Obesity and overweight are the most common cardiovascular risk factors in people who have suffered myocardial infarction. They are also considered a threat to health worldwide. People with obesity ...have twice the risk of suffering heart failure than people with a normal body mass index. In this paper, fuzzy logic models which are optimized are proposed to detect risk factors for heart disease according to age and body mass index.
Giriş: Ortostatik hipotansiyon, klinik ortamda olası semptomlardan şikâyet edilmedikçe genel olarak kontrol edilmeyen ve hayatı tehdit eden ciddi bir sorundur. Amaç: Erişkin bireylerde Ortostatik ...Hipotansiyonun Beden Kütle İndeksi (BKİ) ile ilişkisini incelemek ve Ortostatik Hipotansiyonun nabız, solunum ve oksijen satürasyonu ile ilişkisini değerlendirmektir. Yöntem: Tanımlayıcı ve analitik tipte olan bu araştırma, Şubat-Nisan 2019 tarihleri arasında bir hastanenin karma cerrahi kliniğine estetik ve obezite cerrahisi nedeniyle yatışı yapılan 170 erişkin birey ile yürütülmüştür. Bireyler 10 dakika supine pozisyonda yatırılmış, yataktan kalkmadan ve kalktıktan bir dakika sonra kan basıncı, nabız, solunum ve oksijen satürasyonu değerleri ölçülerek kayıt edilmiştir. Sistolik Kan Basıncı (SKB)’nda 20 mmHg ve/veya daha fazla düşüş Ortostatik Sistolik Hipotansiyon (OSH); Diyastolik Kan Basıncı (DKB)’nda 10 mmHg ve/veya daha fazla düşüş Ortostatik Diyastolik Hipotansiyon (ODH); hem SKB’de 20 mmHg ve/veya üzeri hem de DKB’de 10 mmHg ve üzeri düşüş Ortostatik Hipotansiyon (OH) olarak değerlendirilmiştir. Birey ayağa kaldırıldıktan sonra ortostatik hipotansiyon belirtileri açısından da sorgulanmıştır. Bulgular: Araştırmaya katılan bireylerin yaş ortalaması 34.41±10.50, %87.6’sı kadındır. Bireylerin %12.9’unda OSH, %25.9’ unda ODH ve %4.1’inde OH saptanmıştır. Ortostatik Hipotansiyon saptanan bireylerin BKİ ortalaması saptanmayanlara göre anlamlı olarak daha yüksek bulunmuştur. Nabız, solunum ve oksijen satürasyonu değerlerinde postural değişiklikle birlikte istatistiksel olarak anlamlı bir değişim görülmemiştir. OSH saptanan bireylerde en sık ifade edilen belirtiler göz kararması, baş dönmesi, çarpıntı ve bulanık görme iken ODH ve OH saptanan bireylerde yorgunluk, çarpıntı, bulanık görme ve göz kararmasıdır. Sonuç: Beden Kütle İndeksi ortalamasının yüksek olması OSH, ODH ve OH riskini artırdığı, bu riskin OH saptanan bireylerde anlamlı olduğu görülmüştür.
Background: Orthostatic hypotension is a serious, life-threatening problem in the clinical environment that is generally not controlled unless possible symptoms are complained.
Objectives: The aim of this study is to examine the relationship between Orthostatic Hypotension and Body Mass Index (BMI) in adult individuals hospitalized in mixed surgery clinic and to evaluate the relationship of Orthostatic Hypotension with pulse, respiration and oxygen saturation.
Methods: This quasi-experimental study was conducted from February to April in 2019 in the mixed surgery clinic within a hospital. Individuals were placed in a supine position for 10 minutes, and their blood pressure, heart rate, respiration and oxygen saturation were measured and recorded before getting out of bed and one minute after getting out. The individuals were also questioned in terms of orthostatic hypotension symptoms after standing up.
Results: The mean age of the individuals participating in the study is 34.41±10.50, 87.6% of them are women. Orthostatic Systolic Hypotension (OSH) was detected in 12.9% of the individuals, Orthostatic Diastolic Hypotension (ODH) in 25.9% and Orthostatic Hypotension (OH) in 4.1%. The average BMI of individuals with orthostatic hypotension was found to be significantly higher than those without. There was no statistically significant change in pulse, respiration and oxygen saturation values with postural change. The most common symptoms in individuals with OSH are blackout, dizziness, whereas those in individuals with ODH and OH are fatigue, palpitations.
Conclusion: It was observed that a high mean Body Mass Index increased the risk of OSH, ODH and OH, and this risk was significant in individuals with OH.
The present research aimed to study the relationship between body mass index (BMI), sex hormones, leptin, and irisin in children and adolescents with different body types.
In this study, a stratified ...cluster random sampling method was used to select students aged 8-15 years from two 9-year schools as the research subjects. Based on a case-control study, 183 overweight/obese students were selected. After using sex and age matching to create a matched sample of
students, a total of 366 students, including 214 boys (58.5%) and 152 girls (41.5%) were included. We measured their height and weight and calculated their body mass index BMI. Afterward, their concentrations of leptin, irisin, oestradiol (E2), and testosterone (T) in the serum were detected.
There were significant differences in T, E2, leptin, and irisin between normal-weighted boys and girls (
< 0.05). There were statistically significant differences in T, E2, and irisin between overweight/obese boys and girls (
< 0.05). Overweight/obese students had higher concentrations of irisin and leptin than normal-weight students
< 0.05). The direct effect of BMI on irisin was not statistically significant in either normal or overweight/obese students, but their indirect effects
leptin were statistically significant (for normal-weight boys and girls, standardized indirect effect coefficient: 0.29 and 0.38, respectively; for overweight/obese boys and girls, standardized indirect effect coefficient: 0.36 and 0.34, respectively). There was a negative pathway of E2 → leptin → irisin in normal-weight boys (standardized indirect effect coefficient: -0.24) and a negative pathway of T → leptin → irisin in overweight/obese boys (standardized indirect effect coefficient: -0.27).
The indirect effects of BMI on irisin
leptin exist in children and adolescents of different body types. E2 was negatively correlated with leptin in normal-weight boys, whereas T was negatively correlated with leptin in overweight/obese boys.
Transient elastography (TE) is a noninvasive technique used to measure liver stiffness to estimate the severity of fibrosis. The range of liver stiffness measurements (LSMs) in healthy individuals is ...unclear. We performed a systematic review to determine the range of LSMs, examined by TE, in healthy individuals and individuals who are susceptible to fibrosis.
We collected data from 16,082 individuals, in 26 cohorts, identified from systematic searches of Embase, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for studies of liver stiffness measurements. Studies analyzed included apparently healthy adults (normal levels of liver enzymes, low-risk alcohol use patterns, and negative for markers of viral hepatitis). The presence of diabetes, hypertension, dyslipidemia, or steatosis, based on ultrasound examination, was known for most participants. We performed a meta-analysis of data from individual participants. The cohort was divided into 4 groups; participants with a body mass index <30 kg/m
were examined with the medium probe and those with a body mass index ≥30 kg/m
were examined with the extra-large probe. Linear regression models were conducted after adjusting for potential confounding factors of LSMs. We performed several sensitivity analyses.
We established LSM ranges for healthy individuals measured with both probes-these did not change significantly in sensitivity analyses of individuals with platelets ≥150,000/mm
and levels of alanine aminotransferase ≤33 IU/L in men or ≤25 IU/L in women. In multivariate analysis, factors that modified LSMs with statistical significance included diabetes, dyslipidemia, waist circumference, level of aspartate aminotransferase, and systolic blood pressure at examination time. Significant increases in LSMs were associated with the metabolic syndrome in individuals examined by either probe. Diabetes in obese individuals increased the risk of LSMs in the range associated with advanced fibrosis.
In a systematic review and meta-analysis of data from individual participants, we established a comprehensive set of LSM ranges, measured by TE in large cohorts of healthy individuals and persons susceptible to hepatic fibrosis. Regression analyses identified factors associated with increased LSMs obtained by TE with the medium and extra-large probes.
To evaluate the association between intuitive eating and health outcomes in patients with type 2 diabetes in a cross-sectional study.
Consecutively, outpatients attending at university hospital ...underwent clinical, laboratory, lifestyle, and eating behavior evaluations. Intuitive eating was assessed using the Intuitive Eating Scale-2 (IES-2), and the Three Factor Eating Questionnaire-21 was adopted as a confirmatory tool for disordered eating behavior. Optimized health outcomes were considered according to the American Diabetes Association criteria for BMI, HbA1c, lipid profile, and blood pressure values, and the International Diabetes Federation criteria for waist circumference. Considering the answers of the IES-2 items, patients were grouped by latent class analysis, and their characteristics were compared by appropriate tests.
In total, 267 patients were evaluated: 62.2% women, with 60 (53-65) years, BMI 31.9 ± 5.4 kg/m², diabetes duration of 16 ± 9 years, HbA1c 8.5 ± 1.5%, and an IES-2 total score of 58 (50-67)%. Three intuitive eating groups were identified: higher intuitive eating, nonemotional-oriented coping, and lower intuitive eating. Patients with higher intuitive eating have higher chances of having optimized BMI and serum triglycerides values compared to patients with lower intuitive eating. Also, the 10-point increase on IES-2 was associated with a 0.62 kg/m² reduction on BMI values (95%CI -1.18;-0.06), 1.90 cm on waist circumference (95%CI -3.26;-0.54), and 23 mg/dL in serum triglycerides values (95%CI -38.27;-7.40) after adjustment for age, sex, psychotropic drug use, medication effect score, smoking, and BMI.
Intuitive eating seems to be associated with optimized health outcomes and may contribute to better personalized interventions in nutritional treatment that promote adaptive behaviors in diabetes management, but should be tested.
The objective of this study is to assess the effectiveness of a maternal exercise program (land/aquatic activities, both aerobic and muscular conditioning) in preventing gestational diabetes mellitus ...(GDM).
Three hundred and forty-two pregnant women from Spain (age, 33.24 ± 4.3 yr) without obstetric contraindications were recruited for a clinical randomized controlled trial. The intervention group (IG, n = 101) exercised for 60 and 50 min on land and in water, respectively, three times per week. The control group (n = 156) received usual standard care.
The prevalence of GDM was reduced in the IG group (IG, 1%, n = 1, vs control group, 8.8%, n = 13 (χ1 = 6.84, P = 0.009)) with a significant risk estimate (odds ratio = 0.103; 95% confidence interval, 0.013-0.803).
The exercise program performed during pregnancy reduced the prevalence of GDM by preserving glucose tolerance.
The purpose of the study was to evaluate and identifying the level of excess weight and obesity in older students between 15 and 18 years, as important benchmarks of the level of health in order to ...update the recommendations regarding the promotion of an active and healthy lifestyle. A cross-sectional study was conducted on a sample of 400 subjects, (186 boys and 214 girls), aged 15 to 18. Anthropometric data including: body height, body weight, Body Mass Index (BMI). Participants' BMI was estimated using the Percentile BMI calculator for children and teenagers aged 2 to 19. Study adolescents were defined as underweight, normal (healthy) weight, overweight, and obese according to the CDC child growth characteristics for age, sex, and BMI. 350 (85.5%) subjects were healthy weight; 26 respondents (6.5%) were overweight, 17 (4.25%), were obese, while 7 (1.75%) underweight. The analysis of the individual results of male and female subjects points to increased values of the body mass of males (18.81%), compared to female pupils (3%). Out of a total of 186 male students, 10.75% were in the overweight category, and 8.06% were categorized as obese, in constrast 2.80% of the girls were overweight and (1%<), in the obese category, which is an outstanding result, where obesity practically does not exist. According to the results of this study (for both sexes), in relation to gender, there were more malnourished girls (2.33%), compared to boys (1%<). Among high school students in Bosnia and Herzegovina, the number of children with overweight and obesity is relatively low compared to data from other countries. Based on the relevant results of this study, we consider it necessary to update strategies for promoting an active and healthy lifestyle regarding physical activity and eating habits for adolescents in relation to the specifics of the countries of residence and European trends.
Background: Type 2 diabetes (T2DM) remains a challenge to treat despite the expansion of various therapeutic classes. Visepegenatide (PB-119) is a once a week, subcutaneous, glucagon-like peptide-1 ...receptor agonist (GLP-1 RA) injection without the requirement of dose titration that has shown glycaemic control and safety profile in two phase 2 studies conducted in China and the United States, respectively. The aim of this study was to evaluate the efficacy and safety of visepegenatide as a monotherapy in treatment-naïve patients with T2DM. Methods: This was a multicentre, double-blind, parallel, placebo-controlled, phase 3 trial conducted in 30 centres in China. Adult participants (aged 18–75 years) with T2DM, glycated haemoglobin (HbA1c) of 7.5%–11.0% 58.47–96.73 mmol/mol, body mass index (BMI) of 18–40 kg/m2, and who had been treated with diet and exercise alone for at least 8 weeks before the screening visit were eligible for enrolment. After a 4-week placebo injection run-in period, participants with HbA1c of 7.0%–10.5% 53.0–91.3 mmol/mol and fasting plasma glucose (FPG) < 15 mmol/L were randomised in a ratio of 1:1 to receive visepegenatide (150 μg) or placebo subcutaneous injections once a week for 24 weeks. The treatment was extended to another 28 weeks during which all participants received visepegenatide. The primary outcome was a change in HbA1c from baseline to week 24. This study was registered with ClinicalTrials.gov, as NCT04504370. Findings: Between November 2, 2020, and November 2, 2022, we randomly assigned 273 adult participants to the visepegenatide (n = 137) and placebo (n = 136) groups. In total, 257 (94.12%) participants, 131 (95.6%) on visepegenatide, and 126 (92.6%) on placebo, completed the double-blinded treatment period. At baseline, the mean (SD) HbA1c was 8.47% (0.81) 69.07 8.81 mmol/mol, which rapidly decreased to 7.63% (0.80) 59.94 8.70 mmol/mol with visepegenatide by week 4 of treatment, and the change from baseline was significantly greater than that in the placebo group (−0.82% −0.90 to −0.74; −8.99 −9.89 to −8.10 mmol/mol vs −0.30% −0.41 to −0.19; −3.30 −4.50 to −2.09 mmol/mol). At week 24, when evaluating the effects of treatment with treatment policy estimand, the least square mean (LSM change in HbA1c from baseline was −1.36 (95% confidence interval CI −1.52 to −1.20) −14.84 −16.60 to −13.08 mmol/mol in the visepegenatide group vs −0.63 (−0.79 to −0.46) −6.84 −8.61 to −5.07 mmol/mol in the placebo group. The reduction in HbA1c was significantly greater with visepegenatide than placebo (LSM difference −0.73, 95% CI −0.96 to −0.50; p < 0.001). When evaluating the treatment estimand with hypothetic policy, the LSM change in HbA1c from baseline in the visepegenatide group (−1.37 −1.53 to −1.20) −14.95 −16.76 to −13.14 mmol/mol was significantly greater than the placebo group (−0.63 −0.81 to −0.45) 6.90 (−8.89 to −4.90) mmol/mol. The LSM difference was (−0.74, 95% CI −0.98 to −0.49; −8.00 −10.50 to −5.50 mmol/mol; p < 0.001. A significantly greater proportion of the visepegenatide group achieved a target HbA1c level of <7% (<53 mmol/mol) than the placebo (50.4% vs 14.2%; p < 0.05) and stringent HbA1c level of ≤6.5% (≤48 mmol/mol) (26.7% vs 7.9%), respectively. There was also a significantly greater improvement in FPG, 2-h postprandial glucose, homeostasis model assessment (HOMA) of beta cell function, post-prandial insulin, fasting, and post-prandial C-peptide level (p < 0.05) with visepegenatide treatment. The number (3 2.2%) of participants who received rescue therapy in the visepegenatide group was remarkably lower compared with those (17 12.5%) in the placebo group (p < 0.05). During the extended treatment period, visepegenatide consistently maintained the efficacy till week 52 confirmed by all the above endpoints. The reduction in HbA1c at week 52 was −1.39% (−1.58 to −1.19) −15.14 −17.28 to −13.01 mmol/mol, which was even greater than that at week 24. There was also a significant improvement in HOMA-insulin resistance (p = 0.004) at week 52 compared with the baseline value. For the placebo→visepegenatide group, which received visepegenatide in the extended treatment period, a notable decrease in HbA1c at week 52 compared to baseline was observed. The change from baseline in HbA1c was −1.49% (−1.68 to −1.30) −16.27 −18.37 to −14.16 mmol/mol. The outcome was in the same direction as the visepegenatide group from the double-blind treatment period. Comprehensive benefits of visepegenatide including weight loss, improvement in lipid profile, and reduction in blood pressure have been demonstrated in this study. Visepegenatide reduced the body weight in a BMI-dependent manner that was prominent in BMI ˃32 kg/m2 with a mean (SD) reduction of −4.77 (13.94) kg at week 52 (p < 0.05). Incidences of gastrointestinal adverse events were less common than other weekly GLP-1 RA in the market, and most of the adverse events were mild and moderate in nature, occurring in the first weeks of the treatment, and were transient. No serious hypoglycaemia or grade 2 hypoglycaemia (blood glucose: ≤3 mmol/L) was reported during the study. Interpretation: As a monotherapy, visepegenatide provided rapid without the risk of hypoglycaemia, significant, and sustainable glycaemic control by improving islet β-cell function and insulin resistance. Treatment with visepegenatide induced early treatment response in reducing HbA1c and maintaining glycaemic control for 52 weeks. Meanwhile, visepegenatide provided a comprehensive benefit in body weight loss, lipids, and blood pressure reduction. Visepegenatide had a better safety profile than other weekly GLP-1 RA in participants with T2DM even without the requirement of dose titration. Visepegenatide would provide an optimal treatment approach with its high benefit and low-risk balance. Funding: PegBio Co., Ltd.
Abstract Introduction The large amount of excess adipose tissue affects negatively every single step of the assisted reproductive treatment process – from the controlled ovarian hyperstimulation ...(COH) to obstetric complications and health consequences for the fetus. A number of scientific data show correlation between impaired clinical pregnancy rates (CPR) and obese patients maintaining high body mass index (BMI). The debate whether high proportion of body fat negatively affects oocyte quality or only impacts endometrial receptivity remains open. Aim The aim of this study is to investigate the specific effect of the different BMI range in patients undergoing assisted reproductive technology (ART) treatment with reference to oocyte quality, fertilization capacity and Implantation potential. Materials and methods We analyzed a total of 4,882 women from partner couples who underwent ART treatment. Height and weight data were entered at the start of the in vitro fertilization (IVF) procedure. According to their BMI the female patients were divided in four distinct groups: in group 1 (underweight and BMI below 18.5 kg/m 2 ) – 498 women, group 2 (normal range from 18.5 to 24.9 kg/m 2 ) – 3021 women, group 3 (overweight with BMI between 25 – 29.9 kg/m 2 ) – 789 women and group 4 (obese with BMI over 30 kg/m 2 ) - 484 women. Results Distribution of the women in different BMI groups indicates that most of the Bulgarian patients undergoing fertility treatment are in the normal range. No association between BMI and ovarian response was found. A total of 33,205 oocytes were obtained after the COH. The mean numbers of the retrieved oocytes were similar (6,85 in group 1; 6,83 in group 2, 6,77 in group 3 and 6,67 in group 4) per woman and the fertilization rate was comparable in the four groups as it varies between 74-75%. Proportional categories of good, fair and bad embryos at cleavage stage were found. On the contrary according to CPR, Statistical difference between normal weight group (34,38%) versus overweight (29,6%) and obese groups (28,80%) (p < 0,05) was found. Conclusion No correlation was found between the number of the retrieved oocytes and BMI values. Statistically lower pregnancy rates were reported in overweight women with BMI ≥ 25 kg/m 2 group and further onwards in the obesity group (BMI ≥ 30 kg/m 2 ), which may be associated with impaired endometrial receptivity as a result of abnormally high levels of adipose tissue.
PDF
