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Junn A, Khetpal S, Smetona J, Dinis J, Hirschman A, Mozaffari MA, Singh A, Ching AH, Alperovich M, Lu X, Persing JA. Hockey stick incision: a modified technique for chest wall masculinization. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:600. [PMID: 33987298 DOI: 10.21037/atm-20-7678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Chest wall masculinization is often performed for transgender men in order to address gender dysphoria. Peri-areolar and double-incision mastectomy with free nipple grafts, are the most common techniques employed in chest masculinization surgery, but are limited by their relative inconsistency and inefficiency in reconstructing a natural anterior contour that comprehensively resembles that of a cis-masculine chest. The purpose of this study is two-fold. The first is to describe the "hockey stick" approach, which expands on the widely performed double-incision mastectomy to the axilla, with an additional step of revising lateral chest wall folds of tissue excess. This technique is scalable to the degree of pre-operative excess tissue on the anterior and lateral chest wall. The second is to compare the "hockey stick" incision to existing reconstructive options, with respect to clinical outcomes and patient satisfaction. Methods Patients who received chest masculinization surgery at Yale-New Haven Hospital were included. A retrospective chart review, comprising demographic variables, procedural details, and post-operative events, was conducted. Selected modules from a validated survey instrument, the BODY-Q, were measured. Patients were classified by body mass index and incision, which included peri-areolar, inframammary fold, and "hockey stick" incision by date. Results Twenty-seven of 73 (37.0%) participants completed the full survey and were included in the analysis. The "hockey stick" incision had comparable patient satisfaction and post-operative outcomes, compared to peri-areolar and double-incision mastectomy with free nipple graft techniques. Greater BMI patients had a higher incidence of wound dehiscence, compared to other weight classifications. Conclusions The "hockey stick" incision is a readily performed, effective surgical technique for building a cis-masculine appearing chest in transgender men with efficient and predictable outcomes. While performed in patients with higher BMI, the "hockey stick" confers equivalent patient satisfaction and clinical outcomes to peri-areolar and double-incision mastectomy.
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Poncová R, Skřenková J, Fanta M. Eating disorders in the ambulance of pediatric and adolescence gynecology. CESKA GYNEKOLOGIE-CZECH GYNAECOLOGY 2021; 86:46-53. [PMID: 33752409 DOI: 10.48095/cccg202146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To present a comprehensive overview of the female adolescent population focused on physical development and reproductive healthcare. METHODS A summary of available literature using our own experience with the treatment of patients with eating disorders. CONCLUSION Approximately 0.5% of adolescents suffer from eating disorders (EDs) in the Czech Republic. EDs have the highest incidence during adolescence, it is a period when growth spurt, bone mineralization and reproductive organ development occur. EDs have a significant negative effect on development and can irreversibly lead to its impairment.
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Yun NK, Rouhani SJ, Bestvina CM, Ritz EM, Gilmore BA, Tarhoni I, Borgia JA, Batus M, Bonomi PD, Fidler MJ. Neutrophil-to-Lymphocyte Ratio Is a Predictive Biomarker in Patients with Epidermal Growth Factor Receptor (EGFR) Mutated Advanced Non-Small Cell Lung Cancer (NSCLC) Treated with Tyrosine Kinase Inhibitor (TKI) Therapy. Cancers (Basel) 2021; 13:1426. [PMID: 33804721 PMCID: PMC8003851 DOI: 10.3390/cancers13061426] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND First-line treatment for patients with non-small cell lung cancer (NSCLC) with a sensitizing epidermal growth factor receptor (EGFR) mutation is a tyrosine kinase inhibitor (TKI). Despite higher response rates and prolonged progression free survival (PFS) compared with platinum doublet chemotherapy, a subset of these patients do not receive prolonged benefit from these agents. We investigate if the neutrophil-to-lymphocyte ratio (NLR) and other markers of cachexia and chronic inflammation correlate with worse outcomes in these patients. METHODS This study is a retrospective review of 137 patients with advanced EGFR-mutated NSCLC treated with TKIs at Rush University Medical Center and University of Chicago Medicine from August 2011 to July 2019, with outcomes followed through July 2020. The predictive value of NLR and body mass index (BMI) was assessed at the start of therapy, and after 6 and 12 weeks of treatment by univariable and multivariable analyses. RESULTS On univariable analysis, NLR ≥ 5 or higher NLR on a continuous scale were both associated with significantly worse PFS and overall survival (OS) at treatment initiation, and after 6 or 12 weeks of treatment. On multivariable analysis, NLR ≥ 5 was associated with increased risk of death at 12 weeks of therapy (HR 3.002, 95% CI 1.282-7.029, p = 0.011), as was higher NLR on a continuous scale (HR 1.231, 95% CI 1.063-1.425, p = 0.0054). There was no difference in PFS and OS and amongst BMI categories though number of disease sites and Eastern Cooperative Oncology Group (ECOG) performance status was associated with worse PFS and OS. CONCLUSIONS Patients with NLR ≥ 5 have a worse median PFS and median OS than patients with NLR < 5. NLR may have value as a predictive biomarker and may be useful for selecting patients for therapy intensification in the front-line setting either at diagnosis or after 12 weeks on therapy. NLR needs to be validated prospectively.
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Zhang J, Chen L, Ye J. Correlation analysis of myonectin levels with metabolic and hormonal disorders in patients with polycystic ovary syndrome. ANNALS OF PALLIATIVE MEDICINE 2021; 10:3404-3409. [PMID: 33752430 DOI: 10.21037/apm-21-458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/21/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aimed to investigate the relationship between myonectin levels and metabolic and hormonal disorders in patients with polycystic ovary syndrome (PCOS). METHODS One hundred PCOS patients who sought medical advice from September 2017 to March 2019 in our hospital were selected as the PCOS group, while 100 healthy women matched for age and body mass index (BMI) with the PCOS patients were selected as the control group. General clinical information, myonectin levels, and metabolism and sex hormone-related indicators of the two groups were compared, and the correlation between myonectin, metabolism, and sex hormones was analyzed. RESULTS There were no significant differences in age, BMI, blood pressure, or other general clinical information between the two groups (P>0.05). Compared with the control group, the levels of myonectin, sex hormone-binding globulin (SHBG), and high-density lipoprotein cholesterol (HDL-C) in the PCOS group were significantly decreased (P<0.05), while the levels of fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), luteinizing hormone (LH), and testosterone were significantly increased (P<0.05). Pearson correlation analysis showed that the level of myonectin was negatively correlated with BMI, FBG, HOMA-IR, TG, and testosterone but was positively correlated with SHBG and HDL-C. Multivariate linear regression analysis showed that the level of myonectin was negatively correlated with BMI, HOMA-IR, and TG but positively correlated with SHBG and HDL-C. CONCLUSIONS There is a correlation between the level of myonectin and multiple metabolic and hormone indices in PCOS patients indicating that myonectin may be an effective index to predict metabolic and hormone disorders in PCOS patients.
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Yu Z, Grams ME, Ndumele CE, Wagenknecht L, Boerwinkle E, North KE, Rebholz CM, Giovannucci EL, Coresh J. Association Between Midlife Obesity and Kidney Function Trajectories: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 2021; 77:376-385. [PMID: 32979415 PMCID: PMC7904650 DOI: 10.1053/j.ajkd.2020.07.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 07/21/2020] [Indexed: 01/13/2023]
Abstract
RATIONALE & OBJECTIVE Obesity has been related to risk for chronic kidney disease. However, the associations of different measures of midlife obesity with long-term kidney function trajectories and whether they differ by sex and race are unknown. STUDY DESIGN Observational study. SETTING & PARTICIPANTS 13,496 participants from the Atherosclerosis Risk in Communities (ARIC) Study. PREDICTORS Midlife obesity status as measured by body mass index (BMI), waist-to-hip ratio, and predicted percent fat at baseline. OUTCOMES Estimated glomerular filtration rate (eGFR) calculated using serum creatinine level measured at 5 study visits, and incident kidney failure with replacement therapy (KFRT). ANALYTICAL APPROACH Mixed models with random intercepts and random slopes for eGFR. Cox proportional hazards models for KFRT. RESULTS Baseline mean age was 54 years, median eGFR was 103mL/min/1.73m2, and median BMI was 27kg/m2. Over 30 years of follow-up, midlife obesity measures were associated with eGFR decline in White and Black women but not consistently in men. Adjusted for age, center, smoking, and coronary heart disease, the differences in eGFR slope per 1-SD higher BMI, waist-to-hip ratio, and predicted percent fat were 0.09 (95% CI, -0.18 to 0.36), -0.25 (95% CI, -0.50 to 0.01), and-0.14 (95% CI, -0.41 to 0.13) mL/min/1.73m2 per decade for White men; -0.91 (95% CI, -1.15 to-0.67), -0.82 (95% CI, -1.06 to-0.58), and-1.02 (95% CI, -1.26 to-0.78) mL/min/1.73m2 per decade for White women; -0.70 (95% CI, -1.54 to 0.14), -1.60 (95% CI, -2.42 to-0.78), and-1.24 (95% CI, -2.08 to-0.40) mL/min/1.73m2 per decade for Black men; and-1.24 (95% CI, -2.08 to-0.40), -1.50 (95% CI, -2.05 to-0.95), and-1.43 (95% CI, -2.00 to-0.86) mL/min/1.73m2 per decade for Black women. Obesity indicators were independently associated with risk for KFRT for all sex-race groups except White men. LIMITATIONS Loss to follow-up during 3 decades of follow-up with 5 eGFR assessments. CONCLUSIONS Obesity status is a risk factor for future decline in kidney function and development of KFRT in Black and White women, with less consistent associations among men.
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Zhao S, Li X, Xiang ST, Xie L, Kang R, Li L, Xiao Z, Zhong Y. Changes in the age-specific body mass index distribution among urban children between 2002 and 2018 in Changsha, China. Transl Pediatr 2021; 10:502-509. [PMID: 33850809 PMCID: PMC8039778 DOI: 10.21037/tp-20-305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND It had been reported that the increase in the prevalence of childhood overweight and obesity in several developed countries over the decade was largely a consequence of changes in the upper end of the body mass index (BMI) distribution. We speculated that the change in BMI distribution among Chinese children is different from that in developed countries. Therefore, we investigated the changes in the BMI distribution among urban children in Changsha, China. METHODS A secondary data analysis of the 2002 and 2018 Annual Survey on Students' Constitution and Health from Yuhua District, Changsha City, China was performed. The BMI distribution of children aged 6-15 years (n=72,061) was examined by calculating the BMI value at 5th, 50th, 85th, and 95th percentiles. Differences in the BMI value at the 5th, 50th, 85th, and 95th percentiles between 2002 and 2018 according to age and sex were calculated. RESULTS From 2002 to 2018, the standardized rate of underweight decreased from 6.9% to 3.4%, whereas that of obesity increased from 6.1% to 13.8%. The BMI of the population increased over the 16-year period. The greatest change between the years was seen in the 85th percentile, and moderate changes were seen in the 5th and 50th BMI percentiles. Also, the greatest changes in the BMI percentiles were evident at age 12-14 years. CONCLUSIONS The whole spectrum of BMI distribution among school-aged children shifted over the 16-year study period, although the increases were more marked in the upper than lower percentiles. Health professionals and health policymakers should develop strategies and interventions aimed at preventing adverse health effects caused by this change.
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Analysis of the Nutritional Status in Homeless People in Poland Based on the Selected Biochemical Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052340. [PMID: 33673556 PMCID: PMC7956839 DOI: 10.3390/ijerph18052340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 01/02/2023]
Abstract
The aim of the study was to assess the nutritional status of adult homeless people using both anthropometric and biochemical measurements. The analysis comprised anthropometric indicators, i.e., body mass index and waist circumference, and the following biomarkers: red blood cells, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, white blood cells, complete lymphocyte count, neutrophils-to-lymphocytes ratio, platelets-to-lymphocytes ratio, platelets-to-leukocytes ratio, C reactive protein level, serum iron concentration, serum albumin concentration, total serum protein, fasting lipids and blood glucose level. There were representative Polish homeless people enrolled (n = 580). The analysis of the conducted studies proved that there is a greater frequency of overweight and obesity than underweight in the target population. The major problem was abdominal obesity that was present statistically more frequently in women than men (p < 0.001). In the majority of cases, homeless people were found to have normal complete blood count parameters. In obese people, there were statistically significant both elevated and decreased hematocrit levels, a significant decrease in red blood cells, elevated serum glucose, triglycerides and total protein level (p < 0.05). The presence of abdominal obesity, elevated glucose concentration, low-density lipoprotein cholesterol, and triglycerides, and decreased high-density lipoprotein cholesterol in serum together with smoking increase the risk of cardiovascular disease.
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Poly TN, Islam MM, Yang HC, Lin MC, Jian WS, Hsu MH, Jack Li YC. Obesity and Mortality Among Patients Diagnosed With COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:620044. [PMID: 33634150 PMCID: PMC7901910 DOI: 10.3389/fmed.2021.620044] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/06/2021] [Indexed: 12/28/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has already raised serious concern globally as the number of confirmed or suspected cases have increased rapidly. Epidemiological studies reported that obesity is associated with a higher rate of mortality in patients with COVID-19. Yet, to our knowledge, there is no comprehensive systematic review and meta-analysis to assess the effects of obesity and mortality among patients with COVID-19. We, therefore, aimed to evaluate the effect of obesity, associated comorbidities, and other factors on the risk of death due to COVID-19. We did a systematic search on PubMed, EMBASE, Google Scholar, Web of Science, and Scopus between January 1, 2020, and August 30, 2020. We followed Cochrane Guidelines to find relevant articles, and two reviewers extracted data from retrieved articles. Disagreement during those stages was resolved by discussion with the main investigator. The random-effects model was used to calculate effect sizes. We included 17 articles with a total of 543,399 patients. Obesity was significantly associated with an increased risk of mortality among patients with COVID-19 (RRadjust: 1.42 (95%CI: 1.24-1.63, p < 0.001). The pooled risk ratio for class I, class II, and class III obesity were 1.27 (95%CI: 1.05-1.54, p = 0.01), 1.56 (95%CI: 1.11-2.19, p < 0.01), and 1.92 (95%CI: 1.50-2.47, p < 0.001), respectively). In subgroup analysis, the pooled risk ratio for the patients with stroke, CPOD, CKD, and diabetes were 1.80 (95%CI: 0.89-3.64, p = 0.10), 1.57 (95%CI: 1.57-1.91, p < 0.001), 1.34 (95%CI: 1.18-1.52, p < 0.001), and 1.19 (1.07-1.32, p = 0.001), respectively. However, patients with obesity who were more than 65 years had a higher risk of mortality (RR: 2.54; 95%CI: 1.62-3.67, p < 0.001). Our study showed that obesity was associated with an increased risk of death from COVID-19, particularly in patients aged more than 65 years. Physicians should aware of these risk factors when dealing with patients with COVID-19 and take early treatment intervention to reduce the mortality of COVID-19 patients.
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Chishom T, Stephens A, Raley S, Ange B, Looney S, Street L, Browne P. Amniotic fluid index curves in the obese gravida. J Neonatal Perinatal Med 2021; 14:131-137. [PMID: 32333553 DOI: 10.3233/npm-190290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine whether amniotic fluid volume as measured by amniotic fluid index (AFI) is influenced by maternal pre-gestational obesity as measured by body mass index (BMI). METHODS This was a retrospective cohort study of pregnant women between 20 and 43 weeks gestation receiving ultrasounds with AFI measurements at Augusta University Medical Center between 2003 and 2017. A subset of 500 charts that met inclusion and exclusion criteria were reviewed to obtain maternal clinical data. The study cohort was subdivided by maternal BMI at initial obstetric visit into three groups: normal weight (18.5 kg/m2-24.9 kg/m2), overweight (25.0 kg/m2-29.9 kg/m2), and obese (≥ 30 kg/m2). Chi-square analysis was used to compare BMI groups in terms of categorical clinical characteristics and outcome variables, and analysis of variance (ANOVA) was used for continuous variables. Mixed effects regression models (MRMs) were used to evaluate AFI throughout gestation separately in each group, and MRM-based analysis of covariance was used to compare AFI throughout gestation among groups. AFI curves were constructed for the 5th, 50th, and 95th percentiles for all study subjects combined and separately for normal weight, overweight, and obese subjects. RESULTS Fitted curves relating AFI percentiles to estimated gestational age (EGA) showed statistically significant differences among BMI groups. There was also a significant difference in AFI over gestation across the obesity groups. CONCLUSION Fitted curves for AFI throughout pregnancy showed statistically significant differences among BMI groups.
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Pedrosa T, Kupa LDVK, Pasoto SG, Aikawa NE, Borba EF, Duarte NJ, Leon EP, Silva CA, Bonfá E. The influence of obesity on hydroxychloroquine blood levels in lupus nephritis patients. Lupus 2021; 30:554-559. [PMID: 33402039 DOI: 10.1177/0961203320985214] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION In 2016 the American Academy of Ophthalmology(2016-AAO) recommended a maximum daily HCQ use of 5.0 mg/kg real body weight(RBW) taking into consideration minimizing eye toxicity. Retinopathy in systemic lupus erythematosus(SLE) patients was recently associated with obesity and this condition is progressively more common in these patients. However, the impact of obesity in HCQ blood levels remains controversial. OBJECTIVE To determine if the 2016-AAO recommendation based on RBW with and without maximum daily dose restriction results in adequate and safe blood levels in obese lupus nephritis(LN) patients. METHODS A cross-sectional study was performed with 108 LN patients under the prescribed 2016-AAO dose for at least 3 months. LN patients were assessed for demographic characteristics, body mass index(BMI), disease parameters, HCQ dose, concomitant treatment and HCQ blood levels measured by liquid chromatography-tandem mass spectrometry. Obesity was defined as BMI ≥30kg/m2. RESULTS Obesity was identified in 35/108(32%) LN patients. The calculation of HCQ daily dosage revealed that obese patients were under a lower prescribed daily dose according to the real body weight (RBW) [4.4(2.9-5.4) vs. 4.9(4-5.5)mg/Kg/day, p < 0.001] due to the maximum limit used. Regardless of that the median of HCQ blood levels was significantly higher in obese compared to non-obese patients (1562 ± 548.6 vs. 1208 ± 448.9 ng/mL, p = 0.002). Further analysis of patients under the 20016-AAO recommendation by RBW without the restriction of maximum daily dose confirmed that in spite of comparable daily dose in 14 obese patients and 61 non-obese patients [4.8 (4.5-5.4) vs. 5.0(4.5-5.5) mg/kg, p = 0.312], the median of HCQ blood levels was significantly higher in obese patients than in non-obese (1734 ± 457.3 vs. 1189 ± 449.4 ng/mL, p < 0.001). CONCLUSION Obese patients under the 2016-AAO prescribed dose of HCQ based on RBW with and without maximum daily dose restriction have a very high HCQ blood levels compared to non-obese patients, with a potential increased risk of ocular toxicity. The use of 2016-AAO dose of HCQ according to the ideal body weight for this group of patients should be considered.Clinicaltrials.gov #NCT0312243.
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Mecacci F, Lisi F, Vannuccini S, Ottanelli S, Rambaldi MP, Serena C, Simeone S, Petraglia F. Different Gestational Diabetes Phenotypes: Which Insulin Regimen Fits Better? Front Endocrinol (Lausanne) 2021; 12:630903. [PMID: 33767671 PMCID: PMC7985539 DOI: 10.3389/fendo.2021.630903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/18/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Maternal characteristics and OGTT values of pregnancies complicated by gestational diabetes mellitus (GDM) were evaluated according to treatment strategies. The goal was to identify different maternal phenotypes in order to predict the appropriate treatment strategy. METHODS We conducted a retrospective study among 1,974 pregnant women followed up for GDM in a tertiary referral hospital for high-risk pregnancies (Careggi University Hospital, Florence, Italy) from 2013 to 2018. We compared nutritional therapy (NT) alone (n = 962) versus NT and insulin analogues (n = 1,012) group. Then, we focused on different insulin analogues groups: long acting (D), rapid acting (R), both D and R. We compared maternal characteristics of the three groups, detecting which factors may predict the use of rapid or long-acting insulin analogue alone versus combined therapy. RESULTS Among women included in the analysis, 51.3% of them needed insulin therapy for glycemic control: 61.8% D, 28.3% combined D and R, and 9.9% R alone. Age >35 years, pre-pregnancy BMI >30, family history of diabetes, previous GDM, altered fasting plasma glucose (FPG), hypothyroidism, and assisted reproductive technologies (ART) were identified as maternal variables significantly associated with the need of insulin therapy. Altered 1-h and 2-h glucose plasma glucose level at OGTT, age >35 years, and previous GDM were found as independent predicting factors for the use of combined therapy with rapid and long acting analogues for glycemic control. On the contrary, pre-pregnancy BMI <25 and normal fasting plasma glucose values at OGTT were found to be significantly associated to the use of rapid insulin analogue only. CONCLUSION A number of maternal and metabolic variables may be identified at the diagnosis of GDM, in order to identify different GDM phenotypes requiring a personalized treatment for glycemic control.
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Tan X, Huang D, Zhang F, Zhao Y, Tan M, Li H, Zhang H, Wang K, Li H, Liu D, Guo R, Tang S. Evaluation of the body mass index in breast cancer prognosis in a cohort of small-stature overweight patients: multi-center study in China. Gland Surg 2021; 10:23-34. [PMID: 33633959 DOI: 10.21037/gs-20-488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Overweight and obesity have become a major health issue in the past 30 years. Several studies have already shown that obesity is significantly associated with a higher risk of developing breast cancer. However, few studies have assessed the prognostic value of the body mass index (BMI) in Asian populations. The purpose of this study was to retrospectively analyze the impact of BMI on the prognosis of breast cancer in overweight, under 160 cm tall patients from southern China. Methods We retrospectively analyzed data from 525 breast cancer patients diagnosed between 2003 to 2010 in a multi-center of China. After applying the exclusion criteria, 315 patients with complete data were retained. Their clinical and pathological characteristics were compared using the chi-square test. Survival analysis was performed with the Kaplan-Meier method. Univariate and multivariate analyses were performed using Cox regression to calculate hormone receptor status, HER-2 status, lymph node status, age, BMI and tumor size hazard ratio (HR), and 95% confidence intervals (95% CI). Results There was a strong correlation between BMI and age in the baseline feature analysis (P=0.001). After grouping the patients according to the molecular type of cancer, we found that in Luminal A and B, the BMI was related to age (P=0.002, P=0.010). The disease-free survival (DFS) and overall survival (OS) of patients with different BMI were not significantly different. This conclusion was also reached by pairwise comparison of subgroups. There was no significant difference in recurrence in patients from different BMI groups. We did not find a critical weight threshold associated with higher risk of recurrence. There were no statistically significant differences in treatment among the three BMI groups of overweight patients. Conclusions We found that the BMI of Chinese breast cancer patients is related to age but not prognosis.
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Secular Changes in Body Build and Body Composition in Czech Preschool Children in the Context of Latent Obesity. CHILDREN-BASEL 2020; 8:children8010018. [PMID: 33396305 PMCID: PMC7823761 DOI: 10.3390/children8010018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 11/17/2022]
Abstract
Changes in lifestyle can be significantly reflected in growth and development. Adaptations to reduced levels of physical activity, together with non-corresponding nutritional intakes, can result in body build and body composition changes at an early age. The present cross-sectional study aimed to evaluate the secular trend of modifications of body composition and body mass index (BMI) in Czech preschoolers over the last two to three decades. Boys and girls (386 boys and 372 girls) aged 4 to 6 years in 2014–2019 were measured. Outcome data were compared with the reference sample of preschoolers from 1990: 911 boys and 896 girls. Body height, BMI, and percentage of body fat, muscle, and bone mass were evaluated. Height and BMI have not changed. Body fat increased in both genders (p < 0.01), and contrarily, a significant reduction of muscle and skeletal mass was revealed (p < 0.001). Significant changes in body composition and unchanged BMI indicate the development of latent obesity during the last few decades. Due to latent obesity in a recent cohort, the differences in the prevalence of overweight and obesity markers according to BMI and fat percentage were tested. The prevalence of overweight and obesity was higher by 7.2% in boys, and by 6.5% in girls, as compared to children evaluated according to only their BMI results. Secular changes in preschoolers’ physical builds over the last 25 years are not reflected in body height and BMI, but in body composition. Insufficient development of active, lean body mass proportionally compensated by increased fat mass was also indicated.
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Haase CL, Eriksen KT, Lopes S, Satylganova A, Schnecke V, McEwan P. Body mass index and risk of obesity-related conditions in a cohort of 2.9 million people: Evidence from a UK primary care database. Obes Sci Pract 2020; 7:137-147. [PMID: 33841883 PMCID: PMC8019280 DOI: 10.1002/osp4.474] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/12/2020] [Accepted: 11/28/2020] [Indexed: 11/08/2022] Open
Abstract
Objective Obesity rates in the United Kingdom are some of the highest in Western Europe, with considerable clinical and societal impacts. Obesity is associated with type 2 diabetes (T2D), osteoarthritis, cardiovascular disease, and increased mortality; however, relatively few studies have examined the occurrence of multiple obesity‐related outcomes in the same patient population. This study was designed to examine the associations between body mass index (BMI) and a broad range of obesity‐related conditions in the same large cohort from a UK‐representative primary care database. Methods Demographic data and diagnosis codes were extracted from the Clinical Practice Research Datalink GOLD database in January 2019. Adults registered for ≥ 3 years were grouped by BMI, with BMI 18.5–24.9 kg/m2 as reference group. Associations between BMI and 12 obesity‐related outcomes were estimated using Cox proportional hazard models, adjusted for age, sex, and smoking. Results More than 2.9 million individuals were included in the analyses and were followed up for occurrence of relevant outcomes for a median of 11.4 years during the study period. Generally, there was a stepwise increase in risk of all outcomes with higher BMI. Individuals with BMI 40.0–45.0 kg/m2 were at particularly high risk of sleep apnea (hazard ratio [95% confidence interval] vs. reference group: 19.8 [18.9–20.8]), T2D (12.4 [12.1–12.7]), heart failure (3.46 [3.35–3.57]), and hypertension (3.21 [3.15–3.26]). Conclusions This study substantiates evidence linking higher BMI to higher risk of a range of serious health conditions, in a large, representative UK cohort. By focusing on obesity‐related conditions, this demonstrates the wider clinical impact and the healthcare burden of obesity, and highlights the vital importance of management, treatment approaches, and public health programs to mitigate the impact of this disease.
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Ding C, Jiang Y. The Relationship between Body Mass Index and Physical Fitness among Chinese University Students: Results of a Longitudinal Study. Healthcare (Basel) 2020; 8:E570. [PMID: 33348642 PMCID: PMC7765873 DOI: 10.3390/healthcare8040570] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/14/2022] Open
Abstract
Over the past few decades, a gradual increase in sedentary lifestyles along with the increased consumption of a modern, hypercaloric diet has resulted in a substantial increase in the number of those classified as overweight or obese in China. The prevalence of overweight and obesity has become a key public health issue. However, it is important to be cautious when interpreting the literature as the majority of studies apply cross-sectional data to assess and subjectively compare the relationship between physical fitness and being overweight and obese. In the present study, longitudinal data were collected from 3066 students (enrolled in 2014) at a university in China at the beginning of each academic year throughout their four-year university program. The aim of this study was to analyze the various associations between BMI, explosive power, flexibility, and cardiorespiratory endurance, and a random-intercept panel model (RIPM) was separately employed on male and female participants to identify between- and within-person variations. In this way, the associations for between-person physical fitness and normal/overweight/obese weight ranges, and for within-person physical fitness and normal/overweight/obese weight ranges could be observed. The results of this study revealed that every physical fitness test chosen for evaluation (such as the standing long jump for explosive power or the distance run for cardiorespiratory endurance) was negatively related to the BMI results, irrespective of sex, with the notable exception of the flexibility results. In addition, this study showed that both males and females exhibited positively correlated results in both between-person BMI and flexibility as well as within-person BMI and flexibility. Furthermore, the relationships between and within persons of cardiorespiratory endurance, explosive power, and flexibility all showed positive correlations across both sexes. The dynamics between physical fitness and BMI identified in this study could prove useful to practitioners and researchers investigating such relationships in the future.
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Validity of Bioimpedance Spectroscopy in the Assessment of Total Body Water and Body Composition in Wrestlers and Untrained Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249433. [PMID: 33339316 PMCID: PMC7767207 DOI: 10.3390/ijerph17249433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 12/16/2022]
Abstract
Bioimpedance spectroscopy (BIS) is an easy tool to assess hydration status and body composition. However, its validity in athletes remains controversial. We investigated the validity of BIS on total body water (TBW) and body composition estimation in Japanese wrestlers and untrained subjects. TBW of 49 young Japanese male subjects (31 untrained, 18 wrestlers) were assessed using the deuterium dilution method (DDM) and BIS. De Lorenzo’s and Moissl’s equations were employed in BIS for TBW estimation. To evaluate body composition, Siri’s 3-compartment model and published TBW/fat-free mass (FFM) ratio were applied in DDM and BIS, respectively. In untrained subjects, DDM and BIS with de Lorenzo’s equation showed consistent TBW estimates, whereas BIS with Moissl’s equation overestimated TBW (p < 0.001 vs. DDM). DDM and BIS with de Lorenzo’s equation estimated FFM and percent of fat mass consistently, whereas BIS with Moissl’s equation over-estimated and under-estimated them (p < 0.001 vs. DDM). In wrestlers, BIS with de Lorenzo’s and Moissl’s equations assessed TBW similarly with DDM. However, the Bland–Altman analysis revealed a proportional bias for TBW in BIS with de Lorenzo’s equation (r = 0.735, p < 0.001). Body composition assessed with BIS using both equations and DDM were not different. In conclusion, BIS with de Lorenzo’s equation accurately estimates the TBW and body composition in untrained subjects, whereas BIS with Moissl’s equation is more valid in wrestlers. Our results demonstrated the usefulness of BIS for assessing TBW and body composition in Japanese male wrestlers.
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Assari S, Malek-Ahmadi MR, Caldwell CH. Parental Education or Household Income? Which Socioeconomic Status Indicator Can Better Reduce Body Mass Index Disparities among Latino Children? ACTA ACUST UNITED AC 2020; 7:19-37. [PMID: 34307868 DOI: 10.22158/jepf.v7n1p19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim We compared the effects of parental education and household income on children's body mass index (BMI) in Hispanic White (HW) and non-Hispanic White (NHW) families. Methods In this cross-sectional study, we borrowed data from the Adolescent Brain Cognitive Development (ABCD) study and analyzed data of 5100 children between the ages of 9 and 10. The independent variables were parental education and household income. The primary outcome was BMI value. Ethnicity was the moderating variable. Confounders were age, sex, and family structure. Three mixed-effects regression models were used for data analysis. Results Overall, higher parental education and household income were associated with lower BMI levels in children. While an interaction was found between ethnicity and parental education, no interaction was noted between ethnicity and household income regarding BMI. The interaction indicated weaker protective effects of high parental education on BMI in HW children than NHW children. Household income showed similar protective effects on children's BMI in HW and NHW families. Conclusion Parental education but not household income loses some of its protective effects on childhood BMI among HW families compared to NHW families. Distal social determinants of health may be more vulnerable to the MDRs (minorities' diminished returns) than proximal ones. As a result, closing the income gap may be a good strategy towards closing the childhood BMI gap between highly educated HW and NHW families. Policies that raise the minimum wage and those that help HW families save money (e.g., earned income tax policies) maybe more promising strategies to eliminate the ethnic gap in BMI than increasing the education level of ethnic minority families.
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Ardesch FH, Ruiter R, Mulder M, Lahousse L, Stricker BHC, Kiefte-de Jong JC. The Obesity Paradox in Lung Cancer: Associations With Body Size Versus Body Shape. Front Oncol 2020; 10:591110. [PMID: 33244459 PMCID: PMC7683800 DOI: 10.3389/fonc.2020.591110] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/13/2020] [Indexed: 12/21/2022] Open
Abstract
Background The association between obesity and lung cancer (LC) remains poorly understood. However, other indices of obesity on the basis of body shape instead of body size have not been examined yet. The aim of this study was to evaluate the association between different indices of body size and body shape and the risk of LC. In particular, this study examined the association between A Body Shape Index, a more precise indicator of abdominal fat than traditional anthropometric measures, and the risk of LC. Methods In the prospective cohort the Rotterdam Study, we analysed data of 9,689 participants. LC diagnoses were based on medical records and anthropometric measurements were assessed at baseline. Cox-regression analyses with corresponding Hazard Ratios were used to examine the association between the anthropometric measurements and the risk of LC with adjustment for potential confounders. Potential non-linear associations were explored with cubic splines using the Likelihood ratio (LR) test. Results During follow-up, 319 participants developed LC. Body mass Index (BMI) was inversely associated with the risk of lung cancer (HR 0.94, 95% CI: 0.91–0.97) and persisted after excluding lung cancer cases during the first 10 years of follow-up. There was evidence for a non-linear association between BMI and the risk of lung cancer (0,04, df = 1), which indicated that the inverse association between BMI and lung cancer was mainly present in non-obese participants. Waist circumference (WC) (HR 1.03 95% CI: 1.01–1.05), Waist-to-Hip Ratio (WHR) (HR 1.23 95% CI: 1.09–1.38) and ABSI (A Body Shape Index) (HR 1.17 95% CI: 1.05–1.30) were positively and linearly associated with the risk of lung cancer. Conclusions Body shape rather than body size may be an important risk indicator of LC. Future research should focus on the role of visceral fat and the risk of LC as well as the underlying mechanisms.
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Malik E, Rozner L, Adelson M, Schreiber S, Peles E. The Relation between Changes in Vitamin D and Vitamin B12 Levels, Body Mass Index and Outcome in Methadone Maintenance Treatment Patients. J Psychoactive Drugs 2020; 53:55-64. [PMID: 33143561 DOI: 10.1080/02791072.2020.1840680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients' Body Mass Index (BMI) increase during methadone maintenance treatment (MMT), and both Vitamins D and B12 deficiencies may be associated with BMI. We studied the relations between BMI, these vitamins and treatment outcome in patients with opioid use disorder receiving MMT. Vitamin B12 levels were available for 272 patients and Vitamin D levels were available for 260 patients. Of those 112 and 80 respectively had two measures (at admission or thereafter, and while stabilized or after one year in treatment). Patients' BMI levels and long-term retention were analyzed. Vitamin B12 was lower in patients abusing cocaine/amphetamine on admission. Vitamin D did not change over time, but a significant weight gain could be observed in 38 patients whose vitamin D was elevated compared to 42 whose levels were not, (25.4 ± 4.8 to 28.8 ± 5.2 vs. 24.3 ± 3.7 to 25.5 ± 4.0, p(Time) < 0.0005, p(Group) = 0.03, p(interaction) = 0.02). BMI changes correlated with vitamin D levels change (r = 0.26, p = .04). Longer cumulative retention was observed among the elevated vitamin D group (8.1 years, 95% CI 6.3-9.8) in comparison with the non-elevated group (4.8y 95% CI 3.6-6.1, Kaplan Meier, p = .02). Stimulants misuse was associated with low B12 levels. Vitamin D elevation is associated with weight gain and longer retention in treatment.
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Okoli A, Hanlon EC, Brady MJ. The Relationship between Sleep, Obesity, and Metabolic Health in Adolescents - a Review. ACTA ACUST UNITED AC 2020; 17:15-19. [PMID: 33283071 DOI: 10.1016/j.coemr.2020.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this literature review, we discuss the importance of adequate sleep and the various effects of suboptimal sleep on weight maintenance and metabolic health specifically for adolescents. Two major contributors to adolescents experiencing decreased sleep duration and quality, and thus increasing the risk for developing metabolic syndrome in adolescence as well as later in adulthood, are increased electronic screen time particularly at night and early school start times. The less time adolescents spend sleeping, the less quality sleep they obtain, and the greater the disruption of endocrine hormone function. As another consequence, adolescents are more prone to making poor food choices, from choosing relatively nutrient-poor foods to consuming excess calories without necessarily increasing their energy expenditure. These choices put adolescents at greater risk for becoming obese throughout their lifespan.
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Giménez Garcia-Conde M, Marin L, Ruiz de Maya S, Cuestas PJ. Parental Attitudes to Childhood Overweight: The Multiple Paths through Healthy Eating, Screen Use, and Sleeping Time. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217885. [PMID: 33121180 PMCID: PMC7662269 DOI: 10.3390/ijerph17217885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/26/2022]
Abstract
The main goal of this paper is to examine how parental attitudes toward sleeping, screen use, and feeding their child influence the child's body mass index (BMI) through the child's behaviors related to time dedicated to sleep and television, and their healthy eating. Using survey data from 908 parents, results show that parental attitudes have a significant influence on children's behavior and, more importantly, on their BMI. The three forms of a child's behavior (sleeping, watching TV, and healthy eating patterns) are affected by what parents do and their attitudes toward these three behaviors at home. Results show how changes in parental attitudes are an interesting target to prevent the child's overweight.
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Chintam K, Chang AR. Strategies to Treat Obesity in Patients With CKD. Am J Kidney Dis 2020; 77:427-439. [PMID: 33075388 DOI: 10.1053/j.ajkd.2020.08.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/11/2020] [Indexed: 12/17/2022]
Abstract
Obesity prevalence continues to increase worldwide, accompanied by a rising tide of hypertension, diabetes, and chronic kidney disease (CKD). Although body mass index is typically used to assess obesity in clinical practice, altered body composition (eg, reduced muscle mass and increased visceral adiposity) are common among patients with CKD. Weight loss achieved through behavioral modification or medications reduces albuminuria and in some cases slows the decline in estimated glomerular filtration rate. Use of medications that promote weight loss with favorable cardiovascular risk profiles should be promoted, particularly in patients with type 2 diabetes, obesity, and CKD. For those who fail to achieve weight loss through lifestyle modification, bariatric surgery should be considered because observational studies have shown reductions in risk for estimated glomerular filtration rate decline and kidney failure. Uncertainty persists on the risk to benefit ratio of intentional weight loss in patients with kidney failure due to the lack of prospective trials and limitations of observational data. Regardless, sleeve gastrectomy is increasingly being used for patients with kidney failure and severe obesity, with success in achieving sustained weight loss, improved access to kidney transplantation, and favorable posttransplantation outcomes. More research is needed assessing long-term cardiovascular and kidney outcomes of most weight loss medications.
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Malik P, Patel U, Patel K, Martin M, Shah C, Mehta D, Malik FA, Sharma A. Obesity a predictor of outcomes of COVID-19 hospitalized patients-A systematic review and meta-analysis. J Med Virol 2020; 93:1188-1193. [PMID: 32975814 PMCID: PMC7537321 DOI: 10.1002/jmv.26555] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/07/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is a global health crisis. Very few studies have reported association between obesity and severity of COVID-19. In this meta-analysis, we assessed the association of obesity and outcomes in COVID-19 hospitalized patients. Data from observational studies describing the obesity or body mass index and outcomes of COVID-19 hospitalized patients from December 1, 2019, to August 15, 2020, was extracted following PRISMA guidelines with a consensus of two independent reviewers. Adverse outcomes defined as intensive care units, oxygen saturation less than 90%, invasive mechanical ventilation, severe disease, and in-hospital mortality. The odds ratio (OR) and 95% confidence interval (95% CI) were obtained and forest plots were created using random-effects models. A total of 10 studies with 10,233 confirmed COVID-19 patients were included. The overall prevalence of obesity in our study was 33.9% (3473/10,233). In meta-analysis, COVID-19 patient with obesity had higher odds of poor outcomes compared with better outcomes with a pooled OR of 1.88 (95% CI: 1.25-2.80; p = 0.002), with 86% heterogeneity between studies (p < 0.00001). Our study suggests a significant association between obesity and COVID-19 severity and poor outcomes. Our results findings may have important suggestions for the clinical management and future research of obesity and COVID-19.
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Moon RC, Cunningham SA, Gazmararian J. Impact of Weight Status on the Cardiopulmonary Fitness Outcome of a School-Based Physical Activity Program. THE JOURNAL OF SCHOOL HEALTH 2020; 90:762-770. [PMID: 32794603 PMCID: PMC7856835 DOI: 10.1111/josh.12936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The effectiveness of school-based physical activity interventions for improving cardiopulmonary fitness (CPF) of overweight and obese children is not well established. In this study, we evaluated whether overweight and obese children had similar changes in body mass index (BMI) and CPF as normal weight children after participating in a program for one academic year. METHODS Using purposive sampling at the school level, we selected 16 program and 7 control schools in a large metropolitan area in the Southeast during the 2015-2016 academic year. In these schools, 3396 fourth-graders participated with parental consent. Of these, 2332 (68.7%) participated in BMI measures and 1780 (52.4%) in Progressive Aerobic Cardiovascular Endurance Run (PACER) measures for CPF at two time points. RESULTS Students of all weight statuses pre-program did not show changes in BMI after program implementation. All students showed statistically significant improvements in the PACER test at follow-up, regardless of their participation in the program. However, overweight and obese children showed less improvement in CPF level than their normal weight classmates, regardless of their participation in the program. CONCLUSION Special attention for improving engagements of overweight and obese children may be needed to achieve improvements in their CPF level similar to that of normal weight students.
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Kaeuffer C, Ruch Y, Fabacher T, Hinschberger O, Mootien J, Eyriey M, Greigert V, Meyer N, Fafi-Kremer S, Lefebvre N, Hansmann Y, Martinot M, Danion F. The BAS 2IC Score: A Useful Tool to Identify Patients at High Risk of Early Progression to Severe Coronavirus Disease 2019. Open Forum Infect Dis 2020; 7:ofaa405. [PMID: 33274248 PMCID: PMC7499730 DOI: 10.1093/ofid/ofaa405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/28/2020] [Indexed: 01/08/2023] Open
Abstract
We developed a score, with easily accessible data (age, sex, body mass index, dyspnea, inflammatory parameters), to predict the risk of rapid progression to severe coronavirus disease 2019. Using a cutoff of >6 points, the negative predictive value was 87%.
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