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1.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(1): 54-59, 2020 Jan.
Artículo en Chino | MEDLINE | ID: mdl-31950790

RESUMEN

Objective: To analyze the risk factors of dyslipidemia of adult residents in Shunqing District of Nanchong City. Methods: A five-stage stratified cluster sampling method was used to select adult residents from 9 communities in the urban area of Shunqing District of Nanchong City from January 2013 to April 2018 for questionnaires survey,physical measurement and laboratory test. Univariate analysis and multivariate logistic regression analysis were used to study the influencing factors of dyslipidemia. Results: A total of 105 956 people was investigated,and the prevalence rate of dyslipidemia was 34.2% (36 272 cases). Among them, the prevalence rate of male was 38.11%, and 31.91% for female ( P<0.01). The proportion of dyslipidemia with hypertension, diabetes, and coronary heart disease was 13.46%, 5.74%, and 0.39%, respectively. The proportion of hypertension with diabetes was 2.79%. Multivariate logistic regression analysis showed that gender (odds ratio ( OR)=1.276, P<0.001), body mass index ( OR=1.052, P<0.001), education level (set ≤elementary school as reference, high school OR=1.094, P<0.001, ≥graduated OR=1.185, P<0.001), smoking history ( OR=1.124, P<0.001), coronary heart disease ( OR=1.189, P<0.001), hypertension ( OR=1.148, P<0.001),sdiabetes ( OR=1.967, P<0.001), and family history of dyslipidemia ( OR=1.760, P<0.001) were the influencing factors of dyslipidemia in residents of this region. Conclusions The dyslipidemia of urban residents in Nanchong area is highly concerned with hypertension, diabetes, and coronary heart disease. Male, obesity, high education level, smoking, coronary heart disease, hypertension, diabetes, and family history of dyslipidemia are risk factors for dyslipidemia in urban residents of Nanchong area. It is necessary to actively target the above risk factors and high-risk groups.


Asunto(s)
Dislipidemias , Adulto , China/epidemiología , Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Masculino , Obesidad/epidemiología , Prevalencia , Factores de Riesgo
2.
Mymensingh Med J ; 29(1): 66-72, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915338

RESUMEN

Various forms of sexual dysfunction occur in men with diabetes mellitus (DM) including disorders of libido, ejaculatory problems, and erectile dysfunction (ED). This cross sectional study was conducted in a tertiary hospital of Bangladesh from December 2017 to May 2018 to find out the frequency and risk factors of ED in subjects with type 2 DM (T2DM). One hundred fifty (150) consecutive male patients with T2DM attending the Endocrinology outpatient department (OPD) of the hospital during the study period were evaluated for the presence of ED by using the International Index of Erectile Function-5 (IIEF-5) questionnaire; their socio-demographic, anthropometric, and clinical data were also recorded. Glycemic status was assessed by measurement of fasting plasma glucose (FPG) and HbA1c. Morning serum testosterone was measured in all. Among 150 subjects 68(45.3%) had ED; ED was mild in 14.7%, mild to moderate in 18.0%, moderate in 6.0% whereas severe ED was present in 6.7% of the subjects. The subjects with ED had higher mean age, longer duration of DM, higher body mass index (BMI), higher HbA1c, higher FPG, higher serum creatinine, and lower serum testosterone level than those without ED. Study subjects in the higher age group and higher duration of DM had higher frequencies of ED. IIEF-5 score showed significant negative correlation with age, duration of DM, HbA1c, fasting plasma glucose, serum creatinine and significant positive correlation with serum testosterone. In logistic regression analysis, duration of DM and serum testosterone were found be independent predictors of ED. Frequency of ED among Bangladeshi type 2 diabetic males is high; duration of DM and serum testosterone are independent predictors of ED in them.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Disfunción Eréctil/epidemiología , Adulto , Distribución por Edad , Bangladesh/epidemiología , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Disfunción Eréctil/etiología , Hemoglobina A Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Prevalencia , Factores de Riesgo , Testosterona/sangre
3.
Mymensingh Med J ; 29(1): 142-148, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915350

RESUMEN

Hypertension (HTN) is an important cause of cardiovascular mortality and the prevalence of hypertension is increasing particularly in middle- and low-income countries including Bangladesh. No data are available for the prevalence of hypertension among the government employees in Bangladesh. In this cross-sectional study, conducted from 30 October to 31 December 2016, 1219 government employees aging ≥18 years working in Rangpur city were evaluated for the presence of HTN and its risk factors. Socio-demographic and anthropometric data, data on the presence of various known risk factors of hypertension were collected. Hypertension was defined with systolic BP ≥140mmHg and/or diastolic BP ≥90mmHg or those getting treatment for hypertension. Statistical analysis was done by using SPSS version 23.0; odds of hypertension among subjects with risk factors were calculated and p ≤0.05 was considered to be statistically significant. The prevalence of hypertension was 38.3% among the study subjects. Significantly higher odds of having hypertension were observed in study subjects with the age groups of 35-49 (OR 2.12, 95% CI: 1.51-2.99, p<0.001) and ≥50 (OR: 4.96, 95% CI: 3.43-7.18, p<0.001) years than age group <35 years. Employees who were averagely satisfied and not satisfied for their jobs also had higher odds (OR: 1.38, 95% CI: 1.00-1.91, p=0.049 and OR: 1.48, 95% CI: 3.43-7.18, p=0.337) of having hypertension than fully satisfied ones. Having diabetes mellitus was found to increase the odds (OR 2.12, 95% CI: 1.51-2.99, p<0.001) of hypertension. Male gender, urban/suburban residence, not doing physical exercise, sedentary/light working habit, overweight/obesity also increased the odds of having hypertension though these were not statistically significant. There is a high burden of hypertension among the government employees in Rangpur city. Age, job satisfaction and diabetes were independent risk factors of hypertension.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus/epidemiología , Empleados de Gobierno/estadística & datos numéricos , Hipertensión/epidemiología , Obesidad/epidemiología , Adulto , Bangladesh/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Distribución por Sexo , Población Suburbana/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
4.
BJOG ; 127(3): 345-354, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31749274

RESUMEN

OBJECTIVES: To describe the population of women having bariatric surgery and compare the pregnancy outcomes for women having bariatric surgery with a non-bariatric surgery population having a first and second pregnancy. DESIGN: Population-based record linkage study. SETTING: New South Wales (NSW), Australia. POPULATION: All women aged 15-45 years with a hospital record in NSW (2002-2014) and all women giving birth in NSW (1994-2015; n = 1 606 737 women). METHODS: Pregnancy and birth outcomes were compared between first and second pregnancies using repeated-measures logistic regression and paired Student's t-tests. Bariatric and non-bariatric groups were also compared. MAIN OUTCOME MEASURES: Maternal diabetes, preterm birth (<37 weeks of gestation) and large for gestational age. RESULTS: There was a 13-fold increase in hospitalisations for primary bariatric surgery during 2002-2014. Compared with the general birthing population, women who had bariatric surgery experienced higher rates of hypertension, diabetes, and preterm birth. Among women who had bariatric surgery between a first and second pregnancy, there were reduced rates of hypertension (OR 0.39, 95% CI 0.29-0.53), spontaneous preterm birth (OR 0.37, 95% CI 0.16-0.86), infants that were large for gestational age (OR 0.63, 95% CI 0.44-0.88), and the admission of infants to a special care nursery or neonatal intensive care (OR 0.64, 95% CI 0.46-0.90) in the second pregnancy. Rates for small-for-gestational age and gestational diabetes following surgery were 8.3 and 11.4%, respectively CONCLUSIONS: Bariatric surgery between a first and second pregnancy was associated with reductions in obesity-related adverse pregnancy outcomes. Bariatric surgery performed for the management of obesity in accordance with current clinical criteria is associated with improved pregnancy outcomes in a subsequent pregnancy. TWEETABLE ABSTRACT: Bariatric surgery for obesity may improve pregnancy and birth outcomes in a subsequent pregnancy.


Asunto(s)
Cirugía Bariátrica , Diabetes Gestacional , Obesidad , Nacimiento Prematuro/epidemiología , Sistema de Registros/estadística & datos numéricos , Adulto , Australia/epidemiología , Cirugía Bariátrica/métodos , Cirugía Bariátrica/estadística & datos numéricos , Peso al Nacer , Cesárea/estadística & datos numéricos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Femenino , Humanos , Recién Nacido , Almacenamiento y Recuperación de la Información , Obesidad/epidemiología , Obesidad/cirugía , Paridad , Embarazo , Resultado del Embarazo/epidemiología
5.
Urology ; 135: 124-132, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31655079

RESUMEN

CONTEXT: Phimosis is considered virtually universal in newborn males and likely to resolve within a few years. Persistent phimosis can result in pain, sexual dysfunctions, increased risk of penile inflammatory conditions and penile cancer. There are two forms - primary phimosis and secondary phimosis - the latter often representing a consequence of lichen sclerosis, diabetes and obesity. OBJECTIVES: To conduct a systematic review to determine the prevalence of phimosis at different ages. DATA SOURCES: PubMed, Google Scholar, the Cochrane Library, and bibliographies of original studies were searched using the keyword phimosis. STUDY SELECTION: Studies containing original data on phimosis at any age. DATA EXTRACTION: Two reviewers independently verified study design, extracted data and rated studies for quality. RESULTS: Forty-three eligible studies were included: 27 from PubMed, 4 from Google Scholar, and 12 from bibliography searches. Phimosis was reported in most newborns, then gradually decreased in prevalence. Most studies did not differentiate primary from secondary phimosis, so values reported were net phimosis prevalence. There were 13 studies with data for males age ≥18 years. In all, 962 of 17,136 men had been diagnosed with phimosis (range 0.5%-13%). A random effects model found risk of phimosis in men was 3.4% (95% CI 1.8-6.6). CONCLUSION: Phimosis takes many years to resolve. Apart from spontaneous resolution, clinical interventions also contribute to the gradual reduction in prevalence among uncircumcised boys. The wide range of phimosis prevalence reported in adulthood may reflect variability in the extent of foreskin-preserving treatment of phimosis in different study cohorts.


Asunto(s)
Fimosis/epidemiología , Diabetes Mellitus/epidemiología , Humanos , Liquen Escleroso y Atrófico/complicaciones , Liquen Escleroso y Atrófico/epidemiología , Masculino , Obesidad/complicaciones , Obesidad/epidemiología , Fimosis/etiología , Prevalencia
6.
Eur J Endocrinol ; 182(1): G1-G32, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31855556

RESUMEN

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.


Asunto(s)
Índice de Masa Corporal , Hipotiroidismo/diagnóstico , Obesidad/diagnóstico , Comorbilidad , Endocrinología , Humanos , Hipotiroidismo/epidemiología , Obesidad/epidemiología , Prevalencia , Pruebas de Función de la Tiroides
7.
Lancet ; 395(10217): 65-74, 2020 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-31852602

RESUMEN

The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.


Asunto(s)
Desnutrición/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , África del Sur del Sahara/epidemiología , Calidad de los Alimentos , Humanos , Indonesia/epidemiología , Desnutrición/etiología , Estado Nutricional , Valor Nutritivo , Obesidad/etiología , Sobrepeso/etiología , Pobreza , Prevalencia , Factores Socioeconómicos
8.
Lancet ; 395(10217): 75-88, 2020 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-31852605

RESUMEN

Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Life-course exposure to early undernutrition followed by later overweight increases the risk of non-communicable disease, by imposing a high metabolic load on a depleted capacity for homoeostasis, and in women increases the risk of childbirth complications. These life-course trajectories are shaped both by societal driving factors-ie, rapidly changing diets, norms of eating, and physical activity patterns-and by broader ecological factors such as pathogen burden and extrinsic mortality risk. Mitigation of the DBM will require major societal shifts regarding nutrition and public health, to implement comprehensive change that is sustained over decades, and scaled up into the entire global food system.


Asunto(s)
Desnutrición/metabolismo , Obesidad/metabolismo , Sobrepeso/metabolismo , África del Sur del Sahara/epidemiología , Edad de Inicio , Ejercicio , Femenino , Microbioma Gastrointestinal , Humanos , Indonesia/epidemiología , Masculino , Desnutrición/epidemiología , Desnutrición/microbiología , Redes y Vías Metabólicas , Estado Nutricional , Obesidad/epidemiología , Obesidad/microbiología , Sobrepeso/epidemiología , Sobrepeso/microbiología , Prevalencia
9.
Sci Total Environ ; 702: 135040, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31726339

RESUMEN

Living in greener places may protect against obesity, but epidemiological evidence is inconsistent and mainly comes from developed nations. We aimed to investigate the association between greenness and obesity in Chinese adults and to assess air pollution and physical activity as mediators of the association. We recruited 24,845 adults from the 33 Communities Chinese Health Study in 2009. Central and peripheral obesity were defined by waist circumference (WC) and body mass index (BMI), respectively, based on international obesity standards. The Normalized Difference Vegetation Index (NDVI) was used to quantify community greenness. Two-level logistic and generalized linear mixed regression models were used to evaluate the association between NDVI and obesity, and a conditional mediation analysis was used also performed. In the adjusted models, an interquartile range increase in NDVI500-m was significantly associated with lower odds of peripheral 0.80 (95% confidence interval [CI]: 0.74-0.87) and central obesity 0.88 (95% CI: 0.83-0.93). Higher NDVI values were also significantly associated with lower BMI. Age, gender, and household income significantly modified associations between greenness and obesity, with stronger associations among women, older participants, and participants with lower household incomes. Air pollution mediated 2.1-20.8% of the greenness-obesity associations, but no mediating effects were observed for physical activity. In summary, higher community greenness level was associated with lower odds of central and peripheral obesity, especially among women, older participants, and those with lower household incomes. These associations were partially mediated by air pollutants. Future well-designed longitudinal studies are needed to confirm our findings.


Asunto(s)
Obesidad/epidemiología , Desarrollo Sostenible , Contaminación del Aire , Índice de Masa Corporal , China/epidemiología , Ciudades/epidemiología , Ejercicio , Humanos , Características de la Residencia , Factores Socioeconómicos , Población Urbana/tendencias
10.
Sci Total Environ ; 699: 134397, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31677469

RESUMEN

Children are vulnerable to air pollution-induced lung function deficits, and the prevalence of obesity has been increasing in children. To evaluate the joint effects of long-term PM1 (particulate matter with an aerodynamic diameter ≤ 1.0 µm) exposure and obesity on children's lung function, a cross-sectional sample of 6740 children (aged 7-14 years) was enrolled across seven northeastern Chinese cities from 2012 to 2013. Weight and lung function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF), were measured according to standardized protocols. Average PM1, PM2.5, PM10 and nitrogen dioxide (NO2) exposure levels were estimated using a spatiotemporal model, and sulphur dioxide (SO2) and ozone (O3) exposure were estimated using data from municipal air monitoring stations. Two-level logistic regression and general linear models were used to analyze the joint effects of body mass index (BMI) and air pollutants. The results showed that long-term air pollution exposure was associated with lung function impairment and there were significant interactions with BMI. Associations were stronger among obese and overweight than normal weight participants (the adjusted odds ratios (95% confidence intervals) for PM1 and lung function impairments in three increasing BMI categories were 1.50 (1.07-2.11) to 2.55 (1.59-4.07) for FVC < 85% predicted, 1.44 (1.03-2.01) to 2.51 (1.53-4.11) for FEV1 < 85% predicted, 1.34 (0.97-1.84) to 2.04 (1.24-3.35) for PEF < 75% predicted, and 1.34 (1.01-1.78) to 1.93 (1.26-2.95) for MMEF < 75% predicted). Consistent results were detected in linear regression models for PM1, PM2.5 and SO2 on FVC and FEV1 impairments (PInteraction < 0.05). These modification effects were stronger among females and older participants. These results can provide policy makers with more comprehensive information for to develop strategies for preventing air pollution induced children's lung function deficits among children.


Asunto(s)
Contaminación del Aire/estadística & datos numéricos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Obesidad/epidemiología , Adolescente , Contaminantes Atmosféricos/análisis , Niño , China/epidemiología , Ciudades , Femenino , Volumen Espiratorio Forzado , Humanos , Pulmón/efectos de los fármacos , Masculino , Dióxido de Nitrógeno/análisis , Sobrepeso , Ozono/análisis , Material Particulado/análisis , Pruebas de Función Respiratoria , Dióxido de Azufre , Capacidad Vital
11.
Niger J Clin Pract ; 22(12): 1685-1692, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793475

RESUMEN

Objectives: Obesity was previously seen as a problem in high-income countries. It is also a problem in low and middle-income countries today. The sedentary lifestyle has made this situation more pronounced. Childhood obesity continues in adulthood. Adequate and balanced nutrition and mobile lifestyle have a great role in the prevention and treatment of obesity. The aim of this study was to determine the prevalence of obesity among primary and secondary school students and related factors. Methods: The sample size was calculated as 1278 (213 × 6) for the gender distribution to be appropriate and for the primary and secondary school students to be included in the district center and villages. Considering 15% of the students' non-response rate, the number of students planned to be reached is 1500. Selection was made after the students were ranked by class, gender and place of residence. Of the 1500 students who were sampled, 1298 (86.53%) were evaluated. Results: There was no difference in body mass index between gender and place of residence. The prevalence of being overweight or obesity among secondary school students (25.2%) was significantly higher than primary school students (20.5%). Conclusion: In the childhood age group; sedentary lifestyle, having breakfast and obesity in parents had a significant effect on obesity. It is considered important for children and family members to have proper nutrition and mobile life behaviors.


Asunto(s)
Estilo de Vida , Obesidad/epidemiología , Sobrepeso/epidemiología , Estudiantes/estadística & datos numéricos , Adolescente , Adulto , Índice de Masa Corporal , Niño , Femenino , Humanos , Masculino , Prevalencia , Instituciones Académicas
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1386-1391, 2019 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-31838809

RESUMEN

Objective: To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors. Methods: A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting. Results: The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement. Conclusion: It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.


Asunto(s)
Obesidad , Sobrepeso , Adolescente , Adulto , Anciano , Índice de Masa Corporal , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Sobrepeso/epidemiología , Vigilancia de la Población/métodos , Prevalencia , Factores de Riesgo
13.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852078

RESUMEN

We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.


Asunto(s)
Índice de Masa Corporal , Obesidad/complicaciones , Cáncer Papilar Tiroideo/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Tiroidectomía/métodos , Estudios de Casos y Controles , China/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Estudios Retrospectivos , Cáncer Papilar Tiroideo/etiología , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/cirugía
14.
Medicine (Baltimore) ; 98(51): e18354, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31860991

RESUMEN

Many cancer patients develop diabetes, which may result in reduction of chemotherapy effectiveness and increased infection risk and cardiovascular mortality. Diabetes may also increase the risks of chemotherapy-related toxicity and post-operative mortality, or represent an obstacle to optimal cancer treatment. However, the clinical predictors of diabetes in cancer patients remain largely unknown. Therefore, the aim of our study was to evaluate the risk factors for developing diabetes and construct a nomogram to predict diabetes in cancer patients.We investigated patients from a national sample cohort obtained from the Korea National Health Insurance Service (KNHIS), which included 2% of the Korean population. Patients who had undergone routine medical evaluation by the KNHIS between 2004 and 2008 and been hospitalized due to cancer (ICD-10 codes C00-97) during the past 3 years were included. After excluding patients with type 2 diabetes and missing data, 10,899 patients were enrolled and followed-up until 2013. A total of 7630 (70%) patients were assigned as the training cohort and used to construct the nomogram which was based on a multivariable logistic regression model. The remaining patients (n = 3269) were used as the validation cohort.The incidence rate of diabetes was 12.1 per 1000 person-years over a mean follow-up of 6.6 ±â€Š1.8 years. Significant risk factors for developing diabetes were age, sex, obesity, fasting plasma glucose, hypertension, and hypercholesterolmia. A nomogram was constructed using these variables and internally validated. The area under the curve was 0.70 (95% confidence interval, .666-.730, P < .0001) and the calibration plot showed agreement between the actual and nomogram-predicted diabetes probabilities.The nomogram developed in this study is easy to use and convenient for identifying cancer patients at high-risk for type 2 diabetes, enabling early type 2 diabetes screening and management.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Neoplasias/epidemiología , Medición de Riesgo , Factores de Edad , Anciano , Glucemia/análisis , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Incidencia , Masculino , Nomogramas , Obesidad/epidemiología , República de Corea/epidemiología , Factores de Riesgo , Distribución por Sexo , Factores Sexuales
15.
Medicine (Baltimore) ; 98(50): e18397, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852158

RESUMEN

There are still many controversies about the characteristics and prognosis of gastric cardia cancer. We aimed to evaluate the clinical characteristics and outcome between cardia and noncardia cancer. Also, we evaluated the clinical outcome according to etiologic factors.We performed a retrospective cohort study of 92 patients with gastric cardia cancer from January 2003 to December 2013. The patients with noncardia cancer were selected as age- and sex-matched control.The frequencies of gastroesophageal reflux disease (GERD) and negative Helicobacter pylori infection without atrophy were significantly higher in gastric cardia cancers, but there was no difference in the frequency of obesity. The frequency of early gastric cancers was 40.0%, which was significantly lower than that of noncardia cancer. The rate of recurrence, disease-free survival, and overall survival duration were significantly lower in gastric cardia cancers (P < .01), even though there was no significant difference in the rate of curative resection (R0). In terms of the etiologic factors, there were no differences of disease prognosis, regardless of the presence of GERD, obesity, and H pylori infection with associated gastritis.Gastric cardia cancer showed distinct clinical characteristics and a negative prognostic impact compared with gastric noncardia cancer.


Asunto(s)
Adenocarcinoma/etiología , Cardias , Neoplasias Gástricas/etiología , Adenocarcinoma/diagnóstico , Adenocarcinoma/epidemiología , Estudios de Casos y Controles , Supervivencia sin Enfermedad , Reflujo Gastroesofágico/diagnóstico , Reflujo Gastroesofágico/epidemiología , Reflujo Gastroesofágico/etiología , Infecciones por Helicobacter/epidemiología , Humanos , Recurrencia Local de Neoplasia/epidemiología , Obesidad/epidemiología , Pronóstico , Estudios Retrospectivos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiología
16.
N Engl J Med ; 381(25): 2440-2450, 2019 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-31851800

RESUMEN

BACKGROUND: Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity. METHODS: We developed methods to correct for self-reporting bias and to estimate state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI). BMI data reported by 6,264,226 adults (18 years of age or older) who participated in the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias with the use of measured data from 57,131 adults who participated in the National Health and Nutrition Examination Survey. We fitted multinomial regressions for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI [the weight in kilograms divided by the square of the height in meters], <25), overweight (25 to <30), moderate obesity (30 to <35), and severe obesity (≥35). We evaluated the accuracy of our approach using data from 1990 through 2010 to predict 2016 outcomes. RESULTS: The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low-income adults (31.7%; 95% CI, 30.2 to 33.2). CONCLUSIONS: Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with large disparities across states and demographic subgroups. (Funded by the JPB Foundation.).


Asunto(s)
Obesidad Mórbida/epidemiología , Obesidad/epidemiología , Adulto , Índice de Masa Corporal , Femenino , Predicción , Humanos , Renta , Masculino , Obesidad/etnología , Obesidad Mórbida/etnología , Prevalencia , Autoinforme , Distribución por Sexo , Estados Unidos/epidemiología
17.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 833-839, 2019 Dec 25.
Artículo en Chino | MEDLINE | ID: mdl-31874473

RESUMEN

Objective: To examine the association of pre-pregnancy obesity, excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with the risk of large for gestational age (LGA), and assess the dynamic changes in population attributable risk percent (PAR%) for having these exposures. Methods: A retrospective cohort study was conducted to collect data on pregnant women who received regular health care and delivered in Beijing Obstetrics and Gynecology Hospital from January to December in 2011, 2014 and 2017, respectively. Information including baseline characteristics, metabolic indicators during pregnancy, pregnancy complications, and pregnancy outcomes were collected. Multivariate logistic regression model was constructed to assess their association with LGA delivery. Adjusted relative risk and prevalence of these factors were used to calculate PAR%and evaluate the comprehensive risk. Results: (1)The number of participants were 11 132, 13 167 and 4 973 in 2011, 2014 and 2017, respectively. Corresponding prevalence of LGA were 15.19% (1 691/11 132), 14.98% (1 973/13 167) and 16.21% (806/4 973). No significant change in the prevalence of LGA was observed across all years investigated (all P>0.05). (2)According to results from multivariate logistic regression model, advanced maternal age, multiparity, pre-pregnancy overweight or obesity, GWG,GDM and serum triglyceride level≥1.7 mmol/L in the first trimester were associated with high risk of LGA (all P<0.05). Among these factors, pre-pregnancy overweight or obesity, excessive GWG and multiparity were common risk factors of LGA. GDM was not associated with risk of LGA in 2017 database. (3) Dynamic change of PAR% in these years were notable. PAR% of GWG for LGA decreased (32.6%, 27.2% and 22.2% in 2011, 2014 and 2017, respectively), while PAR% of pre-pregnancy overweight or obesity showed an upward trend (4.2%, 3.3% and 8.4%). In addition, PAR% of multiparity increased as well (3.5%, 6.3% and 15.9%). (4) Further analysis showed that excessive GWG in the first and second trimesters contributed the most (20.2% and 19.0% in 2014 and 2017). Conclusions: Excessive GWG, pre-pregnancy overweight or obesity and multiparity are the important risk factors what contribute to LGA. PAR% of excessive GWG for LGA decrease in recent years. However, GWG in the first and second trimesters is a critical factor of LGA. Appropriate weight management in pre-pregnancy, the first or second trimester is the key point to reduce the risk of LGA.


Asunto(s)
Diabetes Gestacional/epidemiología , Macrosomía Fetal/epidemiología , Obesidad/complicaciones , Peso al Nacer , Índice de Masa Corporal , China/epidemiología , Femenino , Macrosomía Fetal/etiología , Edad Gestacional , Humanos , Obesidad/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Retrospectivos , Aumento de Peso
18.
Pan Afr Med J ; 34: 38, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31762905

RESUMEN

Introduction: The prevalence of diabetes mellitus is rising at an alarming rate, calling for more insights into its pathogenetic mechanisms, and other factors involved in its progression. The prevalence of vitamin D deficiency is higher in diabetic compared to non-diabetic patients, and is associated with poor glycaemic control. This has not been documented among diabetic patients in Kenya. Aims: to determine the prevalence of hypovitaminosis D among type 2 diabetic patients at Kenyatta National Hospital in Nairobi, Kenya. Methods: We recruited type 2 diabetic patients on follow-up at Kenyatta National Hospital. Measurements of height, weight and waist/hip ratios were taken. We drew 6mls of peripheral blood to determine vitamin D, zinc and HbA1c levels. Results: A total of 151 participants were recruited, with 69.5% females and mean age of 58.2 years. Hypertension was found in 72.8% of the participants, and obesity in 37.7%. The mean HbA1c levels were 8.46%, and 62.9% had poor glycaemic control. The mean vitamin D level was 31.40ng/ml. Vitamin D deficiency and insufficiency was found in 38.4% and 21.9% of the participants respectively. We found a significant inverse correlation between vitamin D and glycaemic control (r = -0.09, p = 0.044) and vitamin D and BMI (r = - 0.145, p = 0.045). Conclusion: In this study population on long-term follow-up for diabetes, there was high prevalence of vitamin D deficiency. This forms a basis for further management of patients with poor glycaemic control. Further studies are needed to document the causal association between poor glycaemic control and vitamin D deficiency.


Asunto(s)
Glucemia , Diabetes Mellitus Tipo 2/epidemiología , Deficiencia de Vitamina D/epidemiología , Anciano , Estudios Transversales , Diabetes Mellitus Tipo 2/patología , Femenino , Estudios de Seguimiento , Hemoglobina A Glucada/metabolismo , Humanos , Hipertensión/epidemiología , Kenia , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Prevalencia
19.
BMC Public Health ; 19(1): 1424, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666052

RESUMEN

BACKGROUND: Tobacco smoking, alcohol and obesity are important risk factors for a number of non-communicable diseases. The prevalence of these risk factors differ by socioeconomic group in most populations, but this socially stratified distribution may depend on the social and cultural context. Little information on this topic is currently available in the Caribbean. The aim of this study was to describe the distribution of tobacco smoking, alcohol drinking and obesity by several socioeconomic determinants in the French West Indies (FWI). METHODS: We used data from a cross-sectional health survey conducted in Guadeloupe and Martinique in 2014 in a representative sample of the population aged 15-75 years (n = 4054). All analyses were stratified by gender, and encompassed sample weights, calculated to account for the sampling design and correct for non-response. For each risk factor, we calculated weighted prevalence by income, educational level, occupational class and having hot water at home. Poisson regression models were used to estimate age-adjusted prevalence ratios (PR) and 95% confidence intervals (CI). RESULTS: Current smoking and harmful chronic alcohol use were more common in men than in women (PR = 1.80, 95% CI = 1.55-2.09; PR = 4.53, 95% CI = 3.38-6.09 respectively). On the other hand, the prevalence of obesity was higher in women than in men (PR = 0.67, 95% CI = 0.57-0.79). Higher education, higher occupational class and higher income were associated with lower prevalence of harmful alcohol drinking in men (PR = 0.43, 95% CI = 0.25-0.72; PR = 0.73, 95% CI = 0.53-1.01; PR = 0.72, 95% CI = 0.51-1.03 respectively), but not in women. For tobacco smoking, no variation by socioeconomic status was observed in men whereas the prevalence of current smoking was higher among women with higher occupational class (PR = 1.47, 95% CI = 1.13-1.91) and higher income (PR = 1.50, 95% CI = 1.11-2.03). In women, a lower prevalence of obesity was associated with a higher income (PR = 0.43, 95% CI = 0.33-0.56), a higher occupational class (PR = 0.63, 95% CI = 0.50-0.80), a higher educational level (PR = 0.36, 95% CI = 0.26-0.50) and having hot water at home (PR = 0.65, 95% CI = 0.54-0.80). CONCLUSION: Women of high socio-economic status were significantly more likely to be smokers, whereas alcohol drinking in men and obesity in women were inversely associated with socioeconomic status.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Escolaridad , Renta , Obesidad/epidemiología , Ocupaciones , Clase Social , Fumar Tabaco/epidemiología , Adolescente , Adulto , Anciano , Región del Caribe , Estudios Transversales , Femenino , Guadalupe/epidemiología , Humanos , Masculino , Martinica/epidemiología , Persona de Mediana Edad , Enfermedades no Transmisibles , Prevalencia , Factores de Riesgo , Factores Sexuales , Abastecimiento de Agua , Adulto Joven
20.
BMJ ; 367: l5837, 2019 10 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666218

RESUMEN

OBJECTIVE: To evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction. DESIGN: Quasi-experimental longitudinal study. SETTING: Large franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018. PARTICIPANTS: 104 restaurants with calorie information added to in-store and drive-thru menus in April 2017 and with weekly aggregated sales data during the pre-labeling (April 2015 to April 2017) and post-labeling (April 2017 to April 2018) implementation period. MAIN OUTCOME MEASURES: Primary outcome was the overall level and trend changes in mean purchased calories per transaction after implementation of calorie labeling compared with the counterfactual (ie, assumption that the pre-intervention trend would have persisted had the intervention not occurred) using interrupted time series analyses with linear mixed models. Secondary outcomes were by item category (entrees, sides, and sugar sweetened beverages). Subgroup analyses estimated the effect of calorie labeling in stratums defined by the sociodemographic characteristics of restaurant census tracts (defined region for taking census). RESULTS: The analytic sample comprised 14 352 restaurant weeks. Over three years and among 104 restaurants, 49 062 440 transactions took place and 242 726 953 items were purchased. After labeling implementation, a level decrease was observed of 60 calories/transaction (95% confidence interval 48 to 72; about 4%), followed by an increasing trend of 0.71 calories/transaction/week (95% confidence interval 0.51 to 0.92) independent of the baseline trend over the year after implementation. These results were generally robust to different analytic assumptions in sensitivity analyses. The level decrease and post-implementation trend change were stronger for sides than for entrees or sugar sweetened beverages. The level decrease was similar between census tracts with higher and lower median income, but the post-implementation trend in calories per transaction was higher in low income (change in calories/transaction/week 0.94, 95% confidence interval 0.67 to 1.21) than in high income census tracts (0.50, 0.19 to 0.81). CONCLUSIONS: A small decrease in mean calories purchased per transaction was observed after implementation of calorie labeling in a large franchise of fast food restaurants. This reduction diminished over one year of follow-up.


Asunto(s)
Ingestión de Energía/fisiología , Comida Rápida/efectos adversos , Etiquetado de Alimentos , Obesidad/prevención & control , Restaurantes/estadística & datos numéricos , Comportamiento del Consumidor/estadística & datos numéricos , Comida Rápida/estadística & datos numéricos , Humanos , Renta/estadística & datos numéricos , Estudios Longitudinales , Ensayos Clínicos Controlados no Aleatorios como Asunto , Obesidad/epidemiología , Obesidad/etiología , Prevalencia , Sudeste de Estados Unidos/epidemiología
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