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1.
Wiad Lek ; 73(8): 1668-1670, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055331

RESUMO

OBJECTIVE: The aim: To evaluate the effect of overweight on the quality of life of chronic obstructive pulmonary disease (COPD) patients GOLD III. PATIENTS AND METHODS: Materials and methods: 65 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The pulmonary function (PF) test was performed by means of "SPIROKOM" device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m - body mass in kilograms, h - height, square of the height in meters (kg/m²). Patients' quality of life was evaluated with the help of standardized St.George's Respiratory Questionnaire (SGRQ). RESULTS: Results: The study revealed changes in the PF indices and the decrease in quality of life in overweight patients, especially in case of destabilization of the pathological process. CONCLUSION: Conclusions: The obtained results show that overweight is the underlying condition for more severe course of the pathology and requires further study of its impact on the health and quality of life of patients in order to improve the effectiveness of treatment.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Humanos , Sobrepeso/complicações , Inquéritos e Questionários , Ucrânia
3.
Proc Natl Acad Sci U S A ; 117(35): 21011-21013, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32788355

RESUMO

The role of obesity and overweight in occurrence of COVID-19 is unknown. We conducted a large-scale general population study using data from a community-dwelling sample in England (n = 334,329; 56.4 ±8.1 y; 54.5% women) with prospective linkage to national registry on hospitalization for COVID-19. Body mass index (BMI, from measured height and weight) was used as an indicator of overall obesity, and waist-hip ratio for central obesity. Main outcome was cases of COVID-19 serious enough to warrant a hospital admission from 16 March 2020 to 26 April 2020. Around 0.2% (n = 640) of the sample were hospitalized for COVID-19. There was an upward linear trend in the likelihood of COVID-19 hospitalization with increasing BMI, that was evident in the overweight (odds ratio, 1.39; 95% CI 1.13 to 1.71; crude incidence 19.1 per 10,000) and obese stage I (1.70;1.34 to 2.16; 23.3 per 10,000) and stage II (3.38; 2.60 to 4.40; 42.7 per 10,000) compared to normal weight (12.5 per 10,000). This gradient was little affected after adjustment for a wide range of covariates; however, controlling for biomarkers, particularly high-density lipoprotein cholesterol and glycated hemoglobin, led to a greater degree of attenuation. A similar pattern of association emerged for waist-hip ratio. In summary, overall and central obesity are risk factors for COVID-19 hospital admission. Elevated risk was apparent even at modest weight gain. The mechanisms may involve impaired glucose and lipid metabolism.


Assuntos
Infecções por Coronavirus/complicações , Hospitalização , Obesidade/complicações , Sobrepeso/complicações , Pneumonia Viral/complicações , Adulto , Idoso , Betacoronavirus , Índice de Massa Corporal , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , Reino Unido
4.
Niger J Clin Pract ; 23(8): 1079-1086, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788485

RESUMO

Background: Poor growth and nutritional status are common features of sickle cell anemia (SCA) in children. The rising trend of obesity in children in developing countries has been reported despite a huge burden of undernutrition in these settings. In SCA, overweight/obesity is being increasingly reported. Aims: To evaluate the nutritional status and its determinants in children with SCA and to compare the same with hemoglobin AA (HbAA) controls of similar age, gender, and socioeconomic status. Methods: The study was a cross-sectional analytical study involving 175 subjects and controls aged 1-18 years who met the inclusion criteria. Weight and height were measured and body mass index (BMI) was calculated. Z scores were computed for the anthropometric measurements using the World Health Organization (WHO) standard reference. Hemoglobin concentration was determined using HemoCue Hb201+ Analyzer. Results: Subjects had significantly lower Z- scores for weight, height, and BMI compared with controls. Stunting, wasting, and overweight/obesity were observed in 10.9%, 24.6%, and 5.1% of subjects compared with 2.3%, 5.7%, and 9.7% respectively in controls. Wasting, stunting and overweight/obesity in SCA were significantly associated with age while overweight/obesity was significantly associated with upper social class (P = 0.001). Conclusions: Poor growth and nutritional status are still prevalent while overweight and obesity are emerging comorbidities among children with SCA in our environment. Regular nutritional assessment of children with SCA should be encouraged while those at risk of under/over-nutrition should receive adequate nutritional rehabilitation to prevent possible complications.


Assuntos
Anemia Falciforme/complicações , Anemia Falciforme/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Obesidade Pediátrica/epidemiologia , Adolescente , Índice de Massa Corporal , Peso Corporal , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/complicações , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Avaliação Nutricional , Sobrepeso/complicações , Sobrepeso/epidemiologia , Obesidade Pediátrica/complicações , Prevalência , Classe Social , Fatores Socioeconômicos
5.
Womens Health Issues ; 30(5): 393-400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32646724

RESUMO

BACKGROUND: Excess weight during pregnancy increases risk for adverse obstetrical outcomes. Physical activity (PA) may buffer these effects, although it is unclear what factors are associated with PA in women who begin pregnancy with overweight/obesity. The present study sought to characterize the demographic and psychological correlates of PA among women with prepregnancy overweight/obesity. METHODS: Pregnant women (N = 249; mean age, 28.48 ± 5.48 years; mean body mass index, 34.13 ± 7.07 kg/m2) at 12-20 weeks of gestation (mean, 15.68 ± 2.44 weeks of gestation) completed ratings of perceived stress and depressive symptoms and were interviewed using the pregnancy version of the Eating Disorders Examination. The Paffenbarger Physical Activity Survey was administered via interview to estimate energy expenditure. Continuous outcomes were evaluated via linear regression, while logistic regression was conducted to assess likelihood of meeting PA guidelines. RESULTS: Mean weekly duration of moderate to vigorous PA was 109.50 ± 248.17 minutes, with 21% of women meeting federal PA guidelines of 150 minutes or more. Higher perceived stress (ß = -0.217; p = .02) and eating psychopathology (ß = -0.213; p < .01) were associated with lower total energy expenditure. Black women reported lower expenditure specifically from walking compared with White women (ß = -0.180; p = .03). Depressive symptoms were not associated with PA. No estimate of PA predicted body mass index. CONCLUSIONS: Pregnant women with overweight/obesity engage in modest amounts of PA early in pregnancy, although few meet PA guidelines. Greater perceived stress and eating psychopathology were associated with lower PA engagement. These factors should be monitored by obstetrics providers to identify women who may particularly benefit from counseling about PA during pregnancy.


Assuntos
Exercício Físico/fisiologia , Obesidade/complicações , Sobrepeso/complicações , Adulto , Índice de Massa Corporal , Metabolismo Energético , Feminino , Humanos , Gravidez , Inquéritos e Questionários , Caminhada , Adulto Jovem
6.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(2): 67-78, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193756

RESUMO

El sobrepeso y la obesidad son los problemas más frecuentes en la población laboral. OBJETIVO: Determinar la influencia del sobrepeso y la obesidad con el absentismo laboral debido a enfermedades comunes. MATERIAL Y MÉTODOS: Estudio transversal analítico, se utilizaron bases secundarias de resultados de exámenes médicos ocupacionales y descansos médicos. Se realizó análisis de regresión simple y múltiple utilizando modelos lineales generalizados. RESULTADOS: De 649 participantes, el sobrepeso representó el 44.2% y la obesidad el 19.1%. Las variables que muestran una influencia estadísticamente significativa (p < 0.05) con el absentismo laboral son género, puesto de trabajo, tener antecedente personal patológico, anemia, alteración osteomuscular, alteración en el examen de orina, hipoacusia y diagnóstico nutricional. El género masculino disminuyó en 51% la frecuencia de absentismo y la obesidad aumentó en 35% la frecuencia de absentismo a corto y largo plazo. CONCLUSIONES: Se encontró una frecuencia incrementada de absentismo laboral a corto y largo plazo en los trabajadores de género femenino y en aquellos que presentan obesidad


Overweight and obesity are the most frequent problems in the working population. OBJECTIVE: Determine the influence of overweight and obesity with absenteeism due to common illnesses. MATERIAL AND METHODS: Analytical cross-sectional study, secondary bases of results of occupational medical examinations and medical breaks were used. Simple and multiple regression analysis was performed using generalized linear models. RESULTS: Of 649 participants, overweight represented 44.2% and obesity 19.1%. The variables that show a statistically significant influence (p <0.05) with work absenteeism are gender, job, having a pathological personal history, anemia, musculoskeletal alteration, alteration in the urine test, hearing loss and nutritional diagnosis. The male gender decreased the frequency of absenteeism by 51% and obesity increased the frequency of absenteeism in the short and long term by 35%. CONCLUSIONS: An increased frequency of short-term and long-term absenteeism was found in female workers and in those with obesity


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Absenteísmo , Obesidade/complicações , Sobrepeso/complicações , Saúde do Trabalhador/estatística & dados numéricos , Estudos Transversais/estatística & dados numéricos , Peru
7.
Cancer Causes Control ; 31(8): 777-786, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32506334

RESUMO

PURPOSE: Overweight and obesity are risk factors for several cancers; however, population-based cancer registries do not routinely collect data on body mass index (BMI). This study evaluated the utility of supplementing cancer registry data with BMI data derived from driver's license records. METHODS: We linked self-reported height and weight data from driver's license records to directly measured values, obtained via medical record abstraction, in a sample of 712 adult Iowa residents with cancer diagnosed during 2007-2012. Matched BMI values were subjected to a comprehensive evaluation of quantitative and categorical measures of agreement between data sources. RESULTS: Driver's license issue dates preceded diagnosis dates in 60.7% of cases, with time lags ranging from 3.0 years pre-diagnosis to 2.9 years post-diagnosis. Statistical analysis of agreement between continuous BMI values and ordinal BMI categories yielded an overall intraclass correlation estimate of 0.79 (95% confidence interval [CI] 0.77, 0.82) and an overall weighted kappa estimate of 0.63 (95% CI 0.59, 0.68), respectively. Subgroup analyses indicated reduced reliability among obesity-related cancers, particularly multiple myeloma, ovarian cancer, and pancreatic cancer. Neither measurement order nor time lag significantly affected agreement between BMI values. CONCLUSIONS: These findings suggest that self-reported driver's license data provide a reasonable approximation of BMI, but are less precise than interview- and questionnaire-based methods. Furthermore, the degree of bias is seemingly unaffected by measurement order and time lag, but appears to become more pronounced as BMI itself increases.


Assuntos
Condução de Veículo , Índice de Massa Corporal , Licenciamento , Neoplasias/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Iowa , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações , Sistema de Registros , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
8.
Int J Obes (Lond) ; 44(8): 1784-1789, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32572128

RESUMO

BACKGROUND/OBJECTIVES: During the 2019 coronavirus disease (COVID-19) outbreak, obesity may contribute to COVID-19 transmission and deterioration. In addition, many patients with COVID-19 infection have suffered liver damage which might contribute to a worse prognosis. We conducted a clinical epidemiological analysis to investigate the association of overweight/obesity and abnormal liver function (ALF) with hospitalized duration in patients infected with COVID-19. SUBJECTS/METHODS: Fifty-eight patients with diagnosed COVID-19 (22 women & 36 men; average age: 49.2 ± 13.1 yr) were included, and their clinical data were collected at The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang. Overweight/obesity was determined as body mass index (BMI) ≥24 kg/m2, ALF was determined as alanine aminotransferase >40 U/L, and prolonged hospitalization was lasting more than the median value of the hospitalized days (19 days) in this population. RESULTS: The proportions of prolonged hospitalization were elevated in patients with overweight/obesity and ALF compared with those without overweight/obesity (62.1% versus 26.1%, P = 0.010) and those without ALF (70.6% versus 41.5%, P = 0.043). Kaplan-Meier analysis showed that the hospitalized duration was increased from the patients with neither overweight/obesity nor ALF to those with either overweight/obesity or ALF, and to those with both of overweight/obesity and ALF (mean with 95% confidence interval: 16.4 [14.5-18.3] versus 25.3 [21.6-29.1] versus 28.3 [24.6-32.0], P for trend = 0.001). Being discharged from hospital in time was inversely and independently associated with BMI (hazard ratio [HR] = 0.75, 95% CI: 0.63-0.90, P for trend = 0.002) and ALT (HR = 0.95, 95% CI: 0.92-0.99, P for trend = 0.007). CONCLUSIONS: Present findings suggested that overweight/obesity and/or ALF contributed to predicting a probability of prolonged hospitalization in patients with COVID-19 infection, to whom extra attentions and precautions should be paid during clinical treatments.


Assuntos
Alanina Transaminase/sangue , Infecções por Coronavirus/epidemiologia , Tempo de Internação/estatística & dados numéricos , Fígado/fisiopatologia , Pneumonia Viral/epidemiologia , Adulto , China/epidemiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Fígado/virologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/fisiopatologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Sobrepeso/fisiopatologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Estudos Retrospectivos
9.
Lancet Diabetes Endocrinol ; 8(7): 572-581, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32559473

RESUMO

BACKGROUND: Maternal overweight and obesity might increase risks of adiposity and cardiovascular and metabolic diseases in offspring. We examined associations between maternal overweight and obesity severity and risk of cardiovascular diseases in young offspring. METHODS: In this population-based cohort study, we used data from live singleton births recorded in the Swedish Medical Birth Register. We calculated maternal BMI in early pregnancy from self-reported height and weight measurements at the first prenatal visit. We used multivariable Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% CIs. We calculated the proportion of the associations mediated through known consequences of obesity that also predicted cardiovascular diseases and did family case-control analyses. FINDINGS: We identified 2 230 115 live singleton infants (without congenital malformations) in Sweden registered between Jan 1, 1992, and Dec 31, 2016. Overall, 1741 (0·08%) offspring were diagnosed with a cardiovascular disease between ages 1 and 25 years. Cardiovascular disease rates by maternal BMI categories were 0·57 per 10 000 child-years (BMI 18·5-24·9 kg/m2; normal weight), 0·61 per 10 000 child-years (25·0-29·9 kg/m2; overweight), 0·67 per 10 000 child-years (30·0-34·9 kg/m2; obesity grade I), 1·02 per 10 000 child-years (35·0-39·9 kg/m2; obesity grade II), and 1·38 per 10 000 child-years (≥40·0 kg/m2; obesity grade III). Compared with offspring of mothers with normal BMI, HRs of cardiovascular diseases were 1·10 (95% CI 0·97-1·25) for overweight, 1·16 (0·95-1·43) for obesity grade I, 1·84 (1·36-2·49) for obesity grade II, and 2·51 (1·60-3·92) for obesity grade III. Risks of cerebrovascular diseases increased with maternal obesity severity and were partly mediated through asphyxia-related neonatal complications. The sibling-cohort analysis also indicated a positive trend between maternal BMI and cardiovascular disease rates. INTERPRETATIONS: Our findings indicate that maternal obesity might be a risk factor for cardiovascular diseases in childhood and early adulthood. These results need to be replicated and possible underlying mechanisms identified. FUNDING: Swedish Research Council for Health, Working Life and Welfare.


Assuntos
Doenças Cardiovasculares/etiologia , Obesidade Materna/complicações , Sobrepeso/complicações , Complicações na Gravidez/etiologia , Irmãos , Adolescente , Adulto , Biomarcadores/análise , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/patologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
10.
Clin Drug Investig ; 40(8): 695-713, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32583294

RESUMO

Polycystic ovary syndrome is a complex and heterogenous disorder involving multiple organ systems and different molecular pathways. It is tightly associated with obesity and especially abdominal obesity. As body weight reduction is the main modifiable risk factor for polycystic ovary syndrome, therapeutic approaches in overweight or obese women with polycystic ovary syndrome have been developed. Liraglutide is a glucagon-like peptide-1 receptor agonist that promotes sustained weight loss, as well as abdominal fat reduction, in individuals with obesity, prediabetes, and type 2 diabetes mellitus. The majority of current clinical studies have demonstrated that liraglutide therapy achieved significant reductions in body weight, body mass index, and abdominal circumference in overweight and obese women with polycystic ovary syndrome. Liraglutide therapy promoted significant improvements in free testosterone and sex hormone-binding globulin levels in some studies. Important metabolic and hormonal improvements were also reported after the combination of liraglutide with metformin. Increased menstrual frequency, as well as potential positive effects in reproduction, were described. However, the small number of participants, short duration, and low daily liraglutide dose are some of the main limitations of these studies. Larger and longer, multi-centred, double-blind, placebo-controlled trials of liraglutide monotherapy or combination therapy, with prolonged post-interventional monitoring, are crucially anticipated. Metabolic, hormonal, and reproductive primary outcomes should be uniformly addressed, to tailor future targeted treatment approaches, according to the patient phenotype and needs. This will improve long-term therapeutic outcomes in this population.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Liraglutida/uso terapêutico , Síndrome do Ovário Policístico/complicações , Adulto , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Método Duplo-Cego , Feminino , Humanos , Metformina/administração & dosagem , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/tratamento farmacológico , Sobrepeso/complicações , Síndrome do Ovário Policístico/tratamento farmacológico , Síndrome do Ovário Policístico/fisiopatologia , Perda de Peso/efeitos dos fármacos
11.
Med Hypotheses ; 143: 109853, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32492559

RESUMO

The emergence of the novel betaCoronavirus has raised serious concerns due to the virus rapid dissemination worldwide. Many areas throughout the world are now experiencing the COVID 19 outbreaks with government and policy authorities taking many aggressive isolation or restriction measures, drastically reducing also patient's visits and limiting only to the most urgent ones such as oncological visits or emergencies. Several studies have demonstrated a relationship between increased weight, obesity, diabetes, hypertension and inflammatory skin diseases. Furthermore, weight loss interventions have been shown to improve psoriasis, as well as hidradenitis suppurativa, and increase responsiveness to treatment of this conditions. We suppose that due to aggressive isolation or restriction measures, in the next future dermatologist will face with a common worsening of chronic skin inflammatory conditions due to reduced physical activities, increased intake of calories with the derived increase body weight and always more frequent treatment discontinuation. It is time to start potential preventive strategies which could limit the expected negative impact of COVID-19 related quarantine on skin diseases.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/fisiopatologia , Betacoronavirus , Peso Corporal , Dermatologia/tendências , Surtos de Doenças , Progressão da Doença , Exercício Físico , Humanos , Inflamação , Obesidade/complicações , Sobrepeso/complicações , Pandemias , Quarentena , Isolamento Social , Ganho de Peso
12.
Rev Assoc Med Bras (1992) ; 66(3): 300-306, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520149

RESUMO

OBJECTIVES: To compare the serum concentrations of adipokines resistin and chemerin in children and adolescents with eutrophic and overweight and to evaluate their relationship with anthropometric, biochemical, and blood pressure variables. METHODS: a cross-sectional epidemiological study was conducted with 234 students enrolled in public elementary schools in the city of Juiz de Fora / MG. Anthropometric evaluation, biochemistry, and blood pressure measurement were performed. Statistical analyzes included the Student-t or Mann-Whitney tests, Pearson or Spearman correlation, used according to the distribution of the variables, and linear regression analysis, by means of the evaluation of the effect of the independent variables on the serum levels of chemerin and resistin, adjusted for age and sex. For the data analysis, SPSS® software version 21.0 and STATA® version 10.1 were used, assuming a significance level of 5%. RESULTS: the concentrations of chemerin were higher in eutrophic individuals than in those with excess weight (p> 0.05). In contrast, levels of resistin were higher in the young with excess weight than in the eutrophic ones (p <0.05). In the multiple linear regression analysis, the levels of chemerin were associated with the values of resistin, systolic, and diastolic blood pressure. Resistance levels maintained association only with BMI and chemerin values. CONCLUSION: the adipokines analyzed presented a distinct profile in the groups of children and adolescents with eutrophic and overweight.


Assuntos
Adiponectina/sangue , Quimiocinas/sangue , Sobrepeso/sangue , Resistina/sangue , Adipocinas , Adolescente , Antropometria , Criança , Estudos Transversais , Feminino , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Masculino , Sobrepeso/complicações , Sobrepeso/metabolismo
13.
Obesity (Silver Spring) ; 28(6): 1149-1156, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32379398

RESUMO

OBJECTIVE: People with diabetes show great variability in weight gain and duration of obesity at the time of diagnosis. BMI trajectories and other cardiometabolic risk factors prior to type 2 diabetes were investigated. METHODS: A total of 6,223 participants from the Rotterdam Study cohort were included. BMI patterns before diagnosis of diabetes were identified through latent class trajectories. RESULTS: During a mean follow-up of 13.7 years, 565 participants developed type 2 diabetes. Three distinct trajectories of BMI were identified, including the "progressive overweight" group (n = 481, 85.1%), "progressive weight loss" group (n = 59, 10.4%), and "persistently high BMI" group (n = 25, 4.4%). The majority, the progressive overweight group, was characterized by a steady increase of BMI in the overweight range 10 years before diabetes diagnosis. The progressive weight loss group had fluctuations of glucose and marked beta cell function loss. The persistently high BMI group was characterized by a slight increase in insulin levels and sharp increase of insulin resistance accompanied by a rapid decrease of beta cell function. CONCLUSIONS: Heterogeneity of BMI changes prior to type 2 diabetes was found in a middle-aged and elderly white population. Prevention strategies should be tailored rather than focusing only on high-risk individuals.


Assuntos
Índice de Massa Corporal , Diabetes Mellitus Tipo 2/etiologia , Obesidade/classificação , Sobrepeso/classificação , Adulto , Idoso , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Fatores de Risco , Ganho de Peso , Perda de Peso
14.
Phys Ther ; 100(9): 1681-1689, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32367136

RESUMO

OBJECTIVE: There is limited knowledge on how exercise impacts the pelvic floor muscles (PFM) and prevalence of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) postpartum. The purpose of this study was to investigate whether early onset of general exercise postpartum negatively affects the PFM and/or increases the risk of SUI and POP 12 months postpartum. METHODS: This study used a prospective cohort design. At 6 weeks postpartum, 57 women classified as exercisers (exercising ≥3 times at ≥30 min/wk) were compared with 120 nonexercisers (mean age = 29 years, SD = 4.3). Manometry was used to measure vaginal resting pressure, PFM strength, and PFM endurance, and symptoms of SUI and POP were assessed using questionnaires. Data were presented as standardized beta coefficients (B) and odds ratios (OR). RESULTS: No differences were found between exercisers (n = 57) and non-exercisers (n = 120) at 6 weeks postpartum on vaginal resting pressure (B = -0.04 [95% CI = -3.4 to 2.1]), PFM strength (B = 0.03 [95% CI = -4.7 to 7.4]), PFM endurance (B = -0.02 [95% CI = -59 to 46]), or symptoms of SUI (OR = 0.51 [95% CI = 0.25 to 1.1]) or POP (OR = 0.62 [95% CI = 0.26 to 1.5]) measured at 12 months postpartum. Adjusting for covariates, women with body mass index between 25 and 29.9 and >30 were more likely to report SUI 12 months postpartum (OR = 2.2 [95% CI = 1.0 to 4.7] and OR = 3.3 [95% CI = 1.2 to 9.4], respectively). Women with physically strenuous occupations were more likely to report POP 12 months postpartum (OR = 3.0 [95% CI = 1.2 to 7.3]). CONCLUSIONS: This study suggests that regular exercise 6 weeks postpartum has no negative effect on PFM function or on SUI or POP. Being overweight, however, was associated with more SUI, and women with physically strenuous occupations reported more POP. IMPACT: Results from this study suggest that first-time mothers should be encouraged to start general exercise within the first 6 weeks after giving birth. Women at risk for PFD should be advised accordingly and potentially modifiable risk factors should be addressed prior to delivery. LAY SUMMARY: First-time mothers are encouraged to talk with a physical therapist about starting regular general exercise in the early postpartum weeks. Health care providers should advise patients on possible preventive measures for women at risk for PFD.


Assuntos
Exercício Físico/fisiologia , Doenças Musculares/epidemiologia , Diafragma da Pelve/fisiologia , Período Pós-Parto/fisiologia , Adulto , Feminino , Humanos , Manometria , Força Muscular/fisiologia , Ocupações , Sobrepeso/complicações , Paridade , Prolapso de Órgão Pélvico/epidemiologia , Prolapso de Órgão Pélvico/etiologia , Gravidez , Prevalência , Estudos Prospectivos , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/etiologia , Vagina/fisiologia
15.
Jpn J Clin Oncol ; 50(8): 889-896, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32458984

RESUMO

OBJECTIVE: The relationship between body mass index and overall survival has been controversial in patients who suffered from hematological malignancies and underwent hematopoietic stem cell transplantation. METHODS: We collected the data of 686 acute leukemia patients who received only one allogeneic hematopoietic stem cell transplantation in our center from 2008 to 2017. Patients were divided into four groups (underweight, normal weight, overweight and obesity) according to their body mass index pre-hematopoietic stem cell transplantation. RESULTS: 56.4% of patients had normal body mass indices, 17.3% were underweight, 20.4% were overweight and 5.8% were with obesity. Concerning long-term follow-up, the probability of overall survival was significantly lower in overweight (P = 0.010) and patients with obesity (P = 0.065) as compared with normal weight patients, and no statistically significant difference between underweight and normal weight individuals (P = 0.810). The results demonstrated that higher body mass index was associated with poorer overall survival (hazard ratio: 1.79; 95% confidence interval: 1.33-2.40, P < 0.001) and shorter leukemia-free survival (hazard ratio: 1.78; 95% confidence interval: 1.35-2.34, P < 0.001). Additionally, patients exhibiting a higher body mass index were more likely to face the problem of relapse (30.6 vs 20.9%, P < 0.001). Furthermore, non-relapse mortality of patients with obesity was statistically higher than normal weight patients (22.5 vs 9.6%, P = 0.027). Besides, individuals with a higher abdominal girth had shorter survival (hazard ratio: 1.73; 95% confidence interval: 1.29-2.31, P < 0.001) and higher relapse rate (hazard ratio: 1.78; 95% confidence interval: 1.29-2.45, P = 0.001) as compared with those with a lower abdominal girth. CONCLUSION: Our results indicate that obesity at pre-hematopoietic stem cell transplantation stage, whether characterized by higher body mass index or abdominal girth, is correlated with poorer outcome.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Obesidade/complicações , Adolescente , Adulto , Criança , Intervalo Livre de Doença , Feminino , Transplante de Células-Tronco Hematopoéticas/mortalidade , Humanos , Estimativa de Kaplan-Meier , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia/patologia , Sobrepeso/complicações , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Magreza/complicações , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
16.
Obesity (Silver Spring) ; 28(9): 1586-1589, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32428380

RESUMO

OBJECTIVE: Mortality from coronavirus disease 2019 (COVID-19) is increased in patients with chronic obstructive pulmonary disease (COPD). Furthermore, higher BMI is related to severe disease. Severe acute respiratory syndrome coronavirus 2 utilizes angiotensin converting enzyme 2 (ACE2) to gain cellular entry. METHODS: Whether ACE2 bronchial epithelial expression is increased in COPD patients who have overweight compared with those who do not was investigated by RNA sequencing. RESULTS: Increased ACE2 expression was observed in patients with COPD with overweight (mean BMI, 29 kg/m2 ) compared with those without overweight (mean BMI, 21 kg/m2 ) (P = 0.004). CONCLUSIONS: Increased ACE2 expression may cause increased severe acute respiratory syndrome coronavirus 2 infection of the respiratory tract. Overweight COPD patients may be at greater risk for developing severe COVID-19.


Assuntos
Brônquios , Epitélio/metabolismo , Sobrepeso/complicações , Peptidil Dipeptidase A/genética , Doença Pulmonar Obstrutiva Crônica/genética , Idoso , Betacoronavirus , Infecções por Coronavirus , Feminino , Regulação da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica/complicações
17.
Medicine (Baltimore) ; 99(18): e11005, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358339

RESUMO

INTRODUCTION: Cardamom possesses antioxidant, anti-inflammation, and blood pressure lowering properties, which might improve endothelial function in type 2 diabetic patients. However, no study has examined the effect of cardamom on diabetic patients. The present study aimed to examine the effects of 10-week green cardamom intake on blood pressure, concentrations of inflammatory and endothelial function biomarkers in type 2 diabetes mellitus patients, and its potential mechanisms. METHODS AND ANALYSIS DESIGN: Eighty overweight or obese patients with type 2 diabetes mellitus (aged 30-60 years) will be recruited into the trial and will assign to receive either cardamom (3 g/day, 6 capsules) or placebo (rusk powder, 6 capsules) for a period of 10 weeks. Systolic blood pressure and diastolic blood pressure, asymmetric dimethylarginine, and nitric oxide will be measured. Serum inflammatory markers namely interleukin 6, tumor necrosis factor-α, high-sensitivity C-reactive protein, and factors related to endothelial function including intercellular adhesion molecule-1, vascular cell adhesion molecule 1, CD62 antigen-like family member E, and cluster of differentiation 163 will be measured at baseline and at the end of the trial. Sociodemographic, International Physical Activity Questionnaire, and three 24-hour dietary recall questionnaires will be collected for each participant. ETHICS AND DISSEMINATION: The study has been approved by The Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.REC.1395.2700). Each participant will sign a written informed consent at the beginning of the study. At the end of the study, results will be published timely manner. TRIAL REGISTRATION NUMBER: (http://www.irct.ir, identifier: IRCT-2016042717254N5) Date of registration: 2016-11-23.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Diabetes Mellitus Tipo 2/terapia , Suplementos Nutricionais , Elettaria , Endotélio/efeitos dos fármacos , Adulto , Biomarcadores/sangue , Determinação da Pressão Arterial , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
18.
Ann Epidemiol ; 46: 49-56.e5, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32448735

RESUMO

PURPOSE: To estimate racial/ethnic-stratified effects of maternal prepregnancy BMI on size for gestational age at birth, by comparing siblings within families. METHODS: This study examined linked vital statistics and patient discharge data from 580,960 infants born to 278,770 women in the State of California (2007-2012). To control for family-level confounding, we used fixed effects multinomial regression, modeling size for gestational age (small [SGA], appropriate, large [LGA]) as a function of maternal BMI (underweight, normal weight, overweight, obesity class I, II, III) and time-varying covariates. We conducted overall and race/ethnicity-stratified (non-Hispanic white, black, Asian; Hispanic) analyses. For comparison, we fit analogous random effects models, which do not control for family-level confounding. RESULTS: In fixed effects models, maternal BMI was most strongly associated with LGA in non-Hispanic white women, reaching 6.7 times greater for class III obesity (OR [95% CI]: 6.7 [5.1, 8.7]); and weakest in black women (OR [95% CI]: 3.0 [1.5, 5.7]). Associations with SGA were similar across race/ethnicity. Compared with random effects estimates, fixed effects were most attenuated for LGA associations among racial/ethnic minority women. CONCLUSIONS: Maternal prepregnancy BMI was differentially associated with size for gestational age across racial/ethnic groups, with the strongest family-level confounding in racial/ethnic minority women.


Assuntos
Peso ao Nascer , Grupos Étnicos/estatística & dados numéricos , Obesidade/etnologia , Sobrepeso/etnologia , Irmãos/etnologia , Adulto , Grupo com Ancestrais do Continente Africano , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Feminino , Idade Gestacional , Hispano-Americanos , Humanos , Recém-Nascido , Obesidade/complicações , Sobrepeso/complicações , Gravidez , Estados Unidos , Adulto Jovem
19.
BMC Public Health ; 20(1): 683, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410613

RESUMO

BACKGROUND: Taxi drivers are prone to developing cardiovascular disease (CVD) risk factors by adopting poor health behaviors due to their work environment. The population of Hispanic taxi drivers in inner city South Bronx, NYC, have not been studied. The goal of our qualitative study is to understand the perception, knowledge, behavior and barriers that influence CVD risk in overweight and obese inner-city Hispanic drivers. METHODS: A cross-sectional qualitative study was conducted among community-based taxi drivers in South Bronx, NYC. Hispanic taxi drivers with body mass index of greater than 25 kg/m2 were screened and recruited for the study. Focus groups were organized to evaluate CVD and obesity risk factors through open-ended questions. The discussions were recorded, transcribed and analyzed using standard qualitative techniques. The Health Belief Model framework was applied to understand and evaluate likelihood of promoting health behaviors in this population based on the findings from the focus groups. RESULTS: We conducted 3 focus groups (N = 25) and themes that emerged were evaluated. Through the Health Belief Model framework, Hispanic taxi driver participants reported demanding and stressful work shifts, barriers to better nutrition and good health, poor support systems, and low self-efficacy in overcoming barriers to improve their risk for CVD, due to lower perceived benefits and greater perceived barriers. CONCLUSIONS: Inner-city Hispanic NYC taxi drivers have several contributing factors and barriers leading to a poor CVD risk and high body weight profile. Understanding their knowledge, perception and barriers the drivers face in improving their CVD risk, underscores the importance of community outreach programs to develop a framework in empowering and improving the health of this population.


Assuntos
Condução de Veículo , Doenças Cardiovasculares/etiologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hispano-Americanos , Obesidade/complicações , Ocupações , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque , Sobrepeso/complicações , Pesquisa Qualitativa , Características de Residência , Fatores de Risco , Autoeficácia , Adulto Jovem
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