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1.
Br J Nurs ; 29(18): 1082-1083, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33035084

RESUMO

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the Prime Minister's personal campaign to reduce the impact of COVID-19 by addressing rising levels of obesity in society.


Assuntos
Infecções por Coronavirus/epidemiologia , Obesidade/epidemiologia , Obesidade/prevenção & controle , Pneumonia Viral/epidemiologia , Governo , Humanos , Pandemias , Políticas , Medicina Estatal , Reino Unido/epidemiologia
2.
Medicine (Baltimore) ; 99(40): e22442, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019428

RESUMO

Delivery methods during childbirth and their related gut microbiota profiles have important impacts on health later in life, they can contribute to the development of diseases such as obesity, whose highest prevalence rate is found among the Mexican child population. Coincidentally, Mexico has one of the highest global average annual rate increase in cesarean births (C-section). Since Mexico leads the world in childhood obesity, studying the relationship between childbirth delivery methods and gut microbiota profiles in this vulnerable population may be used to identify early risk factors for obesity in other developed and developing countries. The objective of this study is to determine the association between child delivery method and gut microbiota profiles in healthy Mexican newborns.Fecal samples of 57 term infants who participated in a randomized clinical trial in 2013 to study the safety of Agave fructans in newborns, were used in this study. DNA samples were extracted and used to characterize the microbiota composition using high-throughput 16S rRNA gene sequencing. The samples were further divided based on childbirth delivery method, as well as early diet. Gut microbiota profiles were determined and analyzed using cluster analysis followed by multiple correspondence analysis.An unusual high abundance of Proteobacteria was found in the gut microbiota of all Mexican infants studied, regardless of delivery method. Feces from infants born by C-section had low levels of Bacteroidetes, high levels of Firmicutes, especially Clostridium and Enterococcus, and a strikingly high ratio of Firmicutes/Bacteroidetes (F:B). Profiles enriched in Bacteroidetes and low F:B ratios, were strongly associated with vaginal delivery.The profile of gut microbiota associated with feces from Mexican infants born by C-section, may be added to the list of boosting factors for the worrying obesity epidemic in Mexico.


Assuntos
Cesárea/estatística & dados numéricos , Microbioma Gastrointestinal , Obesidade/epidemiologia , Cesárea/efeitos adversos , Fezes/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Fatores de Risco
3.
BMC Surg ; 20(1): 194, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867744

RESUMO

BACKGROUND: Studies have suggested differences in postoperative outcomes between patients with obesity and those without following adrenalectomy, but these remained to be ascertained with synthesis of available evidence. The aim of this systematic review and meta-analysis was to investigate the association between obesity and outcomes of patients after laparoscopic adrenalectomy. METHODS: We searched EMBASE, PubMed, Global Index Medicus, and Web of Science, without language restriction, to identify cohort studies published between January 1, 2000 and November 6, 2019. We considered studies with data comparing outcomes of adults with and without obesity after laparoscopic adrenalectomy. Random-effects meta-analysis was used to pool study-specific estimates. This review was registered with PROSPERO, CRD42018117070. RESULTS: Five studies with data on a pooled sample of 353 patients with obesity and 828 without were included in the meta-analysis. The risk of bias was moderate to low. We found no association between obesity and the various stages of postoperative complications: Clavien-Dindo grade 1 (OR = 1.57; 95%CI = 0.55-4.48; I2 = 44.6%), grade 2 (OR = 1.12; 95%CI = 0.54-2.32; I2 = 0.0%), grade 3 (OR = 1.79; 95%CI = 0.58-5.47; I2 = 0.0%;), grade 4 (OR = 0.43; 95%CI = 0.05-3.71; I2 = 0.0%), and grade 5 (death) (OR = 0.43; 95% CI = 0.02-14.31). Furthermore, no association was found between obesity and readmission rates (OR = 0.7; 95% CI = 0.13-3.62) and conversion of laparoscopic to open surgery (OR = 0.62; 95% CI = 0.16-2.34; I2 = 19.5%). CONCLUSIONS: This study suggests that obesity is not associated with complications following laparoscopic adrenalectomy. This meta-analysis might have been underpowered to detect a true association between obesity and patient outcome after laparoscopic adrenalectomy due to the small number of included studies. Larger studies are needed to clarify the role of obesity in patients undergoing laparoscopic adrenalectomy.


Assuntos
Adrenalectomia/métodos , Laparoscopia/métodos , Obesidade/epidemiologia , Adulto , Humanos , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório
5.
Ann Ist Super Sanita ; 56(3): 373-377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32959804

RESUMO

We aimed to compare COVID-19-specific and all-cause mortality rates among natives and migrants in Italy and to investigate the clinical characteristics of individuals dying with COVID-19 by native/migrant status. The mortality rates and detailed clinical characteristics of natives and migrants dying with COVID-19 were explored by considering the medical charts of a representative sample of patients deceased in Italian hospitals (n = 2,687) between February 21st and April 29th, 2020. The migrant or native status was assigned based on the individual's country of birth. The expected all-cause mortality among natives and migrants living in Italy was derived by the last available (2018) dataset provided by the Italian National Institute of Statistics. Overall, 68 individuals with a migration background were identified. The proportions of natives and migrants among the COVID-19-related deaths (97.5% and 2.5%, respectively) were similar to the relative all-cause mortality rates estimated in Italy in 2018 (97.4% and 2.6%, respectively). The clinical phenotype of migrants dying with COVID-19 was similar to that of natives except for the younger age at death. International migrants living in Italy do not have a mortality advantage for COVID-19 and are exposed to the risk of poor outcomes as their native counterparts.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Migrantes/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Albânia/etnologia , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , França/etnologia , Efeito do Trabalhador Sadio , Registros Hospitalares , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Mortalidade/etnologia , Neoplasias/epidemiologia , Obesidade/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Insuficiência Renal Crônica/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-32992623

RESUMO

The world is currently struggling to face the coronavirus pandemic (COVID-19), and many countries have imposed lockdowns and recommended quarantine to limit both the spread of the virus and overwhelming demands for medical care. Direct implications include the disruption of work routines, boredom, depression, increased calorie consumption, and other similar harmful effects. The present narrative review article briefly analyzes the preliminary effects of the quarantine lifestyle from the standpoint of dietary habits. In six different databases, we searched for original articles up to 10 August 2020, assessing eating habits among populations during the COVID-19 pandemic, and recorded any change in the intake of major food categories, as well as changes in body weight. The research strategy yielded 364 articles, from which we selected 12 articles that fitted our goal. Our preliminary findings revealed a sharp rise of carbohydrates sources consumption, especially those with a high glycemic index (i.e., homemade pizza, bread, cake, and pastries), as well as more frequent snacks. A high consumption of fruits and vegetables, and protein sources, particularly pulses, was also recorded, although there was no clear peak of increase in the latter. Data concerning the consumption of junk foods lacked consistency, while there was a decreased alcohol intake and fresh fish/seafood consumption. As a possible connection, people gained body weight. Therefore, in the realistic perspective of a continuing global health emergency situation, timely preventive measures are needed to counteract obesity-related behaviors in the long-term, so as to prevent further health complications.


Assuntos
Infecções por Coronavirus/epidemiologia , Comportamento Alimentar , Pandemias , Pneumonia Viral/epidemiologia , Humanos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Saúde Pública
7.
Medicine (Baltimore) ; 99(38): e22243, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957370

RESUMO

Although obesity is an established risk factor of primary stroke, the association between obesity and post-stroke mortality remains unclear. The aim of this study was to investigate the association between dynamic obesity status and mortality in survivors of their first stroke in China.Of 775 patients with first-ever ischemic stroke included in a longitudinal study, 754 patients were included in this study and categorized into 4 categories of body mass index (BMI) (underweight, normal weight, overweight, and obese) and 2 categories of waist circumference (WC) (normal WC and abdominal obesity) according to standard Chinese criteria. The mortality information and obesity status were obtained via telephone follow-up every 3 months, beginning in 2010 through 2016. Time-dependent Cox proportional hazards models were used to estimate the unadjusted and adjusted hazard ratios (HRs) for the relationship between all-cause mortality and dynamic obesity status.Of 754 patients, 60.87% were male, and the overall mean age was 61.45 years. After adjusting for possible confounders, significant inverse associations were identified between BMI and WC and all-cause mortality. Compared with those with normal BMI or WC, those with abdominal obesity or overweight had a significantly lower risk of all-cause mortality (HR and 95% confidence intervals [CIs]: .521 [.303-.897] and 0.545 [.352-.845], respectively), whereas patients with underweight had the highest risk and those with obesity had lower risk of mortality, though it was not statistically significant (1.241 [.691-2.226] and .486 [.192-1.231], respectively).Overweight and abdominal obesity were paradoxically associated with reduced risk of mortality in patients who survived their first-ever ischemic stroke in China. Future prospective studies must look at evaluating the role of obesity in different stroke subtypes and devise appropriate weight-management strategies for optimal prognoses in secondary prevention in these survivors.


Assuntos
Isquemia Encefálica/mortalidade , Obesidade/epidemiologia , Acidente Vascular Cerebral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Isquemia Encefálica/epidemiologia , Isquemia Encefálica/prevenção & controle , China/epidemiologia , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Prevalência , Estudos Prospectivos , Fatores de Risco , Prevenção Secundária , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/prevenção & controle , Sobreviventes , Circunferência da Cintura , Adulto Jovem
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1296-1302, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867439

RESUMO

Objective: To study the relationship between eating behavior and obesity among Chinese adults. Methods: Data were collected from 171 040 people who had been engaged in the 2013 China Chronic and Non-communicable Disease and Risk Factors Surveillance project. Rao-Scott χ(2) test and complex sampling design were used to compare the differences in the rates of eating behavior and obesity. A binary logistic regression model based on complex sampling design was used to investigate the relationship between eating behavior at three meals (breakfast, lunch and dinner) and obesity. Results: The proportion (3.3%) of skipping breakfast appeared the highest. Proportions of eating out for all the three meals were 16.4%, 21.4% and 11.7%, respectively. The prevalence rates of obesity among men who ate lunch at home, ate out or skipped the lunch were 13.2%, 16.1% and 15.9%, respectively. The prevalence rates of obesity among women who ate lunch at home, ate out or skipped lunch were 14.5%, 9.8%, 19.6%, respectively. Results from the multivariate logistic regression analysis showed that eating out for lunch and skipping lunch were both positively correlated with obesity in men (eating out for lunch: OR=1.10, 95%CI: 1.02-1.18; skipping lunch: OR=1.36, 95%CI: 1.02-1.80) while skipping lunch was positively associated with obesity (OR=1.47, 95%CI:1.07-2.02) in women. No statistical association was noticed between eating out for lunch and obesity in women, with OR=0.86 (95%CI: 0.73-1.00). Both eating out for dinner and skipping dinner were positively correlated with obesity in men, with eating out for lunch as OR=1.19 (95%CI: 1.06-1.34) and skipping dinner as OR=1.89 (95%CI: 1.07-3.33). Avoid dinner was positively associated with obesity in women, with OR=1.64 (95%CI: 1.02-2.63). Women who ate out for dinner showed lower risk of obesity than those who ate at home with OR=0.74 (95%CI: 0.59-0.94). Conclusions: Different eating behaviors were seen in Chinese adults, with the highest proportion of eating out for lunch and the lowest proportion for dinner. Both eating out for lunch and dinner appeared risk factors of obesity in men while avoid lunch or dinner were both associated with obesity in both sex.


Assuntos
Comportamento Alimentar , Obesidade/epidemiologia , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco
9.
Adv Respir Med ; 88(4): 335-342, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32869267

RESUMO

In early December 2019, in the city of Wuhan in Hubei Province, China, the first infections by a novel coronavirus were reported. Since then, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been spreading to other cities and countries becoming the global emerging epidemiological issue and quickly reaching the status of a pandemic. Multiple risk factors of disease severity and mortality have been identified so far. These include old age, male sex, smoking, and obesity. This concise narrative review highlights the important role of these factors in the pathobiology and clinical landscape of Coronavirus Disease 2019 (COVID-19). We especially focused on their significant role in disease severity and mortality. However, in spite of intensive research, most of the presented pieces of evidence are weak and need further verification.


Assuntos
Infecções por Coronavirus/epidemiologia , Obesidade/epidemiologia , Pneumonia Viral/epidemiologia , Fumar/epidemiologia , Fatores Etários , Envelhecimento , Feminino , Humanos , Masculino , Pandemias , Fatores de Risco , Fatores Sexuais
11.
Medicine (Baltimore) ; 99(38): e21786, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957307

RESUMO

The present study is a retrospective cohort study. Metabolic syndrome (MetS) is a clustering of clinical findings that has been shown to increase the risk of the surgical outcomes. Our study aimed to evaluate whether MetS was a risk factor for increased perioperative outcomes in patients undergoing posterior lumbar interbody fusion (PLIF).We retrospectively analyzed patients over 18 years following elective posterior lumbar spine fusion from January 2014 to December 2018. Emergency procedures, infections, tumor, fracture, and revision surgeries were excluded. Patients were divided into 2 groups with and without MetS. The MetS was defined by having 3 of the following 4 criteria: obesity (body mass index ≥30 kg/m), dyslipidemia, hypertension, and diabetes. The follow-up period lasted up to 30 days after surgery. The outcomes of demographics, comorbidities, perioperative complications, and length of stay were compared between the 2 groups. Multivariate logistic regression analysis was used to identify perioperative outcomes that were independently associated with MetS.The overall prevalence of MetS was 12.5% (360/2880). Patients with MetS was a significantly higher risk factor for perioperative complications, and longer length of stay cmpared with patients without MetS (P < .05). The MetS group had a higher rate of cardiac complications (P = .019), pulmonary complication (P = .035), pneumonia (P = .026), cerebrovascular event (P = .023), urinary tract infection (P = .018), postoperative ICU admission (P = .02), and deep vein thrombosis (P = .029) than non-MetS group. The patients with MetS had longer hospital stays than the patients without MetS (22.16 vs 19.99 days, P < .001). Logistic regression analysis revealed that patients with MetS were more likely to experience perioperative complications (odds ratio [OR] 1.31; 95% confidence interval [CI]: 1.06-2.07; P < .001), and extend the length of stay (OR: 1.69; 95% CI: 1.25-2028; P = .001).The MetS is a significant risk factor for increased perioperative complications, and extend length of stay after PLIF. Strategies to minimize the adverse effect of MetS should be considered for these patients.


Assuntos
Vértebras Lombares/cirurgia , Síndrome Metabólica/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Fusão Vertebral/efeitos adversos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Comorbidade , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Hipertensão/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Reoperação , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos , Adulto Jovem
12.
Front Immunol ; 11: 1997, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32983141

RESUMO

Obesity is a major independent risk factor for increased morbidity and mortality upon infection with Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), which is responsible for the current coronavirus disease pandemic (COVID-19). Therefore, there is a critical need to identify underlying metabolic factors associated with obesity that could be contributing toward increased susceptibility to SARS-CoV-2 in this vulnerable population. Here, we focus on the critical role of potent endogenous lipid metabolites known as specialized pro-resolving mediators (SPMs) that are synthesized from polyunsaturated fatty acids. SPMs are generated during the transition of inflammation to resolution and have a vital role in directing damaged tissues to homeostasis; furthermore, SPMs display anti-viral activity in the context of influenza infection without being immunosuppressive. We cover evidence from rodent and human studies to show that obesity, and its co-morbidities, induce a signature of SPM deficiency across immunometabolic tissues. We further discuss how the effects of obesity upon SARS-CoV-2 infection are likely exacerbated with environmental exposures that promote chronic pulmonary inflammation and augment SPM deficits. Finally, we highlight potential approaches to overcome the loss of SPMs using dietary and pharmacological interventions. Collectively, this mini-review underscores the need for mechanistic studies on how SPM deficiencies driven by obesity and environmental exposures may exacerbate the response to SARS-CoV-2.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Ácidos Docosa-Hexaenoicos/deficiência , Ácido Eicosapentaenoico/metabolismo , Ácido Linoleico/deficiência , Lipoxinas/deficiência , Obesidade/epidemiologia , Obesidade/imunologia , Pneumonia Viral/epidemiologia , Comorbidade , Infecções por Coronavirus/dietoterapia , Infecções por Coronavirus/virologia , Suscetibilidade a Doenças , Ácidos Docosa-Hexaenoicos/uso terapêutico , Ácido Eicosapentaenoico/uso terapêutico , Humanos , Inflamação/metabolismo , Ácido Linoleico/uso terapêutico , Lipoxinas/uso terapêutico , Morbidade , Obesidade/metabolismo , Pandemias , Pneumonia Viral/dietoterapia , Pneumonia Viral/virologia , Fatores de Risco
13.
Medicine (Baltimore) ; 99(35): e21767, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871897

RESUMO

Risk factors such as smoking and sugar intake threaten the health of human being at an individual national level as well as at a global level. The globalization affect health indirectly through macro and micro-level factors. This study aimed to identify the global trend of dental caries according to countries national income level, and to examine the role of globalization, health services, obesity, and sugar consumption on dental caries. Data for 160 countries were collected for the time period of the 1990s to 2010s. The final sample included 46 countries with complete data (21 high income countries (HIC) and 25 middle and low income countries (MLIC)). The main dependent variable was the mean decayed, missing, and filled teeth (DMFT) index of 12-year-olds as an indicator of dental caries. Globalization was a main independent variable which was measured by economic growth, urbanization and economic freedom. Other independent variables were health services, obesity and sugar consumption. The data were analyzed first using repeated measures analysis of variance to compare dental caries trends in HIC and MLIC. Then, using multiple linear regression and partial least squares structural equation modeling (PLS-SEM), the relationships between globalization, health services, obesity, sugar consumption, and dental caries were examined. The results of PLS-SEM revealed that globalization was associated with lower DMFT in HIC. The global dental caries trend had a declined pattern, but this pattern has been attenuated in MLIC after the new millennium. There is a need for policy change and regulations on sugar trade especially in MLIC to diminish the adverse consequences of globalization, and to improve population dental health.


Assuntos
Índice CPO , Cárie Dentária/epidemiologia , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Internacionalidade , Criança , Açúcares da Dieta , Desenvolvimento Econômico , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Análise de Classes Latentes , Modelos Lineares , Obesidade/epidemiologia , Urbanização
14.
PLoS One ; 15(9): e0238905, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915872

RESUMO

BACKGROUND: Due to a high prevalence of chronic non-degenerative diseases, it is suspected that COVID 19 poses a high risk of fatal complications for the Mexican population. The present study aims to estimate the risk factors for hospitalization and death in the Mexican population infected by SARS-CoV-2. METHODS AND FINDINGS: We used the publicly available data released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health (Secretaría de Salud, SSA). All records of positive SARS-CoV-2 cases were included. Two multiple logistic regression models were fitted to estimate the association between hospitalization and mortality, with other covariables. Data on 10,544 individuals (57.68% men), with mean age 46.47±15.62, were analyzed. Men were about 1.54 times more likely to be hospitalized than women (p<0.001, 95% C.I. 1.37-1.74); individuals aged 50-74 and ≥74 were more likely to be hospitalized than people aged 25-49 (OR 2.05, p<0.001, 95% C.I. 1.81-2.32, and OR 3.84, p<0.001, 95% C.I. 2.90-5.15, respectively). People with hypertension, obesity, and diabetes were more likely to be hospitalized than people without these comorbidities (p<0.01). Men had more risk of death in comparison to women (OR = 1.53, p<0.001, 95% C.I. 1.30-1.81) and individuals aged 50-74 and ≥75 were more likely to die than people aged 25-49 (OR 1.96, p<0.001, 95% C.I. 1.63-2.34, and OR 3.74, p<0.001, 95% C.I. 2.80-4.98, respectively). Hypertension, obesity, and diabetes presented in combination conveyed a higher risk of dying in comparison to not having these diseases (OR = 2.10; p<0.001, 95% C.I. 1.50-2.93). Hospitalization, intubation and pneumonia entail a higher risk of dying (OR 5.02, p<0.001, 95% C.I. 3.88-6.50; OR 4.27, p<0.001, 95% C.I. 3.26-5.59, and OR = 2.57; p<0.001, 95% C.I. 2.11-3.13, respectively). Our study's main limitation is the lack of information on mild (asymptomatic) or moderate cases of COVID-19. CONCLUSIONS: The present study points out that in Mexico, where an important proportion of the population has two or more chronic conditions simultaneously, a high mortality rate is a serious risk for those infected by SARS-CoV-2.


Assuntos
Infecções por Coronavirus/mortalidade , Diabetes Mellitus/epidemiologia , Hospitalização/estatística & dados numéricos , Hipertensão/epidemiologia , Obesidade/epidemiologia , Pneumonia Viral/mortalidade , Adulto , Idoso , Comorbidade , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Taxa de Sobrevida
15.
J Assoc Physicians India ; 68(10): 29-33, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32978922

RESUMO

Introduction: Obesity is associated with insulin resistance and measuring it in an apparently healthy population and correlating them with established risk parameters may identify predisposed individuals who may later develop diabetes or cardiovascular diseases. Material and Methods: 405 participants from a rural area were investigated for various metabolic parameters and indices of insulin resistance. Insulin resistance indices were evaluated in the 3 different groups [Obese Metabolic Syndrome (MetS), Lean MetS and those without MetS]. Various anthropometric and metabolic parameters were compared. Lean MetS is defined as those having waist criteria below the region specific waist criteria and even then satisfying the definition of MetS as per the NCEP ATP-III criteria. Results: The mean fasting insulin level was 7.69+4.38 uIU/ml in normal population, 10.40+5.65 uIU/ml in Lean MetS population and 13.71+6.63 uIU/ml in Obese MetS population (P<0.05). The HOMA-IR2 measured was 2.39+ 1.69 in normal population, while in the Lean MetS and Obese Mets were 3.99+3.40 and 4.04+2.53, respectively (P<0.05). The QUICKI level measured was 0.358+0.041 in normal population and 0.334+0.037 and 0.316+0.026 respectively in the Lean MetS and Obese MetS (P<0.05). McAuley index measured in normal population was 0.49+0.26 and 0.75+0.25 and 0.79+0.17 in the Lean MetS and Obese MetS population (P<0.05).TyG index measured was 8.51+0.46 in normal population and 9.27+0.56 and 9.06+0.49 respectively in the Lean MetS and Obese MetS (P<0.05). Conclusion: Insulin resistance indices are elevated in MetS compared to the normal population but the indices in Lean MetS are not different from Obese MetS. The relevance of ethnicity specific waist circumference may need re-evaluation considering its little impact in influencing the level of insulin resistance.


Assuntos
Resistência à Insulina , Síndrome Metabólica/epidemiologia , Índice de Massa Corporal , Jejum , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Circunferência da Cintura
16.
BMC Public Health ; 20(1): 1364, 2020 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-32891134

RESUMO

BACKGROUND: The co-morbidity of cardiometabolic diseases in patients with Tuberculosis adds a significant burden in current health systems in developing countries including Nepal. The main objective of this study was to explore cardiometabolic risk factors among patients with Tuberculosis. METHODS: This was a cross-sectional study conducted among patients with tuberculosis in 12 tuberculosis treatment centers from eight districts of Nepal between May and July 2017. Interviews with participants were conducted using a structured questionnaire and were supplemented by anthropometric measurements and on-site blood glucose tests. Data were analyzed using descriptive and inferential statistics. RESULTS: Among 221 study participants, 138 (62.4%) had new smear-positive pulmonary tuberculosis, 24 (10.9%) had new smear-negative pulmonary tuberculosis and 34 (15.4%) had new extra- pulmonary tuberculosis. Overall, 43.1% of the patients with tuberculosis had at least one cardiometabolic risk factor. The prevalence of at least one cardiometabolic risk factor was more in male than female (47.8% versus 33.8%). Prevalence of tobacco (18.9% versus 4.8%), and alcohol (12.6% versus 6.5%) use was proportionately higher in male compared to female. The prevalence of hypertension (17% vs. 21%) and obesity (11.9% vs. 12.9%) was lower in male compared to females. Female (AOR = 0.47; CI: 0.23-0.94), those from Gandaki Province (AOR = 0.32; CI: 0.13-0.79) and literate (AOR = 0.49; CI: 0.25-0.96) had reduced risk of cardiometabolic disease risk factors. CONCLUSIONS: This study highlights the role of gender and socio-demographic characteristics associated with the risk of cardiometabolic diseases in patients with Tuberculosis. The findings from this study can guide medical practitioners and policy makers to consider clinical suspicion, diagnosis and treatment. National treatment guideline can benefit by integrating the management of non-communicable diseases in Tuberculosis treatment centers.


Assuntos
Hipertensão/epidemiologia , Obesidade/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Comorbidade , Estudos Transversais , Assistência à Saúde , Feminino , Instalações de Saúde , Humanos , Hipertensão/etiologia , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Doenças não Transmissíveis/epidemiologia , Obesidade/etiologia , Obesidade/terapia , Prevalência , Fatores de Risco , Fatores Sexuais , Uso de Tabaco/efeitos adversos , Tuberculose/epidemiologia , Tuberculose Pulmonar/terapia
17.
Medicine (Baltimore) ; 99(31): e21159, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756093

RESUMO

Being overweight and obese is a serious public health issues in China. However, the effects of substance use and mental factors on weight changes remain unclear. In this study, we aimed to investigate the association among self-perceived stress, history of smoking and drinking, and weight status by using data from the China Health and Nutrition Survey in 2015.A total of 8028 adults were selected from China Health and Nutrition Survey in 2015. The self-reported data primarily included sociodemographic data, self-perceived stress scores, and history of smoking and drinking. Physical measurements including height and weight were logged to calculate body mass index. Multivariate and multinomial regression models were used to estimate effects of substance and perceived stress on weight status.The prevalence of underweight and overweight/obese people were 4.52% and 51.51% in Chinese adults, respectively. Adults with high perceived stress were negatively associated with being overweight and obese (OR = 0.80, 95% CI = 0.66-0.97 in the middle level and OR = 0.69, 95%CI = 0.55-0.88 in the high level). Adults with history of smoking had low risk of being overweight/obese (OR = 0.71, 95% CI = 0.62-0.82). Adults with history of drinking had high risk of overweight/obese (OR = 1.22, 95% CI = 1.06-1.40). In addition, the association between drinking and overweight/obese was affected by different levels of perceived stress (OR = 1.15, 95%CI = 0.83-1.59 in low-stress group and OR = 1.42, 95%CI = 1.04-1.94 in high-stress group).The effects of self-perceived stress and history of smoking as well as drinking on weight status were significant in this study. The government and healthcare policymakers should strengthen early psychological factor and behavioral intervention to decrease the prevalence of abnormal-weight status.


Assuntos
Consumo de Bebidas Alcoólicas , Obesidade/epidemiologia , Fumar , Estresse Psicológico , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/etiologia , Obesidade/psicologia , Prevalência , Fatores Socioeconômicos
18.
Crit Care ; 24(1): 485, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32758295

RESUMO

BACKGROUND: While obesity confers an increased risk of death in the general population, numerous studies have reported an association between obesity and improved survival among critically ill patients. This contrary finding has been referred to as the obesity paradox. In this retrospective study, two causal inference approaches were used to address whether the survival of non-obese critically ill patients would have been improved if they had been obese. METHODS: The study cohort comprised 6557 adult critically ill patients hospitalized at the Intensive Care Unit of the Ghent University Hospital between 2015 and 2017. Obesity was defined as a body mass index of ≥ 30 kg/m2. Two causal inference approaches were used to estimate the average effect of obesity in the non-obese (AON): a traditional approach that used regression adjustment for confounding and that assumed missingness completely at random and a robust approach that used machine learning within the targeted maximum likelihood estimation framework along with multiple imputation of missing values under the assumption of missingness at random. 1754 (26.8%) patients were discarded in the traditional approach because of at least one missing value for obesity status or confounders. RESULTS: Obesity was present in 18.9% of patients. The in-hospital mortality was 14.6% in non-obese patients and 13.5% in obese patients. The raw marginal risk difference for in-hospital mortality between obese and non-obese patients was - 1.06% (95% confidence interval (CI) - 3.23 to 1.11%, P = 0.337). The traditional approach resulted in an AON of - 2.48% (95% CI - 4.80 to - 0.15%, P = 0.037), whereas the robust approach yielded an AON of - 0.59% (95% CI - 2.77 to 1.60%, P = 0.599). CONCLUSIONS: A causal inference approach that is robust to residual confounding bias due to model misspecification and selection bias due to missing (at random) data mitigates the obesity paradox observed in critically ill patients, whereas a traditional approach results in even more paradoxical findings. The robust approach does not provide evidence that the survival of non-obese critically ill patients would have been improved if they had been obese.


Assuntos
Estado Terminal/mortalidade , Estado Terminal/terapia , Obesidade/epidemiologia , Idoso , Causalidade , Feminino , Mortalidade Hospitalar/tendências , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento
19.
J Transl Med ; 18(1): 318, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811530

RESUMO

BACKGROUND: COVID 19-related quarantine led to a sudden and radical lifestyle changes, in particular in eating habits. Objectives of the study were to investigate the effect of quarantine on sleep quality (SQ) and body mass index (BMI), and if change in SQ was related to working modalities. MATERIALS: We enrolled 121 adults (age 44.9 ± 13.3 years and 35.5% males). Anthropometric parameters, working modalities and physical activity were studied. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. At baseline, the enrolled subjects were assessed in outpatient clinic and after 40 days of quarantine/lockdown by phone interview. RESULTS: Overall, 49.6% of the subjects were good sleepers (PSQI < 5) at the baseline and significantly decreased after quarantine (p < 0.001). In detail, sleep onset latency (p < 0.001), sleep efficiency (p = 0.03), sleep disturbances (p < 0.001), and daytime dysfunction (p < 0.001) significantly worsened. There was also a significant increase in BMI values in normal weight (p = 0.023), in subjects grade I (p = 0.027) and II obesity (p = 0.020). In all cohort, physical activity was significantly decreased (p = 0.004). However, analyzing the data according gender difference, males significantly decreased physical activity as well as females in which there was only a trend without reaching statistical significance (53.5% vs 25.6%; p = 0.015 and 50.0% vs 35.9%, p = 0.106; in males and females, respectively). In addition, smart working activity resulted in a significant worsening of SQ, particularly in males (p < 0.001). CONCLUSIONS: Quarantine was associated to a worsening of SQ, particularly in males doing smart working, and to an increase in BMI values.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Sono/fisiologia , Adulto , Índice de Massa Corporal , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Exercício Físico/fisiologia , Comportamento Alimentar/fisiologia , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Inquéritos e Questionários
20.
Clin Transl Gastroenterol ; 11(7): e00215, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32764201

RESUMO

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic of coronavirus disease 2019 (COVID-19) is a global health crisis. Possible pancreatic involvement has recently been observed in these patients; however, its significance is unclear. The aim of this study was to evaluate the association of significantly elevated lipase with disease outcomes. METHODS: Data about demographics, symptoms, laboratory values, and clinical outcomes were collected for 1,003 consecutive patients testing positive for COVID-19. Elevated lipase was defined as greater than 3 times the upper limit of normal (>3 × ULN). Baseline characteristics among patients with or without elevated lipase were compared using Fisher exact test or Student t-test for categorical or numerical variables, respectively. Logistic regression was used to evaluate the association of lipase levels with primary clinical outcomes (intensive care unit admission and intubation) adjusted for age, sex, body mass index, history of diabetes, and hypertension. RESULTS: Of 1,003 patients with COVID-19, 83 had available lipase levels and were all admitted to the hospital. Of 83, 14 (16.8%) had elevated lipase (>3 × ULN), which was associated with higher rates of leukocytosis (P < 0.001) and abnormal liver enzymes (P < 0.01). Compared with lower lipase levels (<3 × ULN), patients with elevated lipase had higher rates of ICU admission (92.9% vs 32.8%; P < 0.001) and intubation (78.6% vs 23.5%; P 0.002). In a multivariable-adjusted model, higher lipase levels were significantly associated with admission to the ICU and rate of intubation. DISCUSSION: Lipase elevation is seen in COVID-19 and is associated with worse disease outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Lipase/sangue , Obesidade , Pâncreas , Pandemias , Pneumonia Viral , Idoso , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Índice de Massa Corporal , Estudos de Coortes , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Pâncreas/metabolismo , Pâncreas/fisiopatologia , Pâncreas/virologia , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos , Estados Unidos/epidemiologia
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