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Turkish Journal of Medical Sciences 2023Adipose tissue produces several inflammatory mediators. Thus, obesity affects the disease course and the responses to the antirheumatic agents in inflammatory diseases....
BACKGROUND/AIM
Adipose tissue produces several inflammatory mediators. Thus, obesity affects the disease course and the responses to the antirheumatic agents in inflammatory diseases. The aim of the study was to determine whether the body mass index (BMI) is involved in the response to rituximab in rheumatoid arthritis (RA).
MATERIALS AND METHODS
This multicenter retrospective study included 206 RA patients who received rituximab from the Turkish Biologic (TURKBIO) registry between 2011 and the end of May 2017. Demographic and clinical data including age, sex, disease type, disease duration, and previous or current treatment with disease-modifying antirheumatic drugs (DMARDs) and biological drug durations are stored in the database. Patients with a BMI ≥30 kg/m were classified as obese, and patients with a BMI <30 kg/m were classified as nonobese. Kaplan-Meier survival analysis was performed to estimate the drug survival. The subgroups were compared using the log-rank test.
RESULTS
The mean BMI of 206 patients included in the study was 27.05 (17.2-43.4) kg/m. There were 59 (28.6%) patients in the obese group and 147 (71.4%) patients in the nonobese group. The mean age, female percentage, and baseline disease activity score 28 (DAS28) were higher in the obese group than in the nonobese group. However, the ΔDAS28 at both 6 and 12 months were not significantly different between the groups (p = 0.785 and p = 0.512, respectively). Patient pain Visual Analogue Scale (VAS), patient fatigue VAS, and patient global VAS scores were also significantly higher at baseline in the obese group (p = 0.003, p = 0.006, and p = 0.006, respectively). However, no significant difference was found in terms of changes in patient pain VAS, patient fatigue VAS, patient global VAS and physician global VAS scores at 6 and 12 months compared to those at baseline. Rituximab treatment was ongoing for 71.2% of the obese and 63.3% of the nonobese patients (p = 0.279). The median drug survival duration was 77 months in the obese group and 62 months in the nonobese group (p = 0.053). The estimated drug survival rates for rituximab were not statistically significantly different in the obese and nonobese groups. Rituximab-related side effects were also similar between the groups.
CONCLUSION
In obese and nonobese patients with RA, rituximab treatment exhibits similar side effects and similar long-term efficacy. These results suggest that obesity does not alter drug survival for rituximab and response rates, in RA and rituximab may be a favorable treatment agent in patients with RA and obesity.
Topics: Humans; Arthritis, Rheumatoid; Female; Rituximab; Male; Middle Aged; Body Mass Index; Antirheumatic Agents; Registries; Retrospective Studies; Obesity; Adult; Treatment Outcome; Aged; Turkey
PubMed: 38813042
DOI: 10.55730/1300-0144.5698 -
Turkish Journal of Medical Sciences 2023Multiple sclerosis (MS) may cause modifications in body composition, particularly for body fat associated with obesity and some biochemical parameters such as lipid...
BACKGROUND/AIM
Multiple sclerosis (MS) may cause modifications in body composition, particularly for body fat associated with obesity and some biochemical parameters such as lipid profiles. We investigated whether there is a link between the inflammatory contents of diets and body composition and lipid profiles in patients with MS.
MATERIALS AND METHODS
This was a cross-sectional study that included 85 MS patients. The study data of the patients were collected in the Neurology Clinic of Ondokuz Mayıs University's Health Practice and Research Center. The data included demographic characteristics; anthropometric measurements such as body weight, height, body mass index, waist circumference, hip circumference, body fat mass, body fat-free mass, and waist-hip ratio; and biochemical parameters such as high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglyceride, and total cholesterol.
RESULTS
The body fat percentages of the patients were higher among those with proinflammatory diets (p < 0.05). Body fat percentage had a positive and very weak correlation with the Dietary Inflammatory Index (DII) score (rho = 0.206 and rho = 0.217, respectively; p < 0.05). HDL-c levels were higher in the group with high DII scores and there was a positive and weak correlation between HDL-c and DII scores (rho = 0.307, p < 0.05). Crude and adjusted linear regression models showed that the effect of HDL-c on DII scores was significant (p < 0.05).
CONCLUSION
We showed that DII scores, associated with the inflammatory potential of the diet and proinflammatory diets, may be associated with adiposity in MS patients and can be used from a clinical point of view for assessment.
Topics: Humans; Male; Female; Cross-Sectional Studies; Body Mass Index; Adult; Multiple Sclerosis; Adipose Tissue; Inflammation; Middle Aged; Lipids; Diet; Cholesterol, HDL; Body Composition
PubMed: 38813018
DOI: 10.55730/1300-0144.5681 -
Turkish Journal of Medical Sciences 2023To reveal the impacts of dapagliflozin, a sodium glucose transporter-2 inhibitor (SGLT-2i), on body weight and body composition, cardiovascular risk indices, and carotid...
BACKGROUND/AIM
To reveal the impacts of dapagliflozin, a sodium glucose transporter-2 inhibitor (SGLT-2i), on body weight and body composition, cardiovascular risk indices, and carotid intima-media thickness (CIMT).
MATERIALS AND METHODS
The data of patients with type-2 diabetes mellitus (T2DM) who applied to Department of Endocrinology and Metabolic Disorders between September 2019 and 2020, and had started dapagliflozin treatment along with their current medications were recorded retrospectively. Body weights, body compositions measured through bioelectrical impedance, and CIMT with T2DM receiving SGLT-2i treatment and medication were measured at weeks 1, 12, and 24 of 42. The visceral adiposity index (VAI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP) were used to determine the lipid measurements and anthropometric values.
RESULTS
The mean change in the total body weight and total fat mass was -2.96 and -1.97 kg, respectively (p < 0.001). There was a reduction in total fat mass of 1.23 kg (from 31.4 to 29.3 kg, p < 0.001) and in body fat percentage of 2.5% (from 35.8% to 34.4%, p < 0.001) in the first 12 weeks. A mild increase was observed in both the total fat mass and body fat percentage between weeks 12 and 24, which was not statistically significant (p = 0.783 and p = 0.925, respectively), whereas there was a statistically significant reduction in high-sensitive C-reactive protein (hsCRP), AIP, and CIMT values (p = 0.006, p = 0.035, and p = 0.007, respectively). No changes were observed in the VAI and LAP values (p = 0.985 and p = 0.636, respectively).
CONCLUSION
It was observed that dapagliflozin not only contributes to weight and fat loss but also has positive impacts on cardiovascular and atherosclerotic indicators.
Topics: Humans; Glucosides; Benzhydryl Compounds; Diabetes Mellitus, Type 2; Male; Female; Middle Aged; Body Composition; Sodium-Glucose Transporter 2 Inhibitors; Body Weight; Retrospective Studies; Carotid Intima-Media Thickness; Cardiovascular Diseases; Adult; Aged; Heart Disease Risk Factors
PubMed: 38813008
DOI: 10.55730/1300-0144.5683 -
Frontiers in Endocrinology 2024Childhood obesity tends to persist into adulthood, predisposing individuals to cardiometabolic risk (CMR). This study aims to investigate the mediating role of...
BACKGROUND
Childhood obesity tends to persist into adulthood, predisposing individuals to cardiometabolic risk (CMR). This study aims to investigate the mediating role of cardiorespiratory fitness (CRF) in the associations between multiple fatness indicators and individual CMR markers and clustered CMR-score, and explore sex differences.
METHODS
We recruited 1,557 children (age: 8 to 10, male/female: 52.7%/47.3%) in September 2022 in Ningbo, China. Physical examinations, overnight fasting blood test, and CRF was evaluated. The CMR-score was calculated by summing age- and sex-specific z scores of four CMR markers, including mean arterial blood pressure, triglycerides, the total cholesterol to high-density lipoprotein cholesterol ratio, and homeostatic model assessment for insulin resistance. Generalized linear mixed models were used to identify the associations, mediation analyses were performed to dissect the function of CRF.
RESULTS
Partial correlation analyses revealed positive associations between high fatness indicators (including body mass index [BMI], BMI z score, body fat mass index [BFMI] and waist-to-height ratio [WHtR]) and increased CMR markers, whereas high CRF was associated with decreased CMR markers (all < 0.05). In the mediation analyses, CRF emerged as a partial mediator, attenuating the relationship between four fatness indicators and CMR-score. Specifically, CRF mediated 6.5%, 7.7%, 5.3%, and 12.5% of the association between BMI, BMI z score, BFMI, WHtR and CMR-score (all < 0.001). And the mediating effects of CRF between WHtR and four individual CMR markers was particularly robust, ranging from 10.4% to 21.1% (all < 0.05). What's more, CRF mediates the associations between WHtR and CMR-score more pronounced in girls than boys with a mediation effect size of 17.3% ( < 0.001).
CONCLUSION
In Chinese children, CRF partially mitigates the adverse effects of fatness on CMR, underscoring the significance of enhancing CRF in children.
Topics: Humans; Male; Female; Child; Cardiorespiratory Fitness; China; Cardiometabolic Risk Factors; Body Mass Index; Adiposity; Pediatric Obesity; Cardiovascular Diseases; Cross-Sectional Studies; East Asian People
PubMed: 38812818
DOI: 10.3389/fendo.2024.1361447 -
Frontiers in Endocrinology 2024Prader-Willi syndrome (PWS) is a rare disease, which shows a peculiar clinical phenotype, including obesity, which is different from essential obesity (EOB).... (Comparative Study)
Comparative Study
INTRODUCTION
Prader-Willi syndrome (PWS) is a rare disease, which shows a peculiar clinical phenotype, including obesity, which is different from essential obesity (EOB). Metabolomics might represent a valuable tool to reveal the biochemical mechanisms/pathways underlying clinical differences between PWS and EOB. The aim of the present (case-control, retrospective) study was to determine the metabolomic profile that characterizes PWS compared to EOB.
METHODS
A validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) targeted metabolomic approach was used to measure a total of 188 endogenous metabolites in plasma samples of 32 patients with PWS (F/M = 23/9; age: 31.6 ± 9.2 years; body mass index [BMI]: 42.1 ± 7.0 kg/m), compared to a sex-, age- and BMI-matched group of patients with EOB (F/M = 23/9; age: 31.4 ± 6.9 years; BMI: 43.5 ± 3.5 kg/m).
RESULTS
Body composition in PWS was different when compared to EOB, with increased fat mass and decreased fat-free mass. Glycemia and HDL cholesterol were higher in patients with PWS than in those with EOB, while insulinemia was lower, as well as heart rate. Resting energy expenditure was lower in the group with PWS than in the one with EOB, a difference that was missed after fat-free mass correction. Carrying out a series of Tobit multivariable linear regressions, adjusted for sex, diastolic blood pressure, and C reactive protein, a total of 28 metabolites was found to be associated with PWS (vs. non-PWS, i.e., EOB), including 9 phosphatidylcholines (PCs) ae, 5 PCs aa, all PCs aa, 7 lysoPCs a, all lysoPCs, 4 acetylcarnitines, and 1 sphingomyelin, all of which were higher in PWS than EOB.
CONCLUSIONS
PWS exhibits a specific metabolomic profile when compared to EOB, suggesting a different regulation of some biochemical pathways, fundamentally related to lipid metabolism.
Topics: Humans; Prader-Willi Syndrome; Female; Male; Adult; Metabolomics; Case-Control Studies; Retrospective Studies; Obesity, Morbid; Metabolome; Young Adult; Body Mass Index; Body Composition; Chromatography, Liquid; Tandem Mass Spectrometry
PubMed: 38812813
DOI: 10.3389/fendo.2024.1386265 -
Turkish Journal of Medical Sciences 2024Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder in children. Determination of risk factors for the development of OSA is essential for early...
BACKGROUND/AIM
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder in children. Determination of risk factors for the development of OSA is essential for early diagnosis and treatment of the disease and decreases the risk of negative consequences. This study aimed to investigate the predictive values of Mallampati score, tonsillar size, and BMI z-score in the presence and severity of OSA in children.
MATERIALS AND METHODS
This prospective cross-sectional study included 114 children with OSA symptoms. All children were assessed by BMI z-score, Mallampati score, and tonsillar size and underwent overnight polysomnography. They were consecutively selected and assigned to 4 groups as follows: Group 1 included normal-weight with a low Mallampati score; Group 2 involved normal-weight with a high Mallampati score; Group 3 included obese with a low Mallampati score; and Group 4 involved obese with a high Mallampati score.
RESULTS
Of the 114 included children, 58 were female and 56 were male, with a mean age of 13.1 ± 2.9 years. OSA frequency and apnea-hypopnea index were significantly higher in group 4 compared with other groups (p = 0.003 and p < 0.0001, respectively), whereas average and minimum spO were significantly lower (for both, p = 0.001). Mallampati score and BMI z-score were found to be significant for predicting OSA (odds ratio = 4.147, 95% CI: 1.440-11.944; p = 0.008 and odds ratio = 1.760, 95% CI: 1.039-2.980; p = 0.035, respectively). Among OSA patients, the Mallampati score, tonsillar size, and BMI z-score were found to be significant for predicting OSA severity (odds ratio = 4.520, 95% CI: 1.332-15.335, p = 0.015, odds ratio = 9.177, 95% CI: 2.513-33.514, p = 0.001, and odds ratio = 2.820, 95% CI: 1.444-5.508; p = 0.002, respectively).
CONCLUSION
The coexistence of the Mallampati score and BMI z-score significantly increases the presence of OSA in children. Mallampati score, tonsillar size, and BMI z-score are promising parameters for predicting OSA severity.
Topics: Humans; Sleep Apnea, Obstructive; Male; Female; Palatine Tonsil; Cross-Sectional Studies; Body Mass Index; Prospective Studies; Child; Adolescent; Severity of Illness Index; Polysomnography; Predictive Value of Tests; Risk Factors
PubMed: 38812649
DOI: 10.55730/1300-0144.5791 -
Cardiovascular Diabetology May 2024Triglyceride and glucose (TyG) index, a surrogate marker of insulin resistance, has been validated as a predictor of cardiovascular disease. However, effects of... (Observational Study)
Observational Study
BACKGROUND
Triglyceride and glucose (TyG) index, a surrogate marker of insulin resistance, has been validated as a predictor of cardiovascular disease. However, effects of TyG-related indices combined with obesity markers on cardiovascular diseases remained unknown. We aimed to investigate the associations between TyG index and modified TyG indices with new-onset cardiovascular disease and the time-dependent predictive capacity using a national representative cohort.
METHODS
This study is a retrospective observational cohort study using data from China Health and Retirement Longitudinal Study (CHARLS) of 7 115 participants. The TyG index was calculated as Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The modified TyG indices were developed combining TyG with body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). We used adjusted Cox proportional hazards regression to analyze the association and predictive capacity based on hazard ratio (HR) and Harrell's C-index.
RESULTS
Over a 7-year follow-up period, 2136 participants developed cardiovascular disease, including 1633 cases of coronary heart disease and 719 cases of stroke. Compared with the lowest tertile group, the adjusted HR (95% CI) for new-onset cardiovascular disease in the highest tertile for TyG, TyG-BMI, TyG-WC, and TyG-WHtR were 1.215 (1.088-1.356), 1.073 (0.967-1.191), 1.078 (0.970-1.198), and 1.112 (1.002-1.235), respectively. The C-indices of TyG index for cardiovascular disease onset were higher than other modified TyG indices. Similar results were observed for coronary heart disease and stroke.
CONCLUSION
TyG and TyG-WhtR were significantly associated with new-onset cardiovascular diseases, and TyG outperformed the modified TyG indices to identify individuals at risk of incident cardiovascular event.
Topics: Aged; Female; Humans; Male; Middle Aged; Age Factors; Biomarkers; Blood Glucose; Body Mass Index; Cardiovascular Diseases; China; East Asian People; Heart Disease Risk Factors; Incidence; Predictive Value of Tests; Prognosis; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Triglycerides; Waist Circumference
PubMed: 38812015
DOI: 10.1186/s12933-024-02278-z -
Journal of Orthopaedic Surgery and... May 2024There is a lack of relevant studies to grade the evidence on the risk factors of chronic pain after total knee arthroplasty (TKA), and only quantitative methods are used...
BACKGROUND
There is a lack of relevant studies to grade the evidence on the risk factors of chronic pain after total knee arthroplasty (TKA), and only quantitative methods are used for systematic evaluation. The review aimed to systematically identify risk factors of chronic postoperative pain following TKA and to evaluate the strength of the evidence underlying these correlations.
METHODS
PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched from initiation to September 2023. Cohort studies, case-control studies, and cross-sectional studies involving patients undergoing total knee replacement were included. A semi-quantitative approach was used to grade the strength of the evidence-based on the number of investigations, the quality of the studies, and the consistency of the associations reported by the studies.
RESULTS
Thirty-two articles involving 18,792 patients were included in the final systematic review. Ten variables were found to be strongly associated with postoperative pain, including Age, body mass index (BMI), comorbidities condition, preoperative pain, chronic widespread pain, preoperative adverse health beliefs, preoperative sleep disorders, central sensitization, preoperative anxiety, and preoperative function. Sixteen factors were identified as inconclusive evidence.
CONCLUSIONS
This systematic review clarifies which risk factors could be involved in future research on TKA pain management for surgeons and patients. It highlights those factors that have been controversial or weakly correlated, emphasizing the need for further high-quality studies to validate them. Most crucially, it can furnish clinicians with vital information regarding high-risk patients and their clinical attributes, thereby aiding in the development of preventive strategies to mitigate postoperative pain following TKA.
TRIAL REGISTRATION
This systematic review has been registered on the PROSPERO platform (CRD42023444097).
Topics: Arthroplasty, Replacement, Knee; Humans; Pain, Postoperative; Risk Factors; Chronic Pain; Body Mass Index; Female; Age Factors; Male; Aged; Sleep Wake Disorders; Middle Aged; Comorbidity; Anxiety
PubMed: 38811979
DOI: 10.1186/s13018-024-04778-w -
BMC Public Health May 2024Obesity and mental health issues are two of the most prevalent global public health issues for a significant portion of people. The purpose of this study was to...
BACKGROUND
Obesity and mental health issues are two of the most prevalent global public health issues for a significant portion of people. The purpose of this study was to investigate the relationship between obesity indicators and mental health in Tehran-dwelling Iranian adults.
METHODS
We conducted a cross-sectional study on healthy Iranian adults using a convenience sampling technique. The short form of the Depression Anxiety and Stress Scale (DASS-21) was used to measure the outcome, and independent variables included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), and a body shape index (ABSI). The relationship between obesity and mental health was investigated using a multivariate logistic regression model. The non-linear dose-response relationships were evaluated using restricted cubic splines (RCS) with three knots. The Benjamini-Hochberg procedure was used to adjust for multiple testing.
RESULTS
In our study of 434 participants, females made up 52% of the participants, with a mean age of 38.57 years. In all, 54.6%, 53.9%, and 56.6% were classified as having anxiety, depression, and stress respectively. Logistic regression analysis showed that the odds of mental health components including anxiety, depression, or stress was not significantly different across the tertiles of the obesity indicators. We observed a significant dose-response relationship between BAI and ABSI and the risk of anxiety (P 0.028 > P 0.023) and stress (P 0.028 > P 0.003) but not depression (P 0.014 < P 0.018). The lowest risk for anxiety was observed in people with a BAI of 28% and ABSI equal to 0.079. The risk of stress seemed to increase beyond an ABSI of 0.086.
CONCLUSION
Our findings showed no direct linear association between obesity indices and anxiety. However, a dose-response relationship was observed between BAI and ABSI and the risk of anxiety and stress, indicating the need for further investigation.
Topics: Humans; Iran; Female; Cross-Sectional Studies; Male; Adult; Obesity; Middle Aged; Depression; Anxiety; Stress, Psychological; Risk Factors; Body Mass Index
PubMed: 38811944
DOI: 10.1186/s12889-024-18670-z -
BMC Pediatrics May 2024To evaluate the effects of local radiotherapy (RT) on growth, we evaluated the chronological growth profiles and vertebral features of children with high-risk...
BACKGROUND
To evaluate the effects of local radiotherapy (RT) on growth, we evaluated the chronological growth profiles and vertebral features of children with high-risk neuroblastoma.
METHODS
Thirty-eight children who received local photon or proton beam therapy to the abdomen or retroperitoneum between January 2014 and September 2019 were included. Simple radiography of the thoracolumbar spine was performed before and every year after RT. The height and vertical length of the irradiated vertebral bodies (VBs) compared with the unirradiated VBs (vertebral body ratio, VBR) were analyzed using the linear mixed model. Shape feature analysis was performed to compare the irradiated and unirradiated vertebrae.
RESULTS
The follow-up was a median of 53.5 months (range, 21-81 months) after RT. A decline in height z-scores was mainly found in the early phase after treatment. In the linear mixed model with height, the initial height (fixed, p < 0.001), sex (time interaction, p = 0.008), endocrine dysfunction (time interaction, 0.019), and age at diagnosis (fixed and time interaction, both p = 0.002) were significant. Unlike the trend in height, the change in VBR (ΔVBR) decreased gradually (p < 0.001). The ΔVBR in the group that received more than 30 Gy decreased more than in the group that received smaller doses. In the shape feature analysis, the irradiated VBs changed to a more irregular surface that were neither round nor rectangular.
CONCLUSION
The irradiated VBs in children were gradually restricted compared to the unirradiated VBs in long-term follow-up, and higher RT doses were significantly affected. Radiation-induced irregular features of VBs were observed.
Topics: Humans; Neuroblastoma; Male; Female; Child, Preschool; Child; Infant; Follow-Up Studies; Retrospective Studies; Body Height; Thoracic Vertebrae; Lumbar Vertebrae; Abdominal Neoplasms; Vertebral Body; Proton Therapy; Retroperitoneal Neoplasms
PubMed: 38811872
DOI: 10.1186/s12887-024-04813-z