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Rerkasem A, Lyons-Reid J, Namwongprom S, Wongsrithep S, Mangklabruks A, Phirom K, Rerkasem K, Derraik JGB. Associations between maternal overweight/obesity during pregnancy and body composition in young adult offspring. Front Public Health 2024; 12:1346900. [PMID: 38544732 PMCID: PMC10968890 DOI: 10.3389/fpubh.2024.1346900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/20/2024] [Indexed: 05/12/2024] Open
Abstract
Background Maternal obesity is associated with an increased risk of large-for-gestational-age births and childhood obesity. However, evidence on its potential associations with long-term offspring body composition remains limited. This prospective cohort study examined associations between maternal body mass index (BMI) during pregnancy and body composition in the young adult offspring. Methods Participants were the offspring from a birth cohort in Chiang Mai (Thailand). Maternal BMI was assessed at the first antenatal clinic visit (≤24 weeks of gestation) in 1989-1990. In 2010-2011, we followed up the offspring at approximately 20 years of age, assessing their body composition using whole-body dual-energy X-ray absorptiometry (DXA) scans. Associations between maternal BMI and offspring body composition were explored using unadjusted and adjusted analyses. Results We assessed 391 young adults (55% were females). Higher maternal BMI was associated with increased offspring fat mass and lean mass. In adjusted analyses, offspring of mothers with overweight/obesity exhibited total body fat percentages 1.5 (95% CI 0.1, 2.9; p = 0.032) and 2.3 (95% CI 0.2, 4.5; p = 0.036) percentage points higher than offspring of normal-weight and underweight mothers, respectively. Fat mass index was similarly higher: 0.9 kg/m2 (95% CI 0.3, 1.5 kg/m2; p = 0.002) and 1.4 kg/m2 (95% CI 0.5, 2.3 kg/m2; p = 0.002), respectively. However, no differences in visceral adiposity were detected. Conclusion Higher maternal BMI during pregnancy was associated with increased adiposity in young adult offspring. Our findings suggest that the cross-generational transmission of maternal obesity-related traits is associated with increased offspring adiposity in the long term.
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Affiliation(s)
- Amaraporn Rerkasem
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Sirianong Namwongprom
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suthathip Wongsrithep
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kochaphan Phirom
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Clinical Surgical Research Center, Chiang Mai University, Chiang Mai, Thailand
| | - José G. B. Derraik
- Environmental-Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Phirom K, Rerkasem K. High Mortality in Patients With an Ischemic Foot Ulcer Following Revascularization. INT J LOW EXTR WOUND 2024; 23:43-48. [PMID: 37750201 DOI: 10.1177/15347346231204237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Critical limb ischemia (CLI) is the advanced stage of peripheral arterial disease, which impairs blood flow to the extremities due to occlusion of arteries, in which patients suffer from ischemic pain at rest and gangrene or ulcers. It is frequently accompanied by major adverse cardiac events, resulting in exceedingly high mortality from a cardiac or cerebrovascular event in this population. Although there have been considerable amounts of novel and costly revascularization and wound dressing technology, mortality is still high. Therefore, the risk factors for such high mortality need to be addressed. This review aimed to summarize the potential risk factors for mortality in patients with CLI of the lower extremities. There are several such risk factors, including modifiable and nonmodifiable risk factors. This review further discusses some highlighted major modified risk factors, including renal failure, cardiovascular, and diabetes. The strategy of regular surveillance and modification of such risk factors in any patients with CLI should be developed.
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Affiliation(s)
- Kochaphan Phirom
- Environmental - Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kitttipan Rerkasem
- Environmental - Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Rerkasem A, Mangklabruks A, Buranapin S, Sony K, Inpankaew N, Rerkasem R, Pongtam S, Phirom K, Rerkasem K. Chronic Kidney Disease Predicts Adverse Major Cardiovascular Events and Adverse Limb Events in Patients With Diabetes and Peripheral Arterial Disease. INT J LOW EXTR WOUND 2024; 23:19-26. [PMID: 37920918 DOI: 10.1177/15347346231211959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
This study aims to explore the effect in each stage of chronic kidney disease (CKD) on the major adverse cardiovascular events (MACE) in diabetes mellitus (DM) patients with peripheral arterial disease (PAD). A total of 246 DM patients with diagnosed PAD were enrolled in this study. Of these, 86 patients (35%) died and 34 patients had non-fatal cardiovascular events occurred at the last 7 years follow-up. The baseline eGFR obtained from the first quantified eGFR value within 6 months from the date of enrollment estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Then, based on eGFR at entry, we defined CKD as an eGFR < 60 mL/min/1.73 m2, and stratified all patients into four groups: eGFR-1, normal eGFR (≥90 mL/min/1.73 m2); eGFR-2, mildly decreased eGFR (60-89 mL/min/1.73 m2); eGFR-3, moderately decreased eGFR (30-59 mL/min/1.73 m2); and eGFR-4, severely decreased eGFR (<30 mL/min/1.73 m2). The mean eGFR was 54.4 ± 28.9 mL/min/1.73m2, and more than 30% of all patients had CKD (eGFR <60 mL/min/1.73m2). The seven-year cumulative incidence of MACE was 29.8% (95% confident interval [95% CI] 15.5-35.7) for eGFR-1 group, 40.4% (95% CI 27.4-45.2) for eGFR-2group, 66.2% (95% CI 47.6-71.4) for eGFR-3 group, and 94% (95% CI 75.0-99.0) for eGFR-4 group. In addition, after adjustment, hazard ratio (HR) for MACE was 2.36 (95% CI 1.26-4.40) in the eGFR-3 group and 7.62 (95% CI 3.71-15.66) in the eGFR-4 group. Restricted mean survival time (RMST) for survival analysis was consistent with HR in this study. After adjusting confounders, relative to eGFR-1 group, an association between the eGFR group and MACE outcome was found only in eGFR-3 group and eGFR-4 group. The moderate to severe reduction in eGFR, was an independent risk factor for MACE among DM patients with PAD throughout a 7-year follow-up duration. Thus, early CKD screening might be essential in the management of diabetic patients with PAD.
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Affiliation(s)
- Amaraporn Rerkasem
- Environmental - Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Research Center for Infectious Diseases and Substance Use, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Supawan Buranapin
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kiran Sony
- Department of Internal Medicine, Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand
| | - Nimit Inpankaew
- Department of Internal Medicine, Lamphun Hospital, Lamphun, Thailand
| | - Rath Rerkasem
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sasinat Pongtam
- Environmental - Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kochaphan Phirom
- Environmental - Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kitttipan Rerkasem
- Environmental - Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Nantakool S, Punturee K, Konghakote S, Sitthichoke C, Phirom K, Chuatrakoon B. Immediate Effects of Aerobic Exercise and Whole-Body Vibration on Fat Oxidation, Lipid Mobilization, and Cardiovascular Response in Individuals with Obesity. J Clin Med 2023; 13:44. [PMID: 38202051 PMCID: PMC10779615 DOI: 10.3390/jcm13010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Among obesity, cumulative fat and poor physical activity are risk factors for cardiovascular disease. Due to the limit in performing aerobic exercise (AER), whole-body vibration (WBV) as a passive form of exercise is an alternative therapeutic strategy. Herein, this study aimed to compare the immediate effects of AER and WBV on metabolic and cardiovascular responses, and dyspnea level in obesity. Forty-nine eligible obesities performed both AER and WBV, with a random order assignment (age = 28.94 ± 11.39 years). Fat oxidation, cardiovascular parameters (i.e., heart rate (HR) and blood pressure (BP)), and dyspnea level (i.e., rating perceived exertion (RPE)) were measured during exercise, while lipid mobilization (i.e., triglycerides) was collected pre- and post-exercise. Fat oxidation rate in AER was significantly higher than in WBV. Significantly increased fat oxidation rates were shown in both groups (within-group analyses) (also shown in females aged 20-45). Triglyceride levels between AER and WBV were similar. A significant decrease in triglyceride levels was only observed in WBV (within-group change). HR and RPE in AER were significantly higher than in WBV (p < 0.05). HR and RPE were significantly increased throughout both AER and WBV, while systolic blood pressure was only significantly elevated in AER (whining-group analyses). WBV may facilitate fat oxidation (particularly in females aged below 45), induce lipid mobilization, and reduce interference on cardiovascular parameters in obesity.
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Affiliation(s)
- Sothida Nantakool
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.N.); (K.P.)
| | - Khanittha Punturee
- Center Research Unit of Associated Medical Sciences (AMS-CRU), Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Supatcha Konghakote
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (C.S.)
| | - Cattaleeya Sitthichoke
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (C.S.)
| | - Kochaphan Phirom
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.N.); (K.P.)
| | - Busaba Chuatrakoon
- Environmental-Occupational Health Sciences and Non Communicable Diseases Research Center, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.N.); (K.P.)
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (C.S.)
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Kamnardsiri T, Phirom K, Boripuntakul S, Sungkarat S. An Interactive Physical-Cognitive Game-Based Training System Using Kinect for Older Adults: Development and Usability Study. JMIR Serious Games 2021; 9:e27848. [PMID: 34704953 PMCID: PMC8581754 DOI: 10.2196/27848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/08/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Declines in physical and cognitive functions are recognized as important risk factors for falls in older adults. Promising evidence suggests that interactive game-based systems that allow simultaneous physical and cognitive exercise are a potential approach to enhance exercise adherence and reduce fall risk in older adults. However, a limited number of studies have reported the development of a combined physical-cognitive game-based training system for fall risk reduction in older adults. OBJECTIVE The aim of this study is to develop and evaluate the usability of an interactive physical-cognitive game-based training system (game-based exercise) for older adults. METHODS In the development phase (Part I), a game-based exercise prototype was created by integrating knowledge and a literature review as well as brainstorming with experts on effective fall prevention exercise for older adults. The output was a game-based exercise prototype that covers crucial physical and cognitive components related to falls. In the usability testing (Part II), 5 games (ie, Fruits Hunter, Where Am I?, Whack a Mole, Sky Falls, and Crossing Poison River) with three difficulty levels (ie, beginner, intermediate, and advanced levels) were tested in 5 older adults (mean age 70.40 years, SD 5.41 years). After completing the games, participants rated their enjoyment level while engaging with the games using the Physical Activity Enjoyment Scale (PACES) and commented on the games. Descriptive statistics were used to describe the participants' characteristics and PACES scores. RESULTS The results showed that the average PACES score was 123 out of 126 points overall and between 6.66 and 7.00 for each item, indicating a high level of enjoyment. Positive feedback, such as praise for the well-designed interactions and user-friendly interfaces, was also provided. CONCLUSIONS These findings suggest that it is promising to implement an interactive, physical-cognitive game-based exercise in older adults. The effectiveness of a game-based exercise program for fall risk reduction has yet to be determined.
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Affiliation(s)
- Teerawat Kamnardsiri
- Research Group of Modern Management and Information Technology, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, Thailand
- Department of Digital Game, College of Arts, Media and Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Kochaphan Phirom
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sirinun Boripuntakul
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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Thaiyanto J, Sittichoke C, Phirom K, Sungkarat S. Effects of Multicomponent Exercise on Cognitive Performance and Fall Risk in Older Women with Mild Cognitive Impairment. J Nutr Health Aging 2021; 25:160-164. [PMID: 33491029 DOI: 10.1007/s12603-020-1458-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Emerging evidence suggests that multicomponent exercise provides greater benefits for physical and cognitive function than single component exercise. However, few studies have been conducted to determine these effects in older adults with mild cognitive impairment (MCI) and findings have been less conclusive. It has been reported that older women have a greater risk of falls and a higher incidence of dementia than men. OBJECTIVES To examine the effects of multicomponent exercise on cognitive performance and fall risk in older women with MCI. DESIGN An experimental design comparing the exercise and control groups. SETTING AND PARTICIPANTS Forty community-dwelling older women with MCI were allocated to the exercise (n = 20) and control (n = 20) groups. INTERVENTION Twelve weeks of multicomponent exercise program (aerobic, resistance, and balance exercise) 60 mins/day, 3 days/week. MEASUREMENT Cognitive performance including the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and Trail Making Test (TMT) and fall risk including the Timed Up and Go (TUG) single-, dual-task, and Physiological Profile Assessment (PPA) were administered before and after the 12-week exercise program. RESULTS At the end of the 12-week training, participants in the exercise group had a significantly greater improvement in TMT part A (p < 0.05), TUG dual-task (p < 0.05), and PPA composite score (p < 0.05) when compared to the control group. The exercise group also demonstrated significant improvement in TUG dual-task, PPA composite score, PPA subcomponents including postural sway and reaction time when compared to baseline (p < 0.05). In contrast, at 12-week, the control group showed a decline in TUG dual-task performance as compared to baseline (p < 0.05). CONCLUSION The 12-week multicomponent exercise improved attention, dual-task ability, and reduced risk of falling in older women with mild cognitive impairment.
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Affiliation(s)
- J Thaiyanto
- Somporn Sungkarat, Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand, 50200; E-mail address: ; Tel. + 66 53 949 249; Fax. +66 53 946 042
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Phirom K, Kamnardsiri T, Sungkarat S. Beneficial Effects of Interactive Physical-Cognitive Game-Based Training on Fall Risk and Cognitive Performance of Older Adults. Int J Environ Res Public Health 2020; 17:ijerph17176079. [PMID: 32825555 PMCID: PMC7504204 DOI: 10.3390/ijerph17176079] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022]
Abstract
Physical and cognitive declines are significant risk factors for falls. Promising evidence suggests that combined physical-cognitive training would be an effective fall risk reduction and cognitive improvement intervention. However, a limited number of studies have been conducted and findings have been inconclusive. This study investigated the effects of interactive physical-cognitive game-based training on the fall risk and cognitive performance of older adults. Forty participants were randomly allocated to the intervention (n = 20) and control (n = 20) groups. Participants in the intervention group performed a 1 h session, 3 times a week for 12 weeks of the interactive physical-cognitive game-based training program. Fall risk (Physiological Profile Assessment, PPA; and Timed Up and Go, TUG) and cognitive outcome (Montreal Cognitive Assessment, MoCA) were assessed at pre- and post-intervention. Thirty-nine participants (mean age = 69.81 ± 3.78 years) completed the study (97.5%). At the end of the trial, participants in the intervention group demonstrated significant improvement in the PPA fall risk score (p = 0.015), postural sway (p = 0.005), MoCA score (p = 0.001), and TUG-dual task (p = 0.045) compared to controls. In conclusion, the interactive physical-cognitive, game-based training was effective in reducing physiological fall risk and improving cognitive function in community-dwelling older adults.
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Affiliation(s)
- Kochaphan Phirom
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Teerawat Kamnardsiri
- Department of Digital Game, College of Arts, Media, and Technology, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Somporn Sungkarat
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand;
- Correspondence:
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