Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 43.299
Filtrar
1.
BMC Pregnancy Childbirth ; 22(1): 241, 2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35321691

RESUMO

BACKGROUND: Sonography based estimate of fetal weight is a considerable issue for delivery planning. The study evaluated the influence of diabetes, obesity, excess weight gain, fetal and neonatal anthropometrics on accuracy of estimated fetal weight with respect to the extent of the percent error of estimated fetal weight to birth weight for different categories. METHODS: Multicenter retrospective analysis from 11,049 term deliveries and fetal ultrasound biometry performed within 14 days to delivery. Estimated fetal weight was calculated by Hadlock IV. Percent error from birth weight was determined for categories in 250 g increments between 2500 g and 4500 g. Estimated fetal weight accuracy was categorized as accurate ≤ 10% of birth weight, under- and overestimated by > ± 10% - ± 20% and > 20%. RESULTS: Diabetes was diagnosed in 12.5%, obesity in 12.6% and weight gain exceeding IOM recommendation in 49.1% of the women. The percentage of accurate estimated fetal weight was not significantly different in the presence of maternal diabetes (70.0% vs. 71.8%, p = 0.17), obesity (69.6% vs. 71.9%, p = 0.08) or excess weight gain (71.2% vs. 72%, p = 0.352) but of preexisting diabetes (61.1% vs. 71.7%; p = 0.007) that was associated with the highest macrosomia rate (26.9%). Mean percent error of estimated fetal weight from birth weight was 2.39% ± 9.13%. The extent of percent error varied with birth weight with the lowest numbers for 3000 g-3249 g and increasing with the extent of birth weight variation: 5% ± 11% overestimation in the lowest and 12% ± 8% underestimation in the highest ranges. CONCLUSION: Diabetes, obesity and excess weight gain are not necessarily confounders of estimated fetal weight accuracy. Percent error of estimated fetal weight is closely related to birth weight with clinically relevant over- and underestimation at both extremes. This work provides detailed data regarding the extent of percent error for different birth weight categories and may therefore improve delivery planning.


Assuntos
Diabetes Gestacional , Peso Fetal , Peso ao Nascer , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Recém-Nascido , Obesidade/epidemiologia , Gravidez , Estudos Retrospectivos
2.
BMC Endocr Disord ; 22(1): 221, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050672

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women globally. Recent studies have reported that the minor allele (C allele) for melanocortin 4 receptor (MC4R) rs17782313 may be related to the incidence of obesity and the risk of CVD. Therefore, the present study aimed to investigate the interactions between the modified Nordic-style diet score (MND) and MC4R gene variant on markers of CVD. METHODS: The current cross-sectional study was conducted on 282 Iranian women, aged 18-48 years, with a body mass index (BMI) ≥ 25. MND score was assessed using a 147 items food frequency questionnaire (FFQ). Genotyping of the MC4R (rs17782313) was conducted by the PCR method. The anthropometric measurements and serum profiles were assessed by standard protocols. RESULTS: The means and standard deviation (SD) of age, weight, and BMI of individuals were 36.67 ± 9.10 years, 81.29 ± 12.43 kg, and 31.26 ± 4.29 kg/m2, respectively. The overall prevalence of rs17782313 genotypes was 30.1%, 24.8%, and 45.1% for TT, TC, and CC, respectively. Our results showed significant negative interactions between high MND score and rs17782313 SNP in terms of visceral fat level (VFL) (ß: -10.84, 95% CI: -20.64 to -1.04, P = 0.03) and total cholesterol (ß: -24.24, 95% CI: -49.87 to 1.38, P = 0.06) in the crude model. After adjusting confounders, the interaction between high MND scores and VFL remained significant. CONCLUSION: In conclusion, the results of the present study suggest that diet, gene variants, and their interaction should be considered in metabolic disease risk assessment. Further studies are needed to confirm these data and better elucidate the interaction.


Assuntos
Doenças Cardiovasculares , Sobrepeso , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/genética , Estudos Transversais , Dieta , Feminino , Predisposição Genética para Doença , Genótipo , Fatores de Risco de Doenças Cardíacas , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/genética , Sobrepeso/epidemiologia , Sobrepeso/genética , Polimorfismo de Nucleotídeo Único , Receptor Tipo 4 de Melanocortina/genética , Fatores de Risco
3.
Sci Rep ; 12(1): 15066, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064965

RESUMO

We analyzed the associations of screen-based behaviors with obesity, hypertension, and diabetes, and the moderation of different physical activity (PA) domains in these associations. We used data from the 2019 Brazilian National Health Survey, including data from 80,940 adults (mean age of 32.6 years). TV viewing, other screens (PC, tablet, and cell phone), PA domains (leisure-time, occupational, and transport) were collected via interview. Logistic regression models were used. There was a dose-response association of higher TV viewing with diabetes. Within the groups with medium and higher time spent on other screens, those with < 150 min/week in leisure-time PA increased the odds for obesity [1-2.9 h/day: OR = 1.18 (1.01, 1.39)] and hypertension [1-2.9 h/day: OR = 1.29 (1.08, 1.53); ≥ 6 h/day: OR = 1.47 (1.03, 2.09)]. Likewise, among the participants who spent ≥ 6 h/day of TV viewing, those with < 150 min/week of occupational PA presented higher odds for hypertension [OR = 1.61 (1.03, 2.53)]. In the group with higher use of other screens, < 150 min per week of occupational PA was associated with lower odds for obesity [1-2.9 h/day: OR = 0.81 (0.68, 0.97)] and hypertension [≥ 6 h/day: OR = 0.65 (0.44, 0.98)]. In conclusion, the associations of other screens with obesity and hypertension were strongest among those without leisure-time PA, while the moderator role of occupational PA was not clear.


Assuntos
Hipertensão , Comportamento Sedentário , Adulto , Doença Crônica , Exercício Físico/fisiologia , Humanos , Hipertensão/epidemiologia , Obesidade/epidemiologia , Televisão
4.
Cardiovasc Diabetol ; 21(1): 176, 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068534

RESUMO

Obesity is characterized by visceral fat accumulation and various metabolic disturbances that cause metabolic syndrome and obesity-related cardiovascular diseases (ORCVDs). Hence, treatments targeting obesity should also prevent ORCVDs. Nonetheless, lifestyle modification therapy alone is still insufficient to reduce the risk of ORCVDs, although most cardiovascular guidelines still list it as the only treatment for obesity. Additionally, conventional anti-obesity drugs, such as orlistat, phentermine-topiramate, and naltrexone-bupropion, can reduce body weight but have not demonstrated a clear reduction in the risk of ORCVDs. To overcome this unmet clinical need, newer anti-obesity drugs must exhibit not only sufficient and long-lasting weight loss but also obvious cardiovascular benefits. Given recent clinical findings and evidences, in this context glucagon-like peptide-1 receptor agonist is currently available as a candidate that is clinically positioned as a first-line anti-obesity agent for the effective prevention of ORCVDs in people with obesity.


Assuntos
Fármacos Antiobesidade , Doenças Cardiovasculares , Fármacos Antiobesidade/efeitos adversos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Humanos , Liraglutida/uso terapêutico , Obesidade/diagnóstico , Obesidade/tratamento farmacológico , Obesidade/epidemiologia , Orlistate/uso terapêutico
5.
Br J Community Nurs ; 27(9): 436-442, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36070328

RESUMO

There are now over four million people living with diabetes in the UK, the majority having type 2 diabetes. The prevalence of type 2 diabetes is rising in line with growing obesity levels. This article will explore prevalence of type 2 diabetes, its prevention and treatment. It also provides guidance on how nurses can work with people at risk of diabetes, to prevent it, induce remission and create awareness of medications used to treat it.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , Obesidade/epidemiologia , Prevalência
6.
Mayo Clin Proc ; 97(9): 1700-1716, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36058582

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in the United States and worldwide. The progressive form of NAFLD, nonalcoholic steatohepatitis (NASH), is a leading indication for liver transplant. Comorbidities associated with NAFLD development and NASH include type 2 diabetes, obesity, metabolic syndrome, and dyslipidemia. Extrahepatic morbidity and mortality are considerable as NAFLD is associated with an increased risk of cardiovascular disease and chronic kidney disease. Once NAFLD is diagnosed, the presence of liver fibrosis is the central determinant of hepatic prognosis. Severe liver fibrosis requires aggressive clinical management. No pharmacologic agents have regulatory approval in the United States for the treatment of NAFLD or NASH. Management is centered on efforts to reduce underlying obesity (lifestyle, medications, surgical or endoscopic interventions) and metabolic derangements (prediabetes, type 2 diabetes, hypertension, hyperlipidemia, and others). Current pharmacologic therapy for NAFLD is limited mainly to the use of vitamin E and pioglitazone, although other agents are being investigated in clinical trials. Cardiovascular and metabolic risk factors must also be assessed and managed. Here, NAFLD evaluation, diagnosis, and management are considered in the primary care setting and endocrinology clinics.


Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Humanos , Fígado/patologia , Cirrose Hepática/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/terapia , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/terapia , Atenção Primária à Saúde , Estados Unidos
7.
Geriatr Gerontol Int ; 22(9): 736-744, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36058621

RESUMO

AIM: Dietary diversity might reduce the risk of malnutrition, although it is also linked to obesity. We examined whether dietary diversity is associated with all-cause mortality in Japanese older adults based on their body mass index (BMI). METHODS: The current study included 2944 people aged 64-65 years who participated in the New Integrated Suburban Seniority Investigation (NISSIN) project from 1996 to 2005. Dietary diversity was measured using the Food Variety Score (FVS), which calculates the frequency of all food items consumed daily using a self-administered food frequency questionnaire. Participants were divided into tertiles according to their FVS (first: low, second: middle, third: high). Multivariate adjusted hazard ratios with 95% confidence intervals were calculated using the Cox proportional hazard regression model. For the stratified analysis, BMI was used to divide the participants into three groups - lean (BMI <20), normal (BMI 20-24.9) and overweight/obese (BMI ≥25). RESULTS: Overall, 454 (30.7%) men and 222 (15.2%) women died over a median follow-up period of 16.6 years. No significant association was observed between FVS and all-cause mortality. However, when grouped by BMI, for the participants in the lean group, the multivariate adjusted hazard ratios were 0.56 (95% confidence interval 0.32-0.96) for the middle FVS and 0.50 (95% confidence interval 0.25-1.02) for the high FVS, compared with the low FVS (P for trend = 0.059). In overweight/obese women, although not significant, total mortality was higher in the middle and high FVS. CONCLUSIONS: These findings show that dietary diversity should be promoted in lean older Japanese adults. Geriatr Gerontol Int 2022; 22: 736-744.


Assuntos
Obesidade , Sobrepeso , Fatores Etários , Idoso , Índice de Massa Corporal , Feminino , Humanos , Japão/epidemiologia , Masculino , Obesidade/epidemiologia , Estudos Prospectivos
8.
ScientificWorldJournal ; 2022: 7274858, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36061981

RESUMO

Objectives: Previous studies have reported conflicting results regarding the relationship between obesity and the antiaging humoral factor klotho. Thus, the present study aimed to examine the association of anthropometric measurements, weight history change, and vitamin D status with serum klotho levels. Methods: The National Health and Nutrition Examination Survey data were used to compare sex-specific logarithm transformed serum klotho levels across standardized anthropometric measurements and weight change history in subjects aged 40-79 years. The baseline measured height, and self-reported weight were used to calculate the body mass index (BMI) at two-time intervals: age 25 and ten years before the measured BMI. Subjects were then categorized as never obese, obese to nonobese, nonobese to obese, and always obese. Results: Of 4,971 participants, the prevalence of general obesity was 41%, and abdominal obesity (waist circumference ≥88 cm) was present in 75% of women. Overall, lower serum klotho levels were seen in older adults, men, nonsmokers, alcohol users, and those with an estimated glomerular filtration rate (eGFR) < 60 ml/min. Multivariate models demonstrated that general and abdominal obesity in women was inversely associated with serum klotho levels. Moreover, women who developed obesity from age 25 and ten years before the baseline BMI had significantly lower mean klotho levels at 765.0 and 757.4 pg/ml compared with 820.5 pg/ml (p < 0.05) among those that were never obese, respectively. In contrast, serum klotho levels did not significantly differ among men, irrespective of their weight history. In a subanalysis, higher klotho levels were seen in participants with an adequate vitamin D status (≥50 nmol/L) than their overweight and obese counterparts (p < 0.05). Conclusions: Obesity among women was significantly and inversely associated with serum klotho levels. Similarly, women who developed obesity during their lifetime had consistently lower klotho levels than their never-obese counterparts.


Assuntos
Obesidade Abdominal , Obesidade , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/epidemiologia , Obesidade Abdominal/epidemiologia , Vitamina D
9.
Front Public Health ; 10: 980973, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36062130

RESUMO

Background: Change in obesity risk could be related to shift in high blood pressure (HBP) risk, while individualized influence of weight change on high blood pressure is in need of exploration. Methods: A total of 16,446 children (53.47% boys) and 13,9021 effective annual measurements from 2006 to 2020 were recruited. Children's weight status, both at baseline and endpoint, was categorized as underweight, normal, overweight, and obese according to the age and sex-specific Body Mass Index z scores. HBP at late adolescence was defined with the last two measurements for each child. Populational attributable risk (PAR) of weight trait on HBP risk was calculated. Results: Compared to children who maintained normal weight during follow-up, staying obese was associated with the highest HBP risk with OR of 6.39 (95% CI: 4.46, 9.15; p < 0.001) and PAR of 28.71% (95% CI: 21.58, 35.54) in boys, and OR of 6.12 (95% CI: 2.80, 13.37; p < 0.001) and PAR of 12.75% (95% CI: 4.29, 21.02) in girls. Returning from obese to normal weight was associated with lowered HBP risk, with ORs of 1.07 (95% CI: 0.69, 1.66; p = 0.771) in boys and 0.73 (95% CI: 0.25, 2.12; p = 0.566) in girls. Conclusion: Weight loss program could be effective to reduce HBP risk during school age, while the underlying mechanism needs further exploration.


Assuntos
Hipertensão , Adolescente , Pressão Sanguínea/fisiologia , Criança , China/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Masculino , Obesidade/epidemiologia
10.
Allergy Asthma Proc ; 43(5): 446-453, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36065107

RESUMO

Background: Inhaled corticosteroids (ICS) are widely prescribed medications. Some studies have reported that ICS may suppress the hypothalamic-pituitary-adrenal axis and induce systemic effects. Objective: To explore the possibility of a dose-dependent association between the long-term use of ICS and the risk of obesity and other markers of metabolic syndrome. Methods: A 5-year retrospective two-arm cohort study explored patients on asthma and not on ICS relative to patients with asthma who were on varying doses of ICS (low, medium, and high) and attributes such as body mass index (BMI) trajectory and prescription of antihypertensive, antidiabetic, and cholesterol-lowering medications. Results: A total of 229 subjects with asthma were in the control cohort, and 215 subjects with asthma were in the ICS cohort. The ICS cohort was subdivided into individuals on low- (n = 88), medium- (n = 107), or high- (n = 20) dose ICS throughout the 5-year study period. For every 1-year increase in time, the BMI in the high-dose ICS group increased at a rate of 0.25 kg/m² when compared with the subjects in the control group after controlling for age and gender. Also, for every 1-year increase in time, the BMI of those on medium-dose ICS increased by 0.06 kg/m² compared with those in the control group after controlling for age and gender. The subjects on ICS also had a statistically increased risk of being prescribed antihypertensive, antidiabetic, and cholesterol-lowering medications. Conclusion: ICS use in the subjects with asthma was associated with a dose-dependent risk of increasing BMI trajectories over time and an increased requirement for antidiabetic and cholesterol-lowering medications. One possible conclusion from this study is that long-term medium- and high-dose ICS have the potential to induce systemic effects.


Assuntos
Antiasmáticos , Asma , Síndrome Metabólica , Administração por Inalação , Corticosteroides/efeitos adversos , Antiasmáticos/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Asma/tratamento farmacológico , Asma/epidemiologia , Colesterol/uso terapêutico , Estudos de Coortes , Humanos , Hipoglicemiantes/uso terapêutico , Sistema Hipotálamo-Hipofisário , Síndrome Metabólica/induzido quimicamente , Síndrome Metabólica/tratamento farmacológico , Síndrome Metabólica/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Sistema Hipófise-Suprarrenal , Estudos Retrospectivos
11.
Wei Sheng Yan Jiu ; 51(4): 579-603, 2022 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-36047262

RESUMO

OBJECTIVE: To analyze the relationship between food intake and chronic diseases of Dulong minority residents living in Yunnan Province. METHODS: 460 Dulong minority residents 6-80-year-old among 304 families(male 191, female 269, children and adolescents aged 6-17 years old 56, aged 18-44 years old 229, aged 45-59 years old 123, aged 60-80 years old 52)in Gongshan County in Yunnan Province were selected with Stratified multistage cluster sampling method. To apply the method of food frequency questionnaire and questionnaire survey obtain the condition of dietary structure and overweight or obesity, diabetes and dyslipidemia among Dulong minority. Non-conditional Logistic regression analysis was utilized to analyze the correlation between food intake and chronic diseases. RESULTS: The prevalence of overweight or obesity, hypertension, diabetes and dyslipidemia were respectively 20.4%, 19.6%, 32.4% and 50.4% in 2016. Marital status and consumption of melons vegetables(OR=0.540, 95%CI 0.306-0.954), benevolence fruit kind fruit(OR=0.348, 95%CI 0.171-0.706) and low fat milk powder(OR=5.267, 95%CI 1.266-21.911) in the past 12 months were associated with hypertension among the Dulong minority population. For the Dulong minority residents, sex, eaten deep-fried dough stick(OR=0.403, 95%CI 0.182-0.894) in the past 12 months, solanaceous vegetables(OR=0.478, 95%CI 0.275-0.832) and whole milk powder(OR=2.090, 95%CI 1.372-3.184) have something to do with diabetes. Occupation, consumption of beancurd and bamboo vegetables(OR=4.753, 95%CI 1.079-20.937), solanaceous vegetables(OR=2.842, 95%CI 1.175-6.871) and edible fungi(OR=1.794, 95%CI 1.116-2.883) over the past 12 months were linked to the prevalence of overweight. Consumption of fresh legumes(OR=1.991, 95%CI 1.130-3.507), whole milk powder(OR=2.342, 95%CI 1.535-3.575), cooked poultry meat(OR=2.092, 95%CI 1.147-3.815), grass carp(OR=0.580, 95% CI 0.379-0.888)and fresh eggs(OR=0.432, 95%CI 0.196-0.950) and in the past 12 months were associated with dyslipidemia among the Dulong minority residents. CONCLUSION: The prevalence of overweight/obesity was mainly related to occupation, consumption of vegetables and products(solanaceous vegetables, edible fungi), and hypertension was mainly related to Marital status, and the intake of melons vegetables, benevolence fruit kind fruit, low fat milk powder), and diabetes was mainly related to sex, deep-fried dough stick, solanaceous vegetables and whole milk powder, and dyslipidemia was mainly related to Marital status, fresh legumes, whole milk powder, cooked poultry meat, grass carp, and fresh eggs for the Dulong nationality residents aged 6-80 years old in Gongshan County, Yunnan Province.


Assuntos
Diabetes Mellitus , Dislipidemias , Hipertensão , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China/epidemiologia , Doença Crônica , Dieta , Dislipidemias/epidemiologia , Feminino , Frutas , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Pós , Verduras , Adulto Jovem
12.
PLoS One ; 17(9): e0273833, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36048796

RESUMO

BACKGROUND: Malnutrition among women disproportionately exists across socioeconomic classes of Bangladesh. According to our knowledge, studies which attempted to identify determinants and their contributions to explain BMI-based nutritional gap between the poorest and the richest categories of Wealth Index are still scarce. OBJECTIVES: To identify the nutritional gap of women between the richest-poorest classes in Bangladesh, and to determine how much of this gap are attributed to differences in predictors and differences in coefficients. STUDY POPULATION: Reproductive-aged (15-49 years) women of Bangladesh. METHODS AND PROCEDURES: We utilized the latest round (2017-2018) data of the Bangladesh Demographic and Health Survey (BDHS). Body mass index (BMI) has been used to measure the nutritional status of women. The kernel density was used to visualize the nutritional gap. The Oaxaca-Blinder (OB) decomposition method was used to ascertain influential determinants and their contributions to the existing gap between the richest-poorest classes of women. RESULTS: We analyzed the data of 18,682 reproductive-aged women. There was a significant mean BMI gap of 4.1 unit (95% CI: 3.90-4.35) between the poorest-richest (25.6 vs 21.5) women. The overall prevalence of underweight, overweight and obese were 11.8%, 33.8% and 15.4%, respectively. The richest women were less underweight (7.5%) but more overweight (23.7%) and obese (42.2%). In contrast, the poorest women were more underweight (32.0%) but less overweight (13.9%) and obese (7.0%). According to results of OB decomposition method, all predictors combinedly can explain 1.62 units (95% CI: 1.31-1.93) of the total mean BMI gap (equivalent to 40%). Some of the major predictors were women years of education (0.45 units, 95% CI: 0.27-0.64), spouse years of education (0.16 units, 95% CI: -0.02-0.34), current working status (0.17 units, 95% CI: 0.10-0.34), access to Television (0.50 units, 95% CI: 0.28-0.72), and place of residence (0.37 units, 95% CI: 0.22-0.72). The unexplained part of the poorest-richest gap was 2.51 units (95% CI: 2.13-2.89), which means that this particular gap will remain unchanged even though the mean difference of the predictors was diminished. CONCLUSIONS: A large part of the nutritional gap (approximately 60%) between the poorest and richest classes of women are found to be unchanged by the predictors of the study. Therefore, further predictors should be identified to minimize such gap. Moreover, policy makers and relevant stakeholders should implement feasible strategies to minimize the existing differences in the major predictors.


Assuntos
Sobrepeso , Magreza , Adulto , Bangladesh/epidemiologia , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Fatores Socioeconômicos , Magreza/epidemiologia
13.
Rev Med Inst Mex Seguro Soc ; 60(5): 540-547, 2022 Aug 31.
Artigo em Espanhol | MEDLINE | ID: mdl-36048806

RESUMO

Background: The coronavirus disease 2019 (COVID-19) pandemic is a serious health problem. The Mexican adult population has a high prevalence of obesity and chronic diseases that increase the risk of dying from this disease. Objective: To identify comorbidities predicting the risk of mortality at 30 days in hospitalized adult subjects with positive laboratory COVID-19 test and to evaluate the interaction between chronic diseases and gender. Material and methods: A retrospective cohort study was conducted in 2020, in a western region of the Mexican Pacific. Data from 51,135 hospitalized patients with positive COVID-19 test were analyzed and were retrieved from a normative system for the epidemiological surveillance of viral respiratory diseases (SINOLAVE, according to its initials in Spanish). Death within the first 30 days from hospital admission was the main outcome and risk ratios (RR) with 95% confidence intervals (95% CI) were calculated. Results: The overall mortality rate was 49.6% and most of the comorbidities analyzed were associated with a higher risk of death. There were significant interactions between gender and obesity (p = 0.003) and chronic kidney disease (p = 0.019). The effect of obesity on the risk of a fatal outcome varied by gender: female, RR = 1.04 (95% CI 1.03-1.07); male, RR = 1.07 (95% CI: 1.06-1.09). Conclusions: A high mortality was observed among the hospitalized patients analyzed and statistically significant factors associated with their risk were identified (gender, obesity, and kidney disease).


Introducción: la pandemia de la enfermedad por coronavirus 2019 (COVID-19) es un problema serio de salud. La población adulta mexicana tiene una alta prevalencia de obesidad y de enfermedades crónicas que incrementan el riesgo de morir por esta enfermedad. Objetivo: identificar comorbilidades predictoras del riesgo de mortalidad a 30 días en sujetos adultos hospitalizados con COVID-19 demostrado por laboratorio y evaluar la interacción entre enfermedades crónicas y el género del paciente. Material y métodos: se hizo un estudio de cohorte retrospectivo en el 2020, en una región del occidente del pacífico mexicano. Se analizaron los datos de 51,135 pacientes hospitalizados con COVID-19, los cuales fueron extraídos de un sistema normativo para la vigilancia epidemiológica de enfermedades respiratorias virales (SINOLAVE). La muerte dentro de los primeros 30 días desde la admisión hospitalaria fue el evento principal y fueron estimadas razones de riesgo (RR) con intervalos de confianza del 95% (IC 95%). Resultados: la mortalidad global fue del 49.6% y la mayoría de las comorbilidades analizadas se asociaron con un mayor riesgo de muerte. Hubo interacciones significativas entre el género y la obesidad (p = 0.003) y la enfermedad renal crónica (p = 0.019). El efecto de la obesidad sobre el riesgo de un desenlace fatal varió en función del género: mujeres, RR = 1.04 (IC 95% 1.03-1.07); hombres, RR = 1.07 (IC 95% 1.06-1.09). Conclusiones: se observó una alta mortalidad entre los pacientes hospitalizados analizados y se identificaron factores asociados a su riesgo (género, obesidad y enfermedad renal).


Assuntos
COVID-19 , Insuficiência Renal Crônica , Adulto , COVID-19/epidemiologia , Comorbidade , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Obesidade/complicações , Obesidade/epidemiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
14.
Arch Endocrinol Metab ; 66(4): 512-521, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36074943

RESUMO

Objective: To evaluate the association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil. Methods: Adults with signs and symptoms suggestive of acute SARS-CoV-2 infection who sought treatment in two hospital (public and private) emergency departments were prospectively enrolled. Patients with confirmed COVID-19 at inclusion were followed by phone calls at days D7, D14 and D28. Multivariable logistic regression models were employed to explore the association between obesity and other potential predictors for hospitalization. Results: A total of 1,050 participants were screened, and 297 completed the 28-day follow-up and were diagnosed with COVID-19 by RT-PCR. The median age was 37.2 (IQR 29.7-44.6) years, and 179 (60.0%) were female. The duration of symptoms was 3.0 (IQR 2.0-5.0) days, and 10.0 (IQR 8.0-12.0) was the median number of symptoms at inclusion. Ninety-five (32.0%) individuals had obesity, and 233 (78.5%) had no previous medical conditions. Twenty-three participants (7.7%) required hospitalization during the follow-up period. After adjusting, obesity (BMI ≥ 30.0 kg/m2) (OR = 2.69, 95% CI 1.63-4.83, P < 0.001) and older age (OR = 1.05, 95% CI 1.01-1.09, P < 0.001) were significantly associated with higher risks of hospitalization. Conclusion: Obesity, followed by aging, was the main factor associated with hospital admission for COVID-19 in a young population in a low-middle income country. Our findings highlighted the need to promote additional protection for individuals with obesity, such as vaccination, and to encourage lifestyle changes.


Assuntos
COVID-19 , Adulto , Brasil/epidemiologia , COVID-19/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Obesidade/epidemiologia , Pacientes Ambulatoriais , Estudos Prospectivos , SARS-CoV-2
15.
BMJ Paediatr Open ; 6(1)2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36053578

RESUMO

OBJECTIVE: To identify risk factors for severe disease in children hospitalised for SARS-CoV-2 infection. DESIGN: Multicentre retrospective cohort study. SETTING: 18 hospitals in Canada, Iran and Costa Rica from 1 February 2020 to 31 May 2021. PATIENTS: Children<18 years of age hospitalised for symptomatic PCR-positive SARS-CoV-2 infection, including PCR-positive multisystem inflammatory syndrome in children (MIS-C). MAIN OUTCOME MEASURE: Severity on the WHO COVID-19 Clinical Progression Scale was used for ordinal logistic regression analyses. RESULTS: We identified 403 hospitalisations. Median age was 3.78 years (IQR 0.53-10.77). At least one comorbidity was present in 46.4% (187/403) and multiple comorbidities in 18.6% (75/403). Eighty-one children (20.1%) met WHO criteria for PCR-positive MIS-C. Progression to WHO clinical scale score ≥6 occurred in 25.3% (102/403). In multivariable ordinal logistic regression analyses adjusted for age, chest imaging findings, laboratory-confirmed bacterial and/or viral coinfection, and MIS-C diagnosis, presence of a single (adjusted OR (aOR) 1.90, 95% CI 1.13 to 3.20) or multiple chronic comorbidities (aOR 2.12, 95% CI 1.19 to 3.79), obesity (aOR 3.42, 95% CI 1.76 to 6.66) and chromosomal disorders (aOR 4.47, 95% CI 1.25 to 16.01) were independent risk factors for severity. Age was not an independent risk factor, but different age-specific comorbidities were associated with more severe disease in age-stratified adjusted analyses: cardiac (aOR 2.90, 95% CI 1.11 to 7.56) and non-asthma pulmonary disorders (aOR 3.07, 95% CI 1.26 to 7.49) in children<12 years old and obesity (aOR 3.69, 1.45-9.40) in adolescents≥12 years old. Among infants<1 year old, neurological (aOR 10.72, 95% CI 1.01 to 113.35) and cardiac disorders (aOR 10.13, 95% CI 1.69 to 60.54) were independent predictors of severe disease. CONCLUSION: We identified risk factors for disease severity among children hospitalised for PCR-positive SARS-CoV-2 infection. Comorbidities predisposing children to more severe disease may vary by age. These findings can potentially guide vaccination programmes and treatment approaches in children.


Assuntos
COVID-19 , Adolescente , COVID-19/complicações , COVID-19/diagnóstico , Teste para COVID-19 , Criança , Criança Hospitalizada , Pré-Escolar , Humanos , Lactente , Obesidade/epidemiologia , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/genética , Síndrome de Resposta Inflamatória Sistêmica
17.
Front Endocrinol (Lausanne) ; 13: 980405, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36120432

RESUMO

Purpose: With type 2 diabetes mellitus (T2DM) occurring at a younger age, a greater number of women with T2DM experience reproductive health problems. The prevalence of polycystic ovary syndrome (PCOS), a common reproductive disease associated with T2DM, remains unknown in women with T2DM. This systematic review and meta-analysis aimed to determine the prevalence of PCOS in women with T2DM. Methods: Stata 15.1 was used to perform a meta-analysis on the prevalence of PCOS in patients with T2DM included in this study. Additionally, a narrative review of the effects of different diagnostic methods, obesity, state, and other factors on the prevalence of PCOS was conducted. Results: Meta-analysis showed that the overall prevalence of PCOS in women with T2DM was approximately 21%. Subgroup analysis showed that the incidence of PCOS in female patients aged 25-45 years was higher than that in female patients aged < 25 years. The prevalence of PCOS in obese women was 14%, which was lower than that in normal weight women and normal weight or overweight or obese women. Women with T2DM in Oceania had the highest incidence of PCOS, followed by those in Europe and Asia; women with T2DM in North America had the lowest incidence. In terms of PCOS diagnostic standards, the prevalence of PCOS diagnosed by the National Institutes of Health was the lowest. The prevalence of PCOS diagnosed on the basis of clinical symptoms and biochemical characteristics was the highest, and the prevalence of PCOS diagnosed on the basis of medical records was 20%. Conclusions: PCOS is a common disease in female patients with T2DM. The prevalence of PCOS in women with T2DM at childbearing age was higher than that in adolescent females. Women with T2DM at childbearing age should pay attention to the screening and prevention of PCOS to avoid the hazards of PCOS to reproductive health. Systematic review registration: PROSPERO, identifier CRD42022318657.


Assuntos
Diabetes Mellitus Tipo 2 , Síndrome do Ovário Policístico , Adolescente , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/diagnóstico , Síndrome do Ovário Policístico/epidemiologia , Prevalência , Estados Unidos
18.
BMC Public Health ; 22(1): 1766, 2022 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-36115935

RESUMO

BACKGROUND: Although a growing body of evidence suggests air pollution is associated with low serum vitamin D status, few studies have reported whether obesity status affects this relationship. The aim of this study was to identify associations between ambient air pollution exposure, obesity, and serum vitamin D status in the general population of South Korea. METHODS: This study was conducted in a cross-sectional design. A total of 30,242 Korean adults from a nationwide general population survey were included for our final analysis. Air pollutants included particulate matter with an aerodynamic diameter ≤ 10 µm (PM10), nitrogen dioxide (NO2), and carbon monoxide (CO). We measured serum 25-hydroxyvitamin D concentration to assess vitamin D status for each participant. Multiple linear and logistic regression analyses were performed to identify associations between ambient air pollution and vitamin D status in each subgroup according to body mass index level. RESULTS: The annual average concentrations of PM10, NO2, and CO were significantly associated with a lower serum vitamin D concentration and higher risk of vitamin D deficiency. The results show a significant association between serum vitamin D status and PM10 exposure in obese subgroup. Based on the gender, females with obesity showed more strong association (negative) between different air pollutants and low serum vitamin D concentration and a higher risk of vitamin D deficiency. However, this pattern was not observed in men. CONCLUSIONS: This study provides the first evidence that women with obesity may be more vulnerable to vitamin D deficiency in the context of persistent exposure to air pollution.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Deficiência de Vitamina D , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Monóxido de Carbono/análise , Estudos Transversais , Feminino , Humanos , Masculino , Dióxido de Nitrogênio/análise , Obesidade/complicações , Obesidade/epidemiologia , Material Particulado/efeitos adversos , Material Particulado/análise , Vitamina D , Vitaminas/análise
19.
BMC Health Serv Res ; 22(1): 1170, 2022 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-36115979

RESUMO

BACKGROUND: Indonesia is in the middle of a rapid epidemiological transition with an ageing population and increasing exposure to risk factors for chronic conditions. This study examines the relative impacts of obesity, tobacco consumption, and physical inactivity, on non-communicable diseases multimorbidity, health service use, catastrophic health expenditure (CHE), and loss in employment productivity in Indonesia. METHODS: Secondary analyses were conducted of cross-sectional data from adults aged ≥ 40 years (n = 12,081) in the Indonesian Family Life Survey 2014/2015. We used propensity score matching to assess the associations between behavioural risk factors and health service use, CHE, employment productivity, and multimorbidity. RESULTS: Being obese, overweight and a former tobacco user was associated with a higher number of chronic conditions and multimorbidity (p < 0.05). Being a former tobacco user contributed to a higher number of outpatient and inpatient visits as well as CHE incidences and work absenteeism. Physical inactivity relatively increased the number of outpatient visits (30% increase, p < 0.05) and work absenteeism (21% increase, P < 0.06). Although being underweight was associated with an increased outpatient care utilisation (23% increase, p < 0.05), being overweight was negatively associated with CHE incidences (50% decrease, p < 0.05). CONCLUSION: Combined together, obesity, overweight, physical inactivity and tobacco use contributed to an increased number of NCDs as well as medical costs and productivity loss in Indonesia. Interventions addressing physical and behavioural risk factors are likely to have substantial benefits for individuals and the wider society in Indonesia.


Assuntos
Sobrepeso , Magreza , Adulto , Doença Crônica , Estudos Transversais , Humanos , Indonésia/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Pontuação de Propensão , Comportamento Sedentário , Fumar/epidemiologia , Magreza/epidemiologia
20.
J Infect Dev Ctries ; 16(8): 1269-1277, 2022 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-36099369

RESUMO

INTRODUCTION: There is limited information about the coronavirus disease 2019 (COVID-19) disease in Latin-American countries. Our objective was to describe the clinical characteristics and outcomes of COVID-19 patients in Mexico. METHODOLOGY: We conducted a retrospective cohort study with 333 consecutive patients who were admitted to Hospital de Especialidades "Dr. Antonio Fraga Mouret" in Mexico City with COVID-19 between April 1, 2020, and June 30, 2020. Demographic, clinical, laboratory data, treatment details and 30-day outcomes were analyzed. RESULTS: The patients studied included 52% men (172/233) and the median age was 45 years. Up to 75% (250/333) of patients were classified as overweight or obese. There were 185 (56%) inpatients; 85% (158/185) were hospitalized in the general ward, and 15% (27/185) in the Intensive Care Unit (ICU). Laboratory measurements showed significant differences between inpatients and outpatients such as lymphocyte-count (median 0.8 vs 1.2×109/L, p < 0.001), LDH (median 650 vs 294 U/L, p < 0.001), CRP (median 147 vs 5 mg/L, p = 0.007), CK-MB (median, 15 vs 10 U/L, p = 0.008), ferritin (median, 860 vs 392 ng/mL, p = 0.02), and D-dimer (median, 780 vs 600 ng/mL, p = 0.15). These differences were seen between survivor and non-survivor patients as well. The rate of death in mechanically ventilated patients was 94% (67/71). Mortality at 30-day follow-up was 57% (105/185). CONCLUSIONS: We observed that majority of the non-survivors were obese and young. Complications leading to death was observed in majority of the cases.


Assuntos
COVID-19 , COVID-19/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Pandemias , Encaminhamento e Consulta , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...