanced BMI in women at risk for preeclampsia may reduce the incidence of placental lesions. [ABSTRACT FROM AUTHOR]

Background: In the context of rising obesity rates globally, understanding the effect of high body mass index (BMI) on breast cancer characteristics is crucial. Previous research has hinted at associations between obesity and some specific features, such as tumor receptor status and axillary lymph node involvement. However, a comprehensive investigation into these relationships is essential for informing targeted interventions and advancing our understanding of breast cancer in the context of obesity. Objective: To investigate the relationship between high BMI and some key tumor characteristics such as hormone receptor status, HER2 receptor status, tumor grade, tumor size and axillary lymph node status. Patients and Methods: A retrospective analysis of the medical records of 186 female breast cancer patients treated at Rizgary Teaching Hospital's Oncology Department in Erbil City during the year 2021. Results: The study revealed a statistically significant association between elevated BMI and certain pivotal breast tumor characteristics, particularly HER2 receptor status. Additionally, obese individuals exhibited a significantly greater probability of having axillary lymph node-positive disease compared to their non-obese counterparts. Conclusion: This study establishes a noteworthy association between high BMI and some critical breast cancer characteristics, which may underscore the clinical relevance of body mass index in shaping breast cancer profiles. [ABSTRACT FROM AUTHOR]

There is currently no available information on the correlation between abdominal obesity indices and the risk of liver fibrosis progression. We aimed to investigate the relationship between the body mass index (BMI), waist circumference (WC), and the visceral adiposity index (VAI) with the progression of liver fibrosis. The study also evaluated the association between these indices and the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. A total of 1403 subjects participated in the cross-sectional and longitudinal population-based study. Liver stiffness was assessed via transient elastography, at baseline and follow-up (median: 4.2 years). The subgroup with dysglycemia was also analyzed. In the cross-sectional study, the highest quartile of VAI, BMI ≥ 30 kg/m2, and abdominal obesity showed significant associations with the prevalence of MASLD and liver fibrosis, as well as with fibrosis progression. However, VAI showed no association with MASLD incidence. Among the dysglycemic subjects, there was no observed association between VAI and the incidence of MASLD or the progression of fibrosis. In conclusion, the BMI, WC, and the VAI are associated with an increased risk of progression to moderate-to-advanced liver fibrosis in the general population. However, the VAI does not perform better than the BMI and WC measurement. [ABSTRACT FROM AUTHOR]

Background: BMI has been reported to be a major risk factor for the increased burden of several diseases. This study explores the burden of cancer linked to high body mass index (BMI) in Gulf Cooperation Council (GCC) countries and assesses the correlation with Socio-demographic Index (SDI). Method: Using Global burden of disease (GBD) 2019 data, the authors quantified cancer burden through mortality, DALYs, age standardized mortality rate (ASMR), and age standardized DALYs rate (ASDR) across sexes, countries, cancer types, and years. Spearman's correlation tested ASMR against SDI. The authors estimated 95% uncertainty limits (UIs) for population attribution fraction (PAFs). Results: Between 1990 and 2019, all six GCC countries showed increased number of the overall cancer-related deaths (398.73% in Bahrain to 1404.25% in United Arab Emirates), and DALYs (347.38% in Kuwait, to 1479.35% in United Arab Emirates) reflecting significant increasing in deaths, and burden cancer attributed to high BMI. In 2019, across GCC countries, pancreatic, uterine, and kidney cancer accounted for 87.91% of the total attributable deaths associated with high BMI in females, whereas in male, colon and rectum cancer alone accounted for 26% of all attributable deaths associated with high BMI. Conclusion: The study highlights the significant impact of high BMI on cancer burden in GCC countries. Moreover, the study identifies specific cancers, such as pancreatic, uterine, and kidney cancer in females, and colon and rectum cancer in males, as major contributors to attributable deaths, urging targeted prevention strategies at reducing weight and encouraging physical activity could greatly lessen the impact of diseases in the GCC countries. [ABSTRACT FROM AUTHOR]

Background and objectives: Colorectal cancer is a major global health concern, with a significant increase in morbidity and mortality rates associated with metastatic stages. This study investigates the prognostic significance of various clinical and laboratory parameters in patients with metastatic CRC. Materials and Methods: A retrospective cohort of 188 CRC patients with hepatic metastasis from the OncoHelp Association in Timisoara was analyzed from January 2016 to March 2023. Data on demographics, clinical characteristics, and biomarkers, such as lymphocyte counts, as well as various inflammation indices, were examined. Statistical analyses included univariate and multivariate logistic regression, Kaplan-Meier survival analysis, and ROC curve assessments. Results: Our findings indicate significant associations between survival outcomes and several biomarkers. Higher BMI and lymphocyte counts were linked with better survival rates, while higher values of Neutrophil-Hemoglobin-Lymphocyte (NHL) score, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) were predictors of poorer outcomes. Notably, the presence of hepatic metastasis at diagnosis was a critical factor, significantly reducing overall survival. Conclusions: The study has expanded the current understanding of prognostic factors in CRC, advocating for a multi-dimensional approach to prognostic evaluations. This approach should consider not only the traditional metrics such as tumor stage and histological grading but also incorporate a broader spectrum of biomarkers. Future studies should aim to validate these findings and explore the integration of these biomarkers into routine clinical practice, enhancing the precision of prognostic assessments and ultimately guiding more personalized treatment strategies for CRC patients. [ABSTRACT FROM AUTHOR]

Background: The proportion of patients with breast cancer and obesity is increasing. While the therapeutic landscape of breast cancer has been expanding, we lack knowledge about the potential differential efficacy of most drugs according to the body mass index (BMI). Here, we conducted a systematic review on recent clinical drug trials to document the dosing regimen of recent drugs, the reporting of BMI and the possible exclusion of patients according to BMI, other adiposity measurements and/or diabetes (leading comorbidity of obesity). We further explored whether treatment efficacy was evaluated according to BMI. Methods: A search of Pubmed and ClinicalTrials.gov was performed to identify phase I-IV trials investigating novel systemic breast cancer treatments. Dosing regimens and exclusion based on BMI, adiposity measurements or diabetes, documentation of BMI and subgroup analyses according to BMI were assessed. Results: 495 trials evaluating 26 different drugs were included. Most of the drugs (21/26, 81%) were given in a fixed dose independent of patient weight. BMI was an exclusion criterion in 3 out of 495 trials. Patients with diabetes, the leading comorbidity of obesity, were excluded in 67/495 trials (13.5%). Distribution of patients according to BMI was mentioned in 8% of the manuscripts, subgroup analysis was performed in 2 trials. No other measures of adiposity/body composition were mentioned in any of the trials. Retrospective analyses on the impact of BMI were performed in 6 trials. Conclusions: Patient adiposity is hardly considered as most novel drug treatments are given in a fixed dose. BMI is generally not reported in recent trials and few secondary analyses are performed. Given the prevalence of patients with obesity and the impact obesity can have on pharmacokinetics and cancer biology, more attention should be given by investigators and study sponsors to reporting patient's BMI and evaluating its impact on treatment efficacy and toxicity. [ABSTRACT FROM AUTHOR]

Objectives: A single measurement of adiposity indices could predict the incidence of cardiovascular disease (CVD); nonetheless their long-term pattern and its association with incident CVD are rarely studied. This study aimed to determine distinct trajectories of adiposity indices among participants of Tehran Lipid and Glucose Study (TLGS) and their association with incident CVD. Furthermore, this study aimed to investigate whether this association differed among individuals according to their menopausal status. Method: A total of 6840 women participated in TLGS, aged 20 years and older were included in this study; they were followed for a median of 16 years. Body mass index (BMI), waist circumference (WC), conicity index (CI) and body roundness index (BRI) were included in the analysis as adiposity indices. The cohort outcome panel of medical specialists identified the CVD outcomes. Trajectory analyses were used to identify homogeneous distinct clusters of adiposity indices trajectories. The association between the trajectory group membership and incident CVD were explored by Cox proportional hazard models, with unadjusted and adjusted model for baseline age, physical activity, smoking status, menopause and family history of CVD. Results: Three BMI trajectory groups of low, medium, and high and two trajectories for WC, BRI and CI were identified. Adjusted cox proportional hazard models revealed significant associations between the hazard of CVD experience and the high trajectory group of the BMI (HR: 2.06, 95% CI: 1.38-3.07), WC (HR: 2.71, 95% CI: 1.98-3.70), CI (HR: 1.87, 95% CI: 1.26-2.77) and BRI (HR: 1.55-95% CI: 1.12-2.15), compared to the low trajectory group. Subgroup analysis based on the menopausal status of participants showed that the HR of CVD incidences for all of trajectories adiposity indices, except BMI, was statistically significant. Adjusted cox proportional hazard models, in those women not reached menopause during study, revealed that the HR (95% CI) of CVD incidences for high trajectory of BMI, WC, CI and BRI were 2.80 (1.86-7.05); 2.09 (1.40-6.16); 1.72 (1.42-5.61), and 3.09 (1.06-9.01), respectively. These values for those were menopause at the initiation of the study were 1.40 (1.11, 2.53); 1.65 (1.04-2.75); 1.69 (1.01-2.87), and 1.61 (0.98-2.65), respectively. Conclusion: Our findings suggest that adiposity trajectories, particularly central adiposity index of CI, could precisely predict the CVD risk. Consequently, preventive strategies should be tailored accordingly. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D deficiency associated with COVID-19 patients has recently garnered interest. This is likely due to the elderly population who are most commonly affected by COVID-19. In this study, we investigated the association of vitamin D levels with the clinico-demographical and laboratory characteristics of COVID-19 patients. Methods: We recruited 77 COVID-19 patients who were admitted to Hospital Pengajar Universiti Putra Malaysia (HPUPM) from January 2022 until February 2023. Their clinico-demographic data were retrieved, and serum vitamin D and C-reactive protein (CRP) immunoassays were conducted. The vitamin D levels of each patient were categorized as normal (≥50 nmol/L) or low (<50 nmol/L). Statistical comparisons of the patients’ clinico-demographic parameters with vitamin D levels were conducted. Results: In univariable analysis of categorical variables, significantly higher proportion of female COVID-19 patients presented with low serum vitamin D levels compared with male COVID-19 patients (p=0.045; 85.3% vs 65.1%). Pertaining to continuous variables, younger COVID-19 patients demonstrated significantly higher prevalence of low vitamin D levels (p=0.040; 45.58 vs 54.90 years old). COVID-19 patients with lower CRP levels also demonstrated significantly higher proportion of low vitamin D levels (p=0.046; 35.70 vs 60.92 mg/dl). These three parameters (i.e. gender, age, and CRP levels) were included in the multivariable logistic regression analysis to determine which factor(s) remained significantly associated with low vitamin D levels. All three parameters did not show significance in the multivariable analysis. Conclusion: Absence of statistical significance in the multivariable analysis indicates that the individual associations between age, gender, and CRP levels with low vitamin D levels are not independent of each other. These suggest underlying interactions between these factors that influence their relationships with vitamin D levels, and further studies are required to clarify such interactions in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Both high serum insulin-like growth factor-binding protein-1 (s-IGFBP-1) and insulin resistance (IR) are associated with poor functional outcome poststroke, whereas overweight body mass index (BMI; 25–30) is related to fewer deaths and favorable functional outcome in a phenomenon labeled "the obesity paradox". Furthermore, IGFBP-1 is inversely related to BMI, in contrast to the linear relation between IR and BMI. Here, we investigated s-IGFBP-1 and IR concerning BMI and 7-year poststroke functional outcome. We included 451 stroke patients from the Sahlgrenska Study on Ischemic Stroke (SAHLSIS) with baseline measurements of s-IGFBP1, homeostasis model assessment of IR (HOMA-IR), BMI (categories: normal-weight (8.5–25), overweight (25–30), and obesity (>30)), and high-sensitivity C-reactive protein (hs-CRP) as a measure of general inflammation. Associations with poor functional outcome (modified Rankin scale [mRS] score: 3–6) after 7 years were evaluated using multivariable binary logistic regression, with overweight as reference due to the nonlinear relationship. Both normal-weight (odds-ratio [OR] 2.32, 95% confidence interval [CI] 1.30–4.14) and obese (OR 2.25, 95% CI 1.08–4.71) patients had an increased risk of poor functional outcome, driven by deaths only in the normal-weight. In normal-weight, s-IGFBP-1 modestly attenuated (8.3%) this association. In the obese, the association was instead attenuated by HOMA-IR (22.4%) and hs-CRP (10.4%). Thus, a nonlinear relation between BMI and poor 7-year functional outcome was differently attenuated in the normal-weight and the obese. [ABSTRACT FROM AUTHOR]

This paper briefly introduced the varying coefficient model and used the varying coefficient Cox model as an example to demonstrate its application in the fields of medicine and public health through real data analysis， thereby provided methodological references for related research. The example was based on chronic disease management data from a Center for Disease Control and Prevention， fitting a varying coefficient Cox model to explore the time-varying association between body mass index （BMI） and mortality risk among a hypertensive population. The results showed that being underweight （BMI< 18.5 kg/m²） was associated with a higher risk of mortality， but this association weakened over time； being overweight （23 kg/m² ≤BMI<25 kg/m²） was associated with a lower risk of mortality， and this association also weakened over time. The varying coefficient model captured how the impact of exposure factors on outcomes changed with other variables， helping to comprehensively understand the complex relationships between variables， and had significant application and promotion value in medical and public health research. [ABSTRACT FROM AUTHOR]

Does the discovery and operation of a nearby giant oil field carry long-term health consequences? Capitalizing on the 2011-2018 waves of the China Health and Retirement Longitudinal Study, we find that a giant oil discovery occurring within a 60-km radius significantly decreases the relative average long-term health conditions of individuals born after it. Specifically, the average share of individuals diagnosed with a chronic disease in these areas increases, in relative terms, by 22%. This effect is observed most notably in diseases related to the respiratory, digestive, and urinary systems and may be driven by changes in the consumption habits of alcohol and tobacco. [ABSTRACT FROM AUTHOR]

The objective of this research was to investigate the relationship between body mass index (BMI) and the mean age at which permanent teeth erupt in school-going children. Materials and Method: This cross-sectional study at RAK College of Dental Sciences, UAE, involved 89 children aged 6–14 years. Erupted teeth in the mouth were included. Statistical analysis, including t-tests, ANOVA, and Kruskal-Wallis, was conducted using SPSS version 29, with a significance threshold set at p < 0.05. Results: Out of 89 children (41 girls and 48 boys) in the study, 56.17 % had normal weight, 20.22 % were overweight, 17.97 % were underweight, and 5.6 % were obese. Female children generally experienced earlier permanent tooth eruption than males. Additionally, there was an observed trend of earlier tooth eruption with increasing weight or BMI. Underweight children notably displayed a delayed mean age of tooth eruption. Conclusion: This study demonstrates a notable correlation between BMI and the mean age at which permanent teeth erupt in school-going children aged 6 to 14 years who visited our dental hospital. To establish a more precise understanding of the connection between BMI and dental development, we recommend conducting further longitudinal studies involving multiple centers. Clinical Significance: Monitoring a child's BMI is crucial for assessing dental health and planning tailored treatment for those aged 6 to 14. Understanding the BMI's connection to permanent tooth eruption timing allows dental professionals to identify trends in early or delayed development. This enables them to customize treatment strategies, promoting a precise and personalized approach for better oral health outcomes in this age group. [ABSTRACT FROM AUTHOR]

Objective: Obesity is known to have negative impaction on reproductive health and ovarian functions. It may alter endocrine axis and quality of oocytes, and indirectly effect the success of in vitro fertilization (IVF). Methods: Medical records of patients with polycystic ovary syndrome (PCOS) who were applied for IVF between 2018 and 2024 were reviewed. Demographics, indications for reproductive treatment, IVF outcome parameters and the factors contributing to morbidity of treatment were recorded. Student's test with one-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the variables. P < 0.05 was considered statistically significant. Results: 186 patients with PCOS were divided as lean (BMI<25 kg/m2, control), overweight (BMI 25-30 kg/m2) and obese (BMI>30 kg/m2). Mean ages and primary infertility rates were similar (both, P > 0.05), but duration of infertility was longer in overweight and obese patients (P < 0.05). Although patients with higher BMI required more induction dose for the cycle, number of retrieved oocytes did not change significantly, with achieved chemical and clinical pregnancy (each, P > 0.05). Moreover, fertilization rates of transferred oocytes and rates of adverse outcomes during pregnancies were similar in the groups (each, P > 0.05). Although overweight and obese patients with PCOS required more gonadotropin induction for IVF cycle (2311 vs 1920 vs 1752 IU, respectively, P < 0.05), the numbers of metaphase II and fertilized oocytes were seen to be similar with increasing BMI (each, P > 0.05). Conclusion: There is longer infertility duration and a higher requirement for gonadotropins in overweight and obese patients with no effect of BMI on most of IVF parameters such as retrieved oocyte, clinical pregnancy, obstetric complication and delivery rate. [ABSTRACT FROM AUTHOR]

Introduction: To date, there are no therapeutics that have gained regulatory approval by the United States Food and Drug Administration (FDA) for the treatment of post-COVID-19 condition (PCC), a debilitating condition characterized by cognitive impairment and mood symptoms. Additionally, persistent inflammation, metabolic dysfunction, and risks associated with an elevated body mass index (BMI) have been observed. Herein, we aimed to assess the efficacy of vortioxetine in improving depressive symptoms among individuals with PCC, as modulated by inflammation, metabolic dysfunction, and BMI. Methods: In this post-hoc analysis, we present preliminary data obtained from an 8-week randomized, double-blind, placebo-controlled trial. Participants included adults aged 18 years and older residing in Canada who were experiencing symptoms of World Health Organization (WHO)-defined PCC. Recruitment began November 2021 and ended January 2023. Of the 200 participants enrolled, 147 were randomized (1:1) to receive vortioxetine (5–20 mg, n = 73) or placebo (n = 74) for daily treatment under double-blind conditions. The primary outcome measure was the change from baseline to endpoint in the 16-Item Quick Inventory of Depressive Symptomatology Self-Report Questionnaire (QIDS-SR-16). Results: Our findings revealed significant effects for time (χ2 = 9.601, p = 0.002), treatment (χ2 = 9.135, p = 0.003), and the treatment × time × CRP × TG-HDL × BMI interaction (χ2 = 26.092, p < 0.001) on PCC-related depressive symptoms in the adjusted model. Moreover, the between-group analysis showed a significant improvement with vortioxetine at endpoint as compared to placebo (mean difference = − 5.41, SEM = 1.335, p < 0.001). Conclusion: Overall, vortioxetine significantly improved depressive symptoms among participants with PCC in the adjusted model. Notably, individuals with baseline markers of increased inflammation, metabolic disruption, and elevated BMI exhibited a more pronounced antidepressant effect at endpoint. Trial Registration Number: NCT05047952 (ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer in women worldwide, including Pakistan. Pakistan has the highest prevalence of breast cancer in Asia, according to reports. Objective: To compare the management of breast cancer patients in pre and post COVID-19 timeline, and to observe for any stage progression in both groups. Methods: In this retrospective cohort study, conducted at West Surgical Ward, Mayo Hospital Lahore, from July 2019 to Dec 2020, adult female patients aged 18 years or older with a history of breast cancer surgery or who visited the breast clinic with the a diagnosis of breast cancer were enrolled. We divided them into pre and post COVID-19 subgroups assessed in nine months each. Variables including ASA grade, BMI, referral, size of tumor, number of lymph nodes removed, surgical procedure performed including axillary surgery, TNM stage, type of cancer. extracted from patient charts retrospectively. Univariate regression analysis performed for the progression of the stage. P-value =0.05 considered significant. Results: Two hundred and sixty-two (n=262) patients presented during the pre-COVID-19 time (Group A) and one hundred seventy-one (n=171) presented in post-COVID-19 times (Group B). All were female patients, with a mean age of 46.6±10.1 year's in-group A and 45.6±11.8 years in-group B. Significantly, referral patients attendance reduced in group B (10.5%) as compared to group A (70.6%). Metastatic disease (stage 4) also seen in higher number in post COVID-19 (26.2% vs. 35%). Stage progression was real in post Covid-19 group (24.6% vs. 6.5%). Results showed waiting time before visiting the breast clinic (p<0.001) and before radiotherapy (p=0.04) were contributing factors to the progression of the disease. Conclusion: Stage progression is real in the post-COVID-19 subgroup. Waiting time before visiting the breast clinic and before radiotherapy were main factors for the progression of the disease. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of Obesity in patients with Type 2 Diabetes Mellitus in patients visiting the Outpatient department of Khyber Teaching Hospital, Peshawar. MATERIALS AND METHODS. This descriptive cross-sectional study was conducted in the Department of Medicine Khyber Teaching Hospital Peshawar after approval from the hospital's ethical committee. All type 2 diabetes mellitus patients fulfilling inclusion criteria, presented to medical OPD and ward were interviewed in detail. Relevant information like age, gender, height weight, etc. recorded using proforma. BMI was calculated using height and weight. Patients with RBS of more than 200 mg/dl and symptomatic were labeled as having diabetes (American diabetes association). Patients with a BMI of more than 25kg/m2 were labeled as having obesity (Asian Pacific criteria). Data was analyzed using SPSS version 20 and presented in tables. RESULTS. The mean and standard deviation (SDs) for age were recorded as 56±9 years. Mean and SDs for height were recorded as 1.5± 0.8 meters. Mean and SDs for weight were recorded as 65±12 kilogram. Mean and SDs for random blood sugar were recorded as 238±77 mg/dl. Mean and SDs for BMI were recorded as 26±5. One hundred and eighty-nine (49.2%) patients were female and 195(50.8%) were male. Two hundred and seven (53.9%) patients were recorded as obese and 177(46.1%) were recorded as non-obese. CONCLUSION. In our study, we found that the majority of type 2 diabetes mellitus patients were obese. Thus, by adopting a healthy lifestyle we can reduce and delay the onset and morbidity associated with diabetes mellitus. [ABSTRACT FROM AUTHOR]

The purpose of the present meta-analysis was to systematically evaluate the effect of GnRHa treatment on the BMI of children with precocious puberty after GnRHa treatment as compared to before, and to analyze the effect of GnRHa treatment on the body composition of children with precocious puberty at different BMIs by classifying into normal body mass, overweight, and obese groups according to BMI at the time of initial diagnosis. A meta-analysis was performed using Stata 12.0 software by searching PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), and Wan fang database for relevant literature on standard deviation score of body mass index (BMI-SDS) after GnRHa treatment as compared to before in children with precocious puberty. A total of eight studies were included with a total sample size of 715 cases, and the results of meta-analysis showed that BMI-SDS increased in children with precocious puberty after GnRHa treatment as compared to before starting [(weighted mean difference (WMD)=0.23, 95 % CI: 0.14–0.33, p=0.000)] and also increased in children with normal body mass [(WMD=0.37, 95 % CI: 0.28–0.46, p=0.000)], and there was no significant change in BMI-SDS in children in the overweight or obese group [(WMD=0.01, 95 % CI: −0.08–0.10, p=0.775)]. Overall, there was an observed increase in BMI-SDS at the conclusion of GnRHa treatment in children with precocious puberty. Additionally, it was found that the effect of GnRHa treatment on body composition varied among children with different BMI status. Clinicians should emphasize the promotion of a healthy lifestyle and personalized dietary management for children. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Energy Deficiency is a condition characterized by a long-term insufficient intake of calories and/or nutrients relative to a person’s energy expenditure, leading to a negative energy balance. It is typically associated with inadequate nutrition and can result in various health issues. Objectives: 1) To find out prevalence of CED in ethnic Punjabi population. 2) To determine the sociodemographic factors affecting CED the study subjects. Materials & Methods: The study was a cross sectional study using simple random sampling technique. Taking the prevalence of CED as 30%, sample size came out to be 336, but for ease of convenience, 400 subjects were selected. Results: The study subjects comprised of 183 males and 217 females and there were 24 cases of CED in males and 52 in females. Maximum cases of CED were found in the age group of 20-29 years, in lower castes and low-income groups and in illiterates. Conclusion: According to this study, maximum number of CED was found in the age group of 20-29 years. Prevalence was significantly higher in females than males and its was maximum in lower castes at 35.8%. In lower income group and in the illiterate group, it was maximum and the results were statistically significant. [ABSTRACT FROM AUTHOR]

Background: Forensic dentistry is a specialized field that evaluates dental evidence to identify unidentified individuals and missing persons in legal proceedings. Dental charts are compared with known records to establish identity. Accurate age determination is crucial, and dental age assessment is reliable up to 17 years. The study aims to analyze permanent teeth eruption patterns of canines and premolarsin school children aged 10 to 12, contributing valuable insights for accurate age determination and identification in legal cases. The research seeks to aid the interest of justice in criminal, civil, and employment-related scenarios by understanding dental eruption patterns in this age group. Methods: This was across-sectional study conducted among the school children of south Kerala belonging to age group of 10-12 years. Eruption pattern of permanent canines and premolars of 562 subjects were recorded and analyzed using SPSS software. Conclusion: Sequence of eruption pattern of permanent canines and premolars were compared and it was observed with statistical significance that eruption of canineprecedes the eruption of second premolars. All the teeth erupted earlier in females compared to males. There was a significant relation with reduced body mass index and delayed eruption of teeth. [ABSTRACT FROM AUTHOR]

In overweight and obese patients, elevated serum and breastmilk leptin concentrations are observed, with serum leptin also being likely affected by the diet. We analyzed serum and breastmilk leptin in normal weight (NW) and overweight/obese (OW/OB) mothers, and evaluated its associations with (1) maternal anthropometric parameters; (2) markers of cardiometabolic health; and (3) the maternal diet. The BLOOM (Breastmilk and the Link to Overweight/Obesity and Maternal diet) study was conducted among 40 women (n = 20 OW/OB; n = 20, NW) who were exclusively or predominantly breastfeeding for 15.5 ± 1.2 (OW/OB group (0.99)) weeks. We collected 24 h breastmilk and fasting blood samples for leptin analysis by ELISA. Maternal dietary habits were evaluated using a 3-day dietary record and food frequency questionnaire, which were used to calculate the Polish-adapted Mediterranean Diet score. Maternal anthropometric measurements and DEXA scans were performed, and anthropometric and cardiometabolic indices were calculated. The OW mothers had 1.4 times higher serum levels, while OB mothers had 4.5 and 6.2 higher serum and breastmilk leptin levels, respectively, in comparison to the NW mothers. The FM% was correlated with serum and breastmilk leptin levels (r = 0.878, r = 0.638). Serum leptin was associated with markers of cardiometabolic health such as AIP, CMI, and VAI in the NW mothers, and with LAP in the OW/OB mothers. Higher energy, fructose intake and adherence to the Mediterranean diet were associated with serum leptin in the NW mothers (β = 0.323, 0.039–0.608; β = 0.318, 0.065–0.572; β = 0.279, 0.031–0.528); meanwhile, higher adherence to the Mediterranean diet could protect against elevated breastmilk leptin concentrations in OW/OB mothers (β = −0.444, −0.839–−0.050), even after adjustment for FM%. Our results suggest a potential association between maternal serum leptin concentrations and cardiometabolic health. In addition, we confirm the importance of healthy dietary patterns in the improvement of breastmilk composition. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: The aging spine often presents multifaceted surgical challenges for the surgeon because it can directly and indirectly impact a patient’s spinal alignment and quality of life. Elderly and osteoporotic patients are predisposed to progressive spinal deformities and potential neurologic compromise and surgical management can be difficult because these patients often present with greater frailty. Methods: This was a literature review of spinal alignment changes, preoperative considerations, and spinal alignment considerations for surgical strategies. Results: Many factors impact spinal alignment as we age including lumbar lordosis flexibility, hip flexion, deformity, and osteoporosis. Preoperative considerations are required to assess the patient’s overall health, bone mineral density, and osteoporosis medications. Careful radiographic assessment of the spinopelvic parameters using various classification/scoring systems provide the surgeon with goals for surgical treatment. An individualized surgical strategy can be planned for the patient including extent of surgery, surgical approach, extent of the constructs, fixation techniques, vertebral augmentation, ligamentous augmentation, and staging surgery. Conclusions: Surgical treatment should only be considered after a thorough assessment of the patient's health, deformity, bone quality and corresponding age matched alignment goals. An individualized treatment approach is often required to tackle the deformity and minimize the risk of hardware related complications and pseudarthrosis. Anabolic agents offer a promising benefit in this patient population by directly addressing and improving their bone quality and mineral density preoperatively and postoperatively.