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3.
BMC Womens Health ; 24(1): 315, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38824522

ABSTRACT

BACKGROUND: Sleep health and obesity may affect the risk of female infertility. However, few studies focused on the interaction of obesity and sleep health on the female infertility risk. This study aimed to evaluate the combined impact of trouble sleeping / sleep duration and overweight/obesity/ abdominal obesity on the risk of female infertility. METHODS: The data for this cross-sectional study was obtained from National Health and Nutritional Examination Survey, which provided information on trouble sleeping, sleep duration, overweight/obesity, abdominal obesity, and confounding factors. Adopted weighted univariate and multivariate logistic regression models to explore the relationship between trouble sleeping, sleep duration, overweight/obesity, abdominal obesity, and the risk of infertility, respectively, and the combined effect of trouble sleeping and overweight/obesity, trouble sleeping and abdominal obesity, sleep duration and overweight/obesity, sleep duration and abdominal obesity, on the female infertility risk. RESULTS: This study included a total of 1,577 women, and 191 were diagnosed with infertility. Women with infertility had a higher proportion of people with overweight/obesity, abdominal obesity, sleep duration ≤ 7 h and trouble sleeping than those with non-infertility. The result indicated that trouble sleeping [odds ratio (OR) = 2.25, 95% confidence intervals (CI): 1.49-3.39], sleep duration ≤ 7 h (OR = 1.59, 95% CI: 1.03-2.48), and the combined impact of abdominal obesity and trouble sleeping (OR = 2.18, 95% CI: 1.28-3.72), abdominal obesity and sleep duration ≤ 7 h (OR = 2.00, 95% CI: 1.17-3.40), overweight/obesity and trouble sleeping (OR = 2.29, 95% CI: 1.24-4.26), and overweight/obesity and sleep duration ≤ 7 h (OR = 1.88, 95% CI: 1.01-3.49) were associated with increased odds of infertility, respectively. CONCLUSION: There was combined effects of trouble sleeping/sleep duration ≤ 7 h and overweight/obesity/ abdominal obesity on increased odds of female infertility.


Subject(s)
Infertility, Female , Nutrition Surveys , Obesity, Abdominal , Obesity , Sleep Wake Disorders , Humans , Female , Adult , Infertility, Female/epidemiology , Infertility, Female/etiology , Cross-Sectional Studies , Obesity/epidemiology , Obesity/complications , Obesity, Abdominal/epidemiology , Obesity, Abdominal/complications , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/complications , Sleep/physiology , Overweight/epidemiology , Overweight/complications , Risk Factors , Young Adult , United States/epidemiology
5.
Nutr J ; 23(1): 64, 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38872173

ABSTRACT

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a globally increasing health epidemic. Lifestyle intervention is recommended as the main therapy for NAFLD. However, the optimal approach is still unclear. This study aimed to evaluate the effects of a comprehensive approach of intensive lifestyle intervention (ILI) concerning enhanced control of calorie-restricted diet (CRD), exercise, and personalized nutrition counseling on liver steatosis and extrahepatic metabolic status in Chinese overweight and obese patients with NAFLD. METHODS: This study was a multicenter randomized controlled trial (RCT) conducted across seven hospitals in China. It involved 226 participants with a body mass index (BMI) above 25. These participants were randomly assigned to two groups: the ILI group, which followed a low carbohydrate, high protein CRD combined with exercise and intensive counseling from a dietitian, and a control group, which adhered to a balanced CRD along with exercise and standard counseling. The main measure of the study was the change in the fat attenuation parameter (FAP) from the start of the study to week 12, analyzed within the per-protocol set. Secondary measures included changes in BMI, liver stiffness measurement (LSM), and the improvement of various metabolic indexes. Additionally, predetermined subgroup analyses of the FAP were conducted based on variables like gender, age, BMI, ethnicity, hyperlipidemia, and hypertension. RESULTS: A total of 167 participants completed the whole study. Compared to the control group, ILI participants achieved a significant reduction in FAP (LS mean difference, 16.07 [95% CI: 8.90-23.25] dB/m) and BMI (LS mean difference, 1.46 [95% CI: 1.09-1.82] kg/m2) but not in LSM improvement (LS mean difference, 0.20 [95% CI: -0.19-0.59] kPa). The ILI also substantially improved other secondary outcomes (including ALT, AST, GGT, body fat mass, muscle mass and skeletal muscle mass, triglyceride, fasting blood glucose, fasting insulin, HbA1c, HOMA-IR, HOMA-ß, blood pressure, and homocysteine). Further subgroup analyses showed that ILI, rather than control intervention, led to more significant FAP reduction, especially in patients with concurrent hypertension (p < 0.001). CONCLUSION: In this RCT, a 12-week intensive lifestyle intervention program led to significant improvements in liver steatosis and other metabolic indicators in overweight and obese Chinese patients suffering from nonalcoholic fatty liver disease. Further research is required to confirm the long-term advantages and practicality of this approach. TRIAL REGISTRATION: This clinical trial was registered on ClinicalTrials.gov (registration number: NCT03972631) in June 2019.


Subject(s)
Caloric Restriction , Life Style , Non-alcoholic Fatty Liver Disease , Obesity , Overweight , Humans , Male , Female , Caloric Restriction/methods , China , Non-alcoholic Fatty Liver Disease/diet therapy , Non-alcoholic Fatty Liver Disease/therapy , Non-alcoholic Fatty Liver Disease/complications , Middle Aged , Obesity/diet therapy , Obesity/therapy , Obesity/complications , Overweight/therapy , Overweight/complications , Overweight/diet therapy , Adult , Liver/metabolism , Body Mass Index , Exercise/physiology , Counseling/methods
6.
Front Endocrinol (Lausanne) ; 15: 1327903, 2024.
Article in English | MEDLINE | ID: mdl-38846495

ABSTRACT

Objectives: To research the connection between the indexes of the indexes of triglyceride-glucose (TyG) combined with obesity indices and the initial neurological severity and short-term outcome of new-onset acute ischemic stroke. Methods: Data of patients with acute ischemic stroke admitted to the Stroke Ward of the Affiliated Hospital of Beihua University from November 2021 to October 2023, were collected. The two indexes were calculated by combining TyG and obesity indices: TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC). The National Institute of Health Stroke Scale (NIHSS) was used to assess and group patients with neurological deficits within 24 hours of admission: mild stroke (NIHSS ≤5) and moderate-severe stroke (NIHSS >5). Short-term prognosis was evaluated using the modified Rankin Scale (mRS) at discharge or 14 days after onset of the disease and grouped: good outcome (mRS ≤2) and poor outcome (mRS >2). According to the quartiles of TyG-BMI and TyG-WC, the patients were placed into four groups: Q1, Q2, Q3 and Q4. Multi-factor logistic regression analysis was utilized to evaluate the correlation of TyG-BMI and TyG-WC with the severity and short-term outcome. Results: The study included 456 patients. After adjusting for multiple variables, the results showed that compared with the quartile 1, patients in quartile 4 of TyG-BMI had a reduced risk of moderate-severe stroke [Q4: OR: 0.407, 95%CI (0.185-0.894), P = 0.025]; Patients in quartiles 2, 3 and 4 of TyG-BMI had sequentially lower risk of short-term adverse outcomes [Q2: OR: 0.394, 95%CI (0.215-0.722), P = 0.003; Q3: OR: 0.324, 95%CI (0.163-0.642), P = 0.001; Q4: OR: 0.158, 95%CI (0.027-0.349), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of moderate-severe stroke [Q3: OR: 0.355, 95%CI (0.173-0.728), P = 0.005; Q4: OR: 0.140, 95%CI (0.056-0.351), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of short-term adverse outcomes [Q3: OR: 0.350, 95%CI (0.175-0.700), P = 0.003; Q4: OR: 0.178, 95%CI (0.071-0.451), P <0.001]. Conclusions: TyG-WC and TyG-BMI were correlated with the severity and short-term outcome of new-onset acute ischemic stroke. As TyG-WC and TyG-BMI increased, stroke severity decreased and short-term outcome was better.


Subject(s)
Blood Glucose , Body Mass Index , Ischemic Stroke , Severity of Illness Index , Triglycerides , Humans , Male , Female , Ischemic Stroke/blood , Middle Aged , Aged , Triglycerides/blood , Prognosis , Blood Glucose/analysis , Blood Glucose/metabolism , Waist Circumference , Obesity/blood , Obesity/complications
7.
J Orthop Trauma ; 38(7): 366-372, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38837209

ABSTRACT

OBJECTIVES: To evaluate the association between obesity and treatment approaches, perioperative factors, and clinical and radiographic outcomes following subtrochanteric fracture fixation. DESIGN: Retrospective Cohort. SETTING: Academic Medical Center. PATIENT SELECTION CRITERIA: Patients operatively treated for an AO/OTA 32Axa, 32Bxa, or 32Cxa subtrochanteric femur fracture. OUTCOME MEASURES AND COMPARISONS: Injury characteristics, perioperative parameters, fixation information, postoperative complications, and clinical and radiographic outcomes. Univariate analyses were conducted between the obese (BMI ≥30 kg/m2) and the nonobese (BMI <30 kg/m2) cohorts. Regression analyses were performed to assess BMI as a continuous variable. RESULTS: Of 230 operatively treated subtrochanteric fracture patients identified, 49 (21%) were obese and 181 (79%) were nonobese. The average age of the obese cohort was 69.6 ± 17.2 years, with 16 (33%) male and 33 (77%) female. The average age of the nonobese cohort was 71.8 ± 19.2 years, with 60 (33%) male and 121 (77%) female. Aside from BMI, there were no significant differences in demographics between the obese and nonobese (age [P = 0.465], sex [P = 0.948], American Society of Anesthesiology Score [P = 0.739]). Both cohorts demonstrated similar injury characteristics including mechanism of injury, atypical fracture type, and AO/OTA fracture pattern (32A, 32B, 32C). Obese patients underwent more open reduction procedures (59% open obese, 11% open nonobese, P < 0.001), a finding further quantified by a 24% increased likelihood of open reduction for every 1 unit increase in BMI (OR: 1.2, 95% CI, 1.2-1.3, P < 0.001). There was no difference in average nail diameter, 1 versus 2-screw nail design, or number of locking screws placed. The obese cohort was operated more frequently on a fracture table (P < 0.001) when compared with the nonobese cohort that was operated more frequently on a flat table (P < 0.001). There were no significant differences (P > 0.050) in postoperative complications, mortality/readmission rates, hospital quality measures, fixation failure, or time to bone healing. CONCLUSIONS: The treatment of subtrochanteric fractures in obese patients is associated with a higher likelihood of surgeons opting for open fracture reduction and the use of different operating room table types, but no difference was observed in postoperative complications, mortality or readmission rates, or healing timeline when compared with nonobese patients. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


Subject(s)
Hip Fractures , Obesity , Humans , Male , Female , Obesity/complications , Aged , Retrospective Studies , Treatment Outcome , Hip Fractures/surgery , Hip Fractures/diagnostic imaging , Middle Aged , Aged, 80 and over , Postoperative Complications/epidemiology , Radiography , Fracture Fixation, Internal/methods , Fracture Healing , Comorbidity , Risk Factors , Body Mass Index , Cohort Studies
8.
J Morphol ; 285(6): e21741, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38837268

ABSTRACT

It is largely unknown how the tongue base and soft palate deform to alter the configuration of the oropharyngeal airway during respiration. This study is to address this important gap. After live sleep monitoring of five Yucatan and two Panepinto minipigs to verify obstructive sleep apnea (OSA), eight and four ultrasonic crystals were implanted into the tongue base and soft palate to circumscribe a cubic and square region, respectively. The 3D and 2D deformational changes of the circumscribed regions were measured simultaneously with electromyographic activity of the oropharyngeal muscles during spontaneous respiration under sedated sleep. The results indicated that both obese Yucatan and Panepinto minipigs presented spontaneous OSA, but not in three nonobese Yucatan minipigs. During inspiration, the tongue base showed elongation in both dorsal and ventral regions but thinning and thickening in the anterior and posterior regions, respectively. The widths showed opposite directions, widening in the dorsal but narrowing in the ventral regions. The soft palate expanded in both length and width. Compared to normal controls, obese/OSA ones showed similar directions of deformational changes, but the magnitude of change was two times larger in the tongue base and soft palate, and obese/OSA Panepinto minipigs presented 10 times larger changes in all dimensions of both the tongue base and the soft palate. The distance changes between the dorsal surface of tongue base and soft palate during inspiration increased in normal but decreased in obese OSA minipigs.


Subject(s)
Obesity , Palate, Soft , Sleep Apnea, Obstructive , Swine, Miniature , Tongue , Animals , Swine , Sleep Apnea, Obstructive/physiopathology , Tongue/physiopathology , Palate, Soft/physiopathology , Obesity/physiopathology , Obesity/complications , Obesity/pathology , Biomechanical Phenomena , Electromyography , Respiration , Male
10.
Sci Rep ; 14(1): 12829, 2024 06 04.
Article in English | MEDLINE | ID: mdl-38834647

ABSTRACT

The present cross-sectional study aimed to explore the relationship between systemic inflammatory indices (SIIs) and anthropometric measures, metabolic, and liver function biomarkers in patients with non-alcoholic fatty liver disease (NAFLD). This study was carried out on 238 NAFLD patients with overweight or obesity, aged 18-55 years. Anthropometric measurements were done and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were estimated. Metabolic factors including serum glucose, lipid profile, liver function biomarkers, and complete blood cell count were assessed after a 24-h fasting state. SIIs including the ratios of neutrophil to lymphocyte (NLR), monocytes to lymphocyte (MLR), platelet to lymphocyte (PLR), and monocytes to high-density lipoprotein cholesterol (MHR) were calculated. Results indicate that apart from PLR, all of the SIIs significantly changed by increasing steatosis severity (all p < 0.05). Moreover, changes in NLR showed a significant association with anthropometric indices including waist circumference (p = 0.032), BMI (p = 0.047), and WHtR (p = 0.002), as well as levels of fasting blood sugar (p = 0.045), triglycerides, (p = 0.025) and low-density lipoprotein cholesterol (p = 0.006). The findings also indicate the relations between lipid profile and all studied SIIs, notably MHR and MLR. All of the SIIs exhibited associations with some liver function indices as well. MHR was positively correlated with the metabolic risk factors of NAFLD while, oppositely, PLR was considered as a preventive marker of NAFLD.


Subject(s)
Body Mass Index , Non-alcoholic Fatty Liver Disease , Humans , Non-alcoholic Fatty Liver Disease/blood , Non-alcoholic Fatty Liver Disease/metabolism , Adult , Male , Female , Middle Aged , Cross-Sectional Studies , Adolescent , Young Adult , Inflammation/blood , Inflammation/metabolism , Biomarkers/blood , Liver/metabolism , Liver/pathology , Anthropometry , Obesity/complications , Obesity/metabolism , Obesity/blood , Liver Function Tests , Blood Glucose/metabolism , Waist-Hip Ratio
11.
BMC Surg ; 24(1): 175, 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38835067

ABSTRACT

BACKGROUND: Pancreatic cancer is often accompanied by wasting conditions. While surgery is the primary curative approach, it poses a substantial risk of postoperative complications, hindering subsequent treatments. Therefore, identifying patients at high risk for complications and optimizing their perioperative general condition is crucial. Sarcopenia and other body composition abnormalities have shown to adversely affect surgical and oncological outcomes in various cancer patients. As most pancreatic tumours are located close to the neuronal control centre for the digestive tract, it is possible that neural infiltration in this area deranges bowel functions and contributes to malabsorption and malnutrition and ultimately worsen sarcopenia and weight loss. METHODS: A retrospective analysis of CT scans was performed for pancreatic cancer patients who underwent surgical tumour resection at a single high-volume centre from 2007 to 2023. Sarcopenia prevalence was assessed by skeletal muscle index (SMI), and visceral obesity was determined by the visceral adipose tissue area (VAT). Obesity and malnutrition were determined by the GLIM criteria. Sarcopenic obesity was defined as simultaneous sarcopenia and obesity. Postoperative complications, mortality and perineural tumour invasion, were compared among patients with body composition abnormalities. RESULTS: Of 437 patients studied, 46% were female, the median age was 69 (61;74) years. CT analysis revealed 54.9% of patients with sarcopenia, 23.7% with sarcopenic obesity and 45.9% with visceral obesity. Sarcopenia and sarcopenic obesity were more prevalent in elderly and male patients. Postoperative surgical complications occurred in 67.7% of patients, most of which were mild (41.6%). Severe complications occurred in 22.7% of cases and the mortality rate was 3.4%. Severe postoperative complications were significantly more common in patients with sarcopenia or sarcopenic obesity. Visceral obesity or malnutrition based on BMI alone, did not significantly impact complications. Perineural invasion was found in 80.1% of patients and was unrelated to malnutrition or body composition parameters. CONCLUSIONS: This is the first and largest study evaluating the associations of CT-based body mass analysis with surgical outcome and histopathological perineural tumour invasion in pancreatic cancer patients. The results suggest that elderly and male patients are at high risk for sarcopenia and should be routinely evaluated by CT before undergoing pancreatic surgery, irrespective of their BMI. Confirmation of the results in prospective studies is needed to assess if pancreatic cancer patients with radiographic sarcopenia benefit from preoperative amelioration of muscle mass and function by exercise and nutritional interventions.


Subject(s)
Body Composition , Pancreatectomy , Pancreatic Neoplasms , Postoperative Complications , Sarcopenia , Humans , Male , Female , Aged , Pancreatic Neoplasms/surgery , Pancreatic Neoplasms/pathology , Retrospective Studies , Middle Aged , Sarcopenia/epidemiology , Sarcopenia/etiology , Sarcopenia/complications , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Pancreatectomy/methods , Neoplasm Invasiveness , Obesity/complications , Tomography, X-Ray Computed
12.
Eur J Gastroenterol Hepatol ; 36(7): 961-969, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38829946

ABSTRACT

Fatty liver disease (FLD) affects approximately 25% of global adult population. Metabolic-associated fatty liver disease (MAFLD) is a term used to emphasize components of metabolic syndrome in FLD. MAFLD does not exclude coexistence of other liver disease, but impact of coexisting MAFLD is unclear. We investigated prevalence and characteristics of MAFLD in patients with biopsy-proven autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), or toxic liver disease. Liver histopathology and clinical data from Helsinki University Hospital district (1.7 million inhabitants) between 2009 and 2019 were collected from patients with AIH, PBC, PSC, or toxic liver disease at the time of diagnosis. MAFLD was diagnosed as macrovesicular steatosis ≥5% together with obesity, type-2 diabetes, or signs of metabolic dysregulation. Of 648 patients included, steatosis was observed in 15.6% (n = 101), of which 94.1% (n = 95) was due to MAFLD. Prevalence of coexisting MAFLD in the four liver diseases varied between 12.4 and 18.2% (P = 0.483). Fibrosis was more severe in MAFLD among patients with toxic liver disease (P = 0.01). Histopathological characteristics otherwise showed similar distribution among MAFLD and non-FLD controls. Alcohol consumption was higher in MAFLD group among patients with AIH or PBC (P < 0.05 for both). In AIH, smoking was more common in patients with coexisting MAFLD (P = 0.034). Prevalence of coexisting MAFLD in other primary liver diseases is lower than reported in general population. Histopathology of MAFLD patients did not clearly differ from non-FLD ones. Alcohol and smoking were associated with MAFLD in AIH.


Subject(s)
Cholangitis, Sclerosing , Hepatitis, Autoimmune , Liver Cirrhosis, Biliary , Humans , Male , Female , Middle Aged , Hepatitis, Autoimmune/complications , Hepatitis, Autoimmune/epidemiology , Prevalence , Liver Cirrhosis, Biliary/epidemiology , Liver Cirrhosis, Biliary/complications , Cholangitis, Sclerosing/complications , Cholangitis, Sclerosing/epidemiology , Adult , Finland/epidemiology , Aged , Chemical and Drug Induced Liver Injury/etiology , Chemical and Drug Induced Liver Injury/epidemiology , Fatty Liver/epidemiology , Fatty Liver/pathology , Fatty Liver/complications , Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/complications , Obesity/complications , Obesity/epidemiology , Metabolic Syndrome/epidemiology , Metabolic Syndrome/complications , Biopsy , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Retrospective Studies , Risk Factors
13.
Saudi Med J ; 45(6): 572-577, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38830663

ABSTRACT

OBJECTIVES: To evaluate the relationship between severity of tricuspid regurgitation (TR) and pulmonary hypertension. METHODS: Cross-sectional study of 118 patients with pulmonary hypertension was carried out at a single center in Jeddah, Saudi Arabia, between 2018-2021. Patients who had pulmonary or tricuspid valves organic diseases, previously undergone tricuspid or pulmonary valve surgeries, had permanent pacemakers or critically ill were excluded. RESULTS: A high proportion of patients were women (n=100, 85%) and obese (n=57, 48%). Patients with more than mild TR had higher systolic pulmonary artery pressure (sPAP) than those with trivial or mild regurgitation (p<0.001). There was a significant association between severity of TR (p<0.001) and right chambers size (p=0.001). Furthermore, pulmonary artery pressure (PAP) was significantly higher in patients with mild right ventricular impairment (p=0.001). CONCLUSION: Increase in degree of TR and right atrial size were predictors of elevated sPAP. Our findings highlight the interplay among TR, right heart size, ventricular function, and PAP. Understanding these associations can aid in risk stratification, monitoring disease progression, and potentially guiding treatment in those patients.


Subject(s)
Hypertension, Pulmonary , Severity of Illness Index , Tricuspid Valve Insufficiency , Humans , Tricuspid Valve Insufficiency/physiopathology , Female , Male , Hypertension, Pulmonary/physiopathology , Cross-Sectional Studies , Middle Aged , Adult , Saudi Arabia/epidemiology , Ventricular Dysfunction, Right/physiopathology , Aged , Heart Atria/physiopathology , Obesity/complications , Obesity/physiopathology , Echocardiography
14.
Sci Rep ; 14(1): 12663, 2024 06 03.
Article in English | MEDLINE | ID: mdl-38830939

ABSTRACT

Patients with metabolic dysfunction-associated fatty liver disease (MAFLD) often present with concomitant metabolic dysregulation and alcohol consumption, potentially leading to distinct clinical outcomes. We analyzed data from 8043 participants with MAFLD in the Thai National Health Examination Survey with linked mortality records. According to the MAFLD criteria, 1432 individuals (17.2%) were categorized as having the diabetes phenotype, 5894 (71.0%) as the overweight/obesity phenotype, and 978 (11.8%) as the lean metabolic phenotype. Over 71,145 person-years, 916 participants died. Using Cox proportional hazard models adjusting for physiological, lifestyle, and comorbid factors, both diabetes (adjusted hazards ratio [aHR] 1.59, 95% CI 1.18-2.13) and lean metabolic phenotypes (aHR 1.28, 95% CI 1.01-1.64) exhibited significantly higher mortality risk compared to the overweight/obesity phenotype. A J-shaped relationship was observed between daily alcohol consumption and the risk of all-cause mortality. Daily alcohol intake exceeding 50 g for women and 60 g for men increased the all-cause mortality risk among MAFLD individuals with the lean metabolic phenotype (aHR 3.39, 95% CI 1.02-11.29). Our study found that metabolic phenotype and alcohol consumption have interactive effects on the risk of all-cause mortality in patients with MAFLD, indicating that evaluating both factors is crucial for determining prognostic outcomes and management strategies.


Subject(s)
Alcohol Drinking , Phenotype , Humans , Male , Female , Alcohol Drinking/adverse effects , Middle Aged , Adult , Risk Factors , Cohort Studies , Proportional Hazards Models , Obesity/complications , Obesity/mortality , Obesity/metabolism , Aged , Thailand/epidemiology , Metabolic Diseases/mortality , Metabolic Diseases/metabolism
15.
Sci Rep ; 14(1): 12727, 2024 06 03.
Article in English | MEDLINE | ID: mdl-38830947

ABSTRACT

Coronary artery disease is a leading cause of morbidity and mortality worldwide. It occurs due to a combination of genetics, lifestyle, and environmental factors. Premature coronary artery disease (PCAD) is a neglected clinical entity despite the rising number of cases worldwide. This study aimed to investigate the risk factors of premature coronary artery disease. In this study, we searched articles that had studied the risk factors of premature coronary artery diseases from January 2000 to July 2022 in Saudi Arabia in Web of Science, Pub Med, Scopus, Springer, and Wiley databases. The final analysis is based on seven articles. The smoking prevalence was 39%, diabetes mellitus 41%, hypertension 33%, overweight and obesity 18%, family history of coronary artery disease (CAD) 19%, dyslipidemia 37%, and the prevalence range of low-density lipoprotein cholesterol was 33.8-55.0%. The results revealed a mortality prevalence of 4% ranging from 2 to 8% which is similar to the prevalence in older patients which was 2-10%. Smoking, diabetes mellitus, hypertension, family history of CAD, dyslipidemia, and overweight/obesity are significantly and positively associated with premature coronary artery diseases. The health authorities should design and implement an intensive and effective prophylactic plan to minimize the subsequent impact of PCAD on the young population. In addition, early diagnosis of PCAD has great value in providing timely treatment, managing the patients, and minimizing the burden of the disease.


Subject(s)
Coronary Artery Disease , Humans , Saudi Arabia/epidemiology , Coronary Artery Disease/epidemiology , Coronary Artery Disease/mortality , Coronary Artery Disease/genetics , Risk Factors , Male , Prevalence , Female , Adult , Smoking/adverse effects , Smoking/epidemiology , Hypertension/epidemiology , Obesity/epidemiology , Obesity/complications , Dyslipidemias/epidemiology , Diabetes Mellitus/epidemiology , Diabetes Mellitus/mortality , Middle Aged
16.
Acta Neurochir (Wien) ; 166(1): 246, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38831229

ABSTRACT

BACKGROUND: Endoscopic spine surgery has recently grown in popularity due to the potential benefits of reduced pain and faster recovery time as compared to open surgery. Biportal spinal endoscopy has been successfully applied to lumbar disc herniations and lumbar spinal stenosis. Obesity is associated with increased risk of complications in spine surgery. Few prior studies have investigated the impact of obesity and associated medical comorbidities with biportal spinal endoscopy. METHODS: This study was a prospectively collected, retrospectively analyzed comparative cohort design. Patients were divided into cohorts of normal body weight (Bone Mass Index (BMI)18.0-24.9), overweight (BMI 25.0-29.9) and obese (BMI > 30.0) as defined by the World Health Organization (WHO). Patients underwent biportal spinal endoscopy by a single surgeon at a single institution for treatment of lumbar disc herniations and lumbar spinal stenosis. Demographic data, surgical complications, and patient-reported outcomes were analyzed. Statistics were calculated amongst treatment groups using analysis of variance and chi square where appropriate. Statistical significance was determined as p < 0.05. RESULTS: Eighty-four patients were followed. 26 (30.1%) were normal BMI, 35 (41.7%) were overweight and 23 (27.4%) were obese. Patients with increasing BMI had correspondingly greater American Society of Anesthesiologist (ASA) scores. There were no significant differences in VAS Back, VAS Leg, and ODI scores, or postoperative complications among the cohorts. There were no cases of surgical site infections in the cohort. All cohorts demonstrated significant improvement up to 1 year postoperatively. CONCLUSIONS: This study demonstrates that obesity is not a risk factor for increased perioperative complications with biportal spinal endoscopy and has similar clinical outcomes and safety profile as compared to patients with normal BMI. Biportal spinal endoscopy is a promising alternative to traditional techniques to treat common lumbar pathology.


Subject(s)
Body Mass Index , Decompression, Surgical , Endoscopy , Lumbar Vertebrae , Obesity , Spinal Stenosis , Humans , Obesity/surgery , Obesity/complications , Male , Female , Middle Aged , Decompression, Surgical/methods , Decompression, Surgical/adverse effects , Lumbar Vertebrae/surgery , Spinal Stenosis/surgery , Aged , Treatment Outcome , Adult , Retrospective Studies , Endoscopy/methods , Endoscopy/adverse effects , Intervertebral Disc Displacement/surgery , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Cohort Studies
17.
Diabetes Metab Res Rev ; 40(5): e3830, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38873748

ABSTRACT

Metabolic/bariatric surgery as a treatment for obesity and related diseases, such as type 2 diabetes mellitus (T2DM), has been increasingly recognised in recent years. However, compared with conventional pharmacologic therapy, the long-term effect (≥ 5 years) of metabolic surgery in T2DM patients is still unclear. This study aimed to evaluate the diabetes remission rate, incidence of diabetic microvascular complications, incidence of macrovascular complications, and mortality in T2DM patients who received metabolic surgery versus pharmacologic therapy more than 5 years after the surgery. Searching the database, including PubMed, Embase, Web of Science, and Cochrane Library from the inception to recent (2024), for randomised clinical trials (RCTs) or cohort studies comparing T2DM patients treated with metabolic surgery versus pharmacologic therapy reporting on the outcomes of the diabetes remission rate, diabetic microvascular complications, macrovascular complications, or mortality over 5 years or more. A total of 15 articles with a total of 85,473 patients with T2DM were eligible for review and meta-analysis in this study. There is a significant long-term increase in diabetes remission for metabolic surgery compared with conventional medical therapy in the overall pooled estimation and RCT studies or cohort studies separately (overall: OR = 4.58, 95% CI: 1.89-11.07, P < 0.001). Significant long-term decreases were found in the pooled results of microvascular complications incidence (HR = 0.57, 95% CI: 0.41-0.78, P < 0.001), macrovascular complications incidence (HR = 0.59, 95% CI: 0.50-0.70, P < 0.001) and mortality (HR = 0.53, 95% CI: 0.53-0.79, P = 0.0018). Metabolic surgery showed more significant long-term effects than pharmacologic therapy on diabetes remission, macrovascular complications, microvascular complications incidence, and all-cause mortality in patients with T2DM using currently available evidence. More high-quality evidence is needed to validate the long-term effects of metabolic surgery versus conventional treatment in diabetes management.


Subject(s)
Bariatric Surgery , Diabetes Mellitus, Type 2 , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/surgery , Diabetes Mellitus, Type 2/complications , Humans , Bariatric Surgery/methods , Hypoglycemic Agents/therapeutic use , Obesity/complications , Obesity/surgery , Prognosis , Treatment Outcome
18.
JAMA Netw Open ; 7(6): e2417115, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38874924

ABSTRACT

Importance: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) have recently proposed a consensus definition and diagnostic criteria for sarcopenic obesity (SO). Objective: To implement the ESPEN-EASO diagnostic algorithm to investigate the prevalence of SO and its association with outcomes in patients with solid tumor cancers, with particular regard to associations among SO, overall survival (OS), and patient quality of life (QoL). Design, Setting, and Participants: This prospective cohort study included patients diagnosed with solid tumor starting in May 7, 2013, with the last follow-up on June 30, 2022. Patients with solid tumors were categorized into SO and non-SO groups according to ESPEN-EASO criteria. The primary outcome was OS and the secondary outcomes included patient QoL and risk of intensive care unit (ICU) admission. Data were analyzed from June to December 2023. Results: A total of 6790 patients were included in the study (mean [SD] age, 59.64 [10.77] years; 3489 were female [51.4%]). The prevalence of SO was 4.36% (296 of 6790) in the whole cohort and 14.98% (296 of 1976) in the subgroup with obesity. SO prevalence increased with age. During a median (IQR) follow-up period of 6.83 (5.67-7.04) years, 2103 patients died. Cox regression analysis indicated that SO was independently associated with lower OS (hazard ratio [HR], 1.54; 95% CI, 1.23-1.92), which was observed in both men (HR, 1.51; 95% CI, 1.09-2.10) and women (HR, 1.53; 95% CI, 1.12-2.07). SO was also associated with poorer QoL and higher risk of ICU admission (odds ratio, 2.39; 95% CI, 1.06-5.29). Among the diagnostic components of SO, low hand grip strength (HGS) was the only SO component associated with poor OS (HR, 1.15; 95% CI, 1.04-1.28). Conclusions and Relevance: This cohort study of SO found that SO was significantly associated with lower OS, poorer QoL, and higher risk of ICU admission. Weak HGS, 1 of the diagnostic conditions, was the only component of SO associated with OS. The ESPEN-EASO algorithm appears to be an applicable tool to identify cancer-associated SO, which represents a major clinical complication and factor associated with risk for poor outcomes in these patients.


Subject(s)
Neoplasms , Obesity , Quality of Life , Sarcopenia , Humans , Male , Female , Neoplasms/epidemiology , Neoplasms/mortality , Neoplasms/complications , Middle Aged , Obesity/epidemiology , Obesity/complications , Sarcopenia/epidemiology , Prospective Studies , Aged , Prevalence
19.
Rev Med Liege ; 79(5-6): 400-404, 2024 Jun.
Article in French | MEDLINE | ID: mdl-38869130

ABSTRACT

Type 2 diabetes (T2D) represents a major medical and public health problem. The ability to prevent or delay T2D by modifying some of its risk factors has been hypothesized for several decades. Indeed, the slow and gradual deterioration of glycaemia prior to the diabetes diagnosis constitutes a period during which interventions could be effective in preventing T2D. Lifestyle modifications demonstrated that modest weight loss (at least 7% of initial weight) and moderate to intense physical activity of at least 150 minutes per week, markedly and significantly delayed the onset of T2D in subjects at high risk of developing the disease. Pharmacological interventions indicated that metformin should be considered, particularly in young patients (< 60 years) with a body mass index ≥ 35 kg/m², and in women with a history of gestational diabetes. Bariatric surgery, which allows significant weight loss in subjects with severe or morbid obesity, has also demonstrated important preventive effectiveness and metabolic surgery in now considered in at-risk patients with less severe obesity. In conclusion, in overweight or obese adults at high risk of developing T2D, treatment aimed at losing weight (including bariatric surgery) and increasing physical activity should be implemented, and a pharmacotherapy might be considered case by case.


Le diabète de type 2 (DT2) constitue un problème majeur, tant au niveau médical individuel qu'en termes de santé publique. La capacité de prévenir ou retarder le DT2 en modifiant certains facteurs de risque est une hypothèse envisagée depuis plusieurs décennies. En effet, la lente et graduelle détérioration de la glycémie avant le diagnostic de diabète constitue une période au cours de laquelle des interventions pourraient se révéler efficaces. Les modifications de comportement concernant le mode de vie ont démontré qu'une perte de poids modeste (au moins 7 % du poids initial) et une activité physique modérée à intense d'au moins 150 minutes par semaine retardaient, de manière importante et significative, l'apparition du DT2 chez des sujets à haut risque de développer la maladie. Au niveau médicamenteux, la metformine s'est également révélée efficace, en particulier chez les patients jeunes (< 60 ans) avec un indice de masse corporelle ≥ 35 kg/m², et chez les femmes avec des antécédents de diabète gestationnel. La chirurgie bariatrique, qui permet d'obtenir une perte de poids importante chez les sujets avec obésité sévère ou morbide, a également démontré une grande efficacité pour prévenir la survenue d'un DT2. Une chirurgie métabolique est même maintenant envisagée chez des sujets à risque avec une obésité moins sévère. En conclusion, chez les adultes en surpoids ou obèses à haut risque de développer un DT2, une prise en charge visant à perdre du poids (y compris via la chirurgie bariatrique) et augmenter l'activité physique devrait être mise en place, couplée le cas échéant à une approche pharmacologique.


Subject(s)
Diabetes Mellitus, Type 2 , Humans , Diabetes Mellitus, Type 2/prevention & control , Diabetes Mellitus, Type 2/complications , Bariatric Surgery , Life Style , Risk Factors , Hypoglycemic Agents/therapeutic use , Weight Loss , Obesity/complications , Exercise , Female
20.
Sci Rep ; 14(1): 13411, 2024 06 11.
Article in English | MEDLINE | ID: mdl-38862756

ABSTRACT

A novel concept of Metabolic Associated Fatty Liver Disease (MAFLD) was proposed, incorporating metabolic abnormalities such as obesity and diabetes, which are risk factors that affect the prognosis. Non-Alcoholic Fatty Liver Disease (NAFLD), entails fat accumulation in the liver without alcohol consumption and is often linked to obesity, insulin resistance, and metabolic syndrome. However, the broad nature of the disease concept has hindered prognosis accuracy. In this study, we assess the contribution of the impact of diagnostic criteria for MAFLD on metabolic disease progression compared to conventional diagnostic criteria for NAFLD. A total of 7159 patient who were presented to the health screening center in Tokai University Hospital both in 2015 and 2020 were included in the study. Fatty liver was diagnosed using abdominal ultrasonography. The diagnostic criteria for NAFLD were consistent with the global guidelines based on alcohol consumption. The diagnostic criteria for MAFLD were based on the International Consensus Panel. Medications (anti-hypertensive, diabetic, and dyslipidemia medications) were evaluated by self-administration in the submitted medical questionnaire. A total of 2500 (34.9%) participants were diagnosed with fatty liver (FL +), 1811 (72.4%) fit both NAFLD and MAFLD diagnostic criteria (overlap), 230 (9.2%) fit only the NAFLD diagnostic criteria (NAFLD group) and 404 (16.1%) fit the MAFLD diagnostic criteria (MAFLD group) at 2015. Over the next 5 years, medication rates increased in the NAFLD group for anti-hypertensive, + 17 (7.4%); diabetes, + 3 (1.3%); and dyslipidemia, + 32 (13.9%). In contrast, the only-MAFLD group showed a more significant increase with + 49 (12.1%), + 21 (5.2%), and + 49 (12.1%), for the respective medications, indicating a substantial rise in patients starting new medications. Our analysis of repeated health check-ups on participants revealed that the diagnostic criteria for MAFLD are more predictive of future treatment for metabolic disease than conventional diagnostic criteria for NAFLD.


Subject(s)
Non-alcoholic Fatty Liver Disease , Humans , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/metabolism , Non-alcoholic Fatty Liver Disease/drug therapy , Male , Female , Middle Aged , Adult , Metabolic Syndrome/complications , Prognosis , Risk Factors , Disease Progression , Aged , Obesity/complications
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