Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography

AIM:To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography(SS-OCT).METHODS:According to the body mass index(BMI)results,the adults enrolled in the cross-sectional study were divided into the normal group(18.50≤BMI<25.00 kg/m^(2)),the overweight group(25.00≤BMI<30.00 kg/m^(2)),and the obesity group(BMI≥30.00 kg/m^(2)).The one-way ANOVA and the Chi-square test were used for comparisons.Pearson’s correlation analysis was used to evaluate the relationships between the measured variables.RESULTS:This research covered the left eyes of 3 groups of 434 age-and sex-matched subjects each:normal,overweight,and obesity.The mean BMI was 22.20±1.67,26.82±1.38,and 32.21±2.35 kg/m^(2) in normal,overweight and obesity groups,respectively.The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group(P<0.05 for all),while the retinal thickness of the three groups did not differ significantly.Pearson’s correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness,but no significant correlation was observed between BMI and retinal thickness.CONCLUSION:Choroidal thickness is decreased in people with overweight or obesity.Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.

Epidemiological Aspects of Obesity, Overweight and Cardiovascular Risk Factors at Associes in Semi-Urban Areas (Case of Sébikotane)

Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

Food insecurity increases the risk of overweight and chronic diseases in adolescents: a systematic review and meta-analysis

To investigate the relationship between food insecurity(FI)and overweight/obesity(OW/OB)or corresponding chronic diseases in adolescents,33 studies with 181135 individuals were included in this meta-analysis.Six studies and 10 studies,reported a higher risk of overweight and obesity in adolescents experiencing FI,respectively(OR 1.38,95%CI 1.20‒1.58,P<0.0001;OR 1.11,95%CI 1.01‒1.22,P=0.035,respectively).Based on the pooled results,adolescents with severe FI had the highest risk of OW/OB(OR 1.45,95%CI 1.20‒1.75,P<0.0001).The pooled OR indicated no signifi cant association between FI and OW/OB,when the adolescents were stratifi ed into those under 6 years old and those between 6 and 18 years old.Eleven studies assessed the relationship between FI and the risk of chronic diseases.The anemia subgroup was significantly associated with FI(OR 1.67,95%CI 1.30‒2.13,P<0.0001).Severe FI was reported to increase the risk of hypertension(OR 1.59,95%CI 1.28‒1.98,P<0.0001).Furthermore,a pooled analysis revealed a signifi cant association between FI and the risk of chronic diseases in both 6 and 6-18-year-old subgroups.

Effects of glucagon-like peptide-1 receptor agonists on glucose excursion and inflammation in overweight or obese type 2 diabetic patients

BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.

Report on Childhood Obesity in China (4) Prevalence and Trends of Overweight and Obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on Obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive program should be focused on the improvement of the balance between caloric intake and energy expenditure, and interventions aimed at changing children＇s life styles.

Report on Childhood Obesity in China (1) Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.

Trends of Overweight and Obesity in Yi People between 1996 and 2007:An Yi Migrant Study

Objective To evaluate trends of overweight and obesity prevalence between 1996 and 2007 in Yi farmers and Yi migrants.Methods An Yi migrant study was conducted in Liangshan Yi Autonomous Prefecture,Sichuan Province,China from 1996 to 2007.Data were collected with identical methods,including standardized questionnaire and body measurements.Results Age‐ and sex‐specific body mass index （BMI） significantly increased from 20.02 in 1996 to 22.36 in 2007,among Yi farmers,which was significantly different from those among Yi migrants （23.67 in 2007 and 20.90 in 1996） （P0.05）.Prevalence of obesity rose from 1.21 % in 1996 to 4.55 % in 2007 （OR=1.15,P0.001） in Yi migrants,while that in Yi farmers from none in 1996 to 0.12 % in 2007 （P0.05）.Prevalence of overweight rose significantly to 26.24 %in 2007 from 17.24 % in 1996 （OR=1.06,P0.001） in Yi migrants,while that in Yi farmers from 1.29 % in 1996 to 4.45 % in 2007 （OR=1.14,P0.001）.Yi migrants appeared to have a 5.52‐fold higher risk ondeveloping overweight and obesity than Yi farmers have.Conclusion The Yi migrants had a steeper increase of overweight with year and consequently caused more obesity.Change in lifestyle may contribute most likely to higher prevalence of overweight and obesity in Yi migrants.

ApoB/apoA1 is an effective predictor of coronary heart disease risk in overweight and obesity

We investigated the relationship of apoB/apoA1 ratio and coronary heart disease （CHD） in persons who were overweight or obese. The subjects were divided by the body mass indexes （BMI） into the normal weight group （n=397, BMI〈24 kg/m2） and the overweight group （n=400, BMI〉24 kg/m2）. Our results showed that the overweight group had higher blood pressure [（130.15±19.01） mmHg vs （123.66±18.70） mmHg] and higher levels of blood sugar [（7.09±2.89） mmol/L vs （6.21±2.59） mmol/L], triglyceride [（1.93±1.19） mmol/L vs （1.44 ±0.85） mmol/L], total cholesterol [（4.26±1.06） mmol/L vs （4.09±0.99） mmol/L], low-density lipoprotein cholesterol （LDL-C） [（2.56±0.75） mmol/L vs （2.39±0.72） mmol/L], and apoB [（0.83±0.27） mg/L vs （0.78±0.23） mg/L], and a higher apoB/apoA1 ratio （0.83 ±0.27 vs 0.75±0.25） and lower levels high-density lipoprotein cholesterol [（1.10±0.26） mmol/L vs （1.21±0.31） mmol/L] and apoA1 [（1.04±0.20） mg/L vs （1.08±0.22） mg/L] than those of the normal weight group （all P 〈 0.05）. The prevalence of CHD in the over-weight group in the lowest LDL quartile was almost twice greater than that of the highest apoB/apoA1 quartile, compared with the subjects in the lowest apoB/apoA1 quartile. The higher apoB/apoA1 quartile was in agreement with the higher prevalence of CHD. In the overweight and obesity group, the area under ROC curve （AUC） was the highest for apoB/apoA1 （0.655）. The cut-off point of apoB/apoA1 for optimal sensitivity and specificity was at 0.80, with a sensitivity of 57.19% and a specificity of 71.72%. In conclusion, apoB and apoA1 were simple clinical indicators, and the apoB/apoA1 ratio was closely related with CHD in overweight and obese patients. The apoB/apoA1 ratio may provide some useful information in the differential diagnosis.

Prevalence of Overweight and Obesity among Students Aged 7-22 Years in Jiangsu Province,China

Objective To report the prevalence and trend of overweight and obesity among students aged 7-22 years in Jiangsu, 2010 to 2013. Methods This cross-sectional study was carried out as part of students physical fitness and health survey in Jiangsu province. A total of 255,581 subjects （50.03% males and 49.97% females） enrolled in 82 school and 10 universities in Jiangsu. Weights and heights were obtained for each subject and its body mass index （BMI） was calculated using the Chinese Working Group on Obesity in China （CWGO）. Results Anthropometric measurement including bodyweight, height, BMI and bust were significantly different between males in urban compared to females living rural areas （P〈0.001）. The total prevalence of overweight and obesity was 12.4% and 5.7%. Males had a significantly higher rate than in female＇s student. The prevalence of overweight and obesity by age groups was （14.5%, 10.3%） at age 7-11 years, （11.2%, 6.8%） at age 12-14 years, （11.7%, 3.1%） at age 15-17 years, and （11.4%, 2.3%） at age 18-22 years. By regions; the highest prevalence of overweight obesity reported in Taizhou （10.0%, 14.2%）, Xuzhou （9.4%, 12.5%）, and Nanjing （9.2%, 15.6%）, respectively. Conclusion The finding declares that overweight and obesity are important health problems among students in Jiangsu Province. Early intervention programme are needed to address this problems.

Impact of being overweight on the surgical outcomes of patients with gastric cancer: A meta-analysis

AIM: To investigate the effect of being overweight on the surgical results of patients with gastric cancer. METHODS: Comprehensive electronic searches of the PubMed, Web of Science, and Cochrane Library databases were conducted. Studies were identified that included patients with surgical complications from gastric cancer who were classified as normal weight [body mass index (BMI) < 25 kg/m 2 ] or overweight (BMI ≥ 25 kg/m 2 ). The operative time, retrieved lymph nodes, blood loss, and long-term survival were analyzed. A subgroup analysis was conducted based on whether patients received laparoscopic or open gastrectomy procedures. All statistical tests were performed using ReviewerManager 5.1.2 software. RESULTS: This meta-analysis included 23 studies with 20678 patients (15781 with BMI < 25 kg/m 2 ; 4897 with BMI ≥ 25 kg/m 2 ). Overweight patients had significantly increased operation times [MD: -29.14; 95%CI: -38.14-(-20.21); P < 0.00001], blood loss [MD: -194.58; 95%CI: -314.21-(-74.95); P = 0.001], complications (RR: 0.75; 95%CI: 0.66-0.85; P < 0.00001), anastomosis leakages (RR: 0.59; 95%CI: 0.42-0.82; P = 0.002), and pancreatic fistulas (RR: 0.486; 95%CI: 0.34-0.63; P < 0.00001), whereas lymph node retrieval was decreased significantly in the overweight group (MD: 1.69; 95%CI: 0.75-2.62; P < 0.0001). In addition, overweight patients had poorer long-term survival (RR: 1.14; 95%CI: 1.07-1.20; P < 0.0001). No significant difference was detected for the mortality and length of hospital stay. CONCLUSION: This meta-analysis demonstrates that a high BMI not only increases the surgical difficulty and complications but also impairs the long-term survival of patients with gastric cancer.

Overweight and Obesity-Induced Oxidative Stress in Children

Objective To investigate whether overweight and obesity might cause oxidative stress and potential oxidative damage in overweight and obese children, and to explore its possible mechanism. Methods Eighty-five overweight and obese children （OOC）, and eighty-five age-matched healthy children （HC） were recruited in this case-control study. The present study analyzed spectrophotometrically vitamin C （VC）, vitamin E （VE）, and β-carotene （β-CAR） in plasma, as well as the activities of superoxide dismutase （SOD）, catalase （CAT）, and the level of malondialdehyde （MDA） in erythrocytes. Results Compared with those of VC, VE, β-CAR, SOD, CAT and MDA in the HC group, the average values of VC, VE, β-CAR, SOD, and CAT in the OOC group were significantly decreased （P〈0.001）, while the average value of MDA in the OOC group was significantly increased （P〈0.001）. The regression analysis demonstrated that VC, VE, β-CAR, SOD, and CAT were negatively correlated （P〈0.05-0.01）, and MDA was positively correlated with BMI （P〈0.05）. Fitting to the model of multiple stepwise regression of BMI on VC, VE, β-CAR, SOD, CAT, and MDA in 85 OOC was Y = 27.0041 ＋ 0,2541MDA - 2.1448β-CAR -- 0.0090CAr, where F = 43.8088, P〈0.001, r = 0.7866, r^2= 0.6187, adjusted r^2= 0.6046. The findings from the reliability analysis for VC, VE, β-CAR, SOD, CAT, and MDA used to reflect increased oxidative stress and potential oxidative damage in the OOC showed that the reliability coefficients （alpha, 6 items） = 0.7231, P〈0.0001, and that the standardized item alpha = 0.9207, P〈0.0001, Conclusion The present study suggests that there exists an increased oxidative stress in overweight and obese children.

Low-income and overweight in China:Evidence from a life-course utility model

Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey(CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation;while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation.We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas.

Gender Differences in the Prevalence of Overweight and Obesity,Associated Behaviors,and Weight-related Perceptions in a National Survey of Primary School Children in China

Objective To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children. Methods Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders. Results Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio （OR） 2.30, 95% CI 2.00 to 2.65] and rural areas （OR = 1.85, 95% CI 1.55 to 2.20）. Girls reported healthier diets （e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85） whereas boys consumed fried food （OR = 1.21, 95% CI 1.06 to 1.38） and sugar-sweetened drinks more often （OR = 1.49, 95% CI 1.34 to 1.65）. Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers （OR = 1.35, 95% CI 1.09 to 1.68）, less educated fathers （OR = 0.79, 95% CI 0.63 to 0.99）, and if they frequently consumed carbonated drinks （OR = 1.48, 95% CI 1.07 to 2.05）. Conclusion Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.

Overweight and obesity in hip and knee arthroplasty:Evaluation of 6078 cases

AIM: To evaluate a possible association between thevarious levels of obesity and peri-operative characteristics of the procedure in patients who underwent endoprosthetic joint replacement in hip and knee joints. METHODS: We hypothesized that obese patients were treated for later stage of osteoarthritis, that more conservative implants were used, and the intraand perioperative complications increased for such patients. We evaluated all patients with body mass index(BMI) ≥ 25 who were treated in our institution from January 2011 to September 2013 for a primary total hip arthroplasty(THA) or total knee arthroplasty(TKA). Patients were split up by the levels of obesity according to the classification of the World Health Organization. Average age at the time of primary arthroplasty, preoperative Harris Hip Score(HHS), Hospital for Special Surgery score(HSS), gender, type of implanted prosthesis, and intra-and postoperative complications were evaluated.RESULTS: Six thousand and seventy-eight patients with a BMI ≥ 25 were treated with a primary THA or TKA. Age decreased significantly(P < 0.001) by increasing obesity in both the THA and TKA. HHS and HSS were at significantly lower levels at the time of treatment in the super-obese population(P < 0.001). Distribution patterns of the type of endoprostheses used changed with an increasing BMI. Peri- and postoperative complications were similar in form and quantity to those of the normal population. CONCLUSION: Higher BMI leads to endoprosthetic treatment in younger age, which is carried out at significantly lower levels of preoperative joint function.

A plant-based diet for overweight and obesity prevention and treatment

The goal of this paper is to review the evidence related to the effect of plant-based dietary pattems on obesity and weight loss, includingboth observational and intervention trials. Literature from plant-based diets （PBDs） epidemiological and clinical trial research was used toinform this review. In addition, data on dietary quality, adherence, and acceptability were evaluated and are presented. Both clinical trials andobservational research indicate an advantage to adoption of PBDs for preventing overweight and obesity and promoting weight loss. PBDsmay also confer higher levels of diet quality than are observed with other therapeutic diet approaches, with similar levels of adherence andacceptability. Future studies should utilize health behavior theory to inform intervention development and delivery of PBDs studies and newtechnologies to bring interventions to scale for greater public health impact. Research examining PBDs and weight loss is also needed withmore diverse populations, including older adults. Based on the available evidence, PBDs should be considered a viable option for the treat-ment and prevention of overweight and obesity.

Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring

BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in adulthood.It is very important to identify relevant risk factors and intervene as early as possible.At present,the relationship between maternal and offspring metabolic factors is conflicting.AIM To estimate the association of maternal obesity and gestational diabetes mellitus(GDM)with overweight/obesity and fatty liver risk in offspring at 8 years of age.METHODS The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age.Offspring birth weight,sex,height,weight,and body mass index(BMI)were measured and calculated.FibroScan-502 examination with an M probe(Echosens,Paris,France)was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.RESULTS A total of 430 mother-child pairs were included in the analysis.A total of 62(14.2%)mothers were classified as obese,and 48(11.1%)were classified as having GDM.The mean age of the offspring at follow-up was 8 years old.Thirty-seven(8.6%)offspring were overweight,14(3.3%)had obesity,and 60(14.0%)had fatty liver.The prevalence of overweight,obesity and fatty liver in offspring increased significantly across maternal BMI quartiles(all P<0.05).Among offspring of mothers with GDM,12(25.0%)were overweight,4(8.3%)were obese,and 12(25.0%)had fatty liver vs.25(6.5%),10(2.6%)and 48(12.6%),respectively,for offspring of mothers without GDM(all P<0.05).In multiple logistic regression,after adjustment for variables,the OR for fatty liver in offspring was 8.26(95%CI:2.38-28.75)for maternal obesity and GDM.CONCLUSION This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring,and GDM status also increases the odds of overweight/obesity in offspring.Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.

Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center.Patients were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI<25;Group A),overweight(25≤BMI<30;Group B)and obese(BMI≤30;Group C),for a total of 412 patients evaluable for this study.Preoperative total serum prostate-specific antigen(PSA),digital rectal examination of the prostate,transrectal ultrasound(TRUS),renal ultrasound,urine culture,uroflowmetry,International Prostate Symptoms Score(IPSS),and Quality of Life(QoL)score were analyzed.Post-operative complications,hospital stay and days of catheterization,questionnaires and uroflowmetry at 1 and 3 months after surgery were evaluated.Preoperative data,surgical outcomes,complication rate and clinical outcomes were compared between groups.Results:The median age of patients was 69 years(Interquartile Range[IQR 10]).The preoperative median IPSS among groups was 19(IQR 8.75),20(IQR 10),and 18(IQR 10)respectively.At 1 and 3 months of follow-up,this value was 8(IQR 7),8(IQR 4),7(IQR 5)and 5(IQR 6.25),5(IQR 6),6(IQR 5),respectively(all p between groups>0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.

Body mass index and its effects on liver fat content in overweight and obese young adults by proton magnetic resonance spectroscopy technique

AIM To assess the association between liver fat content(LFC) and weight status in young adults using proton magnetic resonance spectroscopy(1H MRS) technique.METHODSSeventy-eight healthy young adults, between 19-30 years of age participated in this study. This group was then separated into a control of 39 subjects and an overweight/obese group(OW/OB group) consisting of 39 subjects. Blood biochemical quantity and 1 H MRS was performed for LFC assessment.RESULTS LFC was found to be almost three times higher in OW/OB group when compared to the control group. A 48.7% incidence of non-alcoholic fatty liver disease in the OW/OB group was found. Blood biochemical measurements showed statistically higher low-density lipoproteins and triglyceride, lower highdensity lipoproteins, and increased glycosylated hemoglobin and fasting glucose in the OW/OB group. Body mass index was a significant independent predictor for LFC after adjusting for age and sex(multiple linear regression; β = 0.459, P <0.001).CONCLUSION Due to the prevalence of high LFC in the OW/OB group, it can be proposed that weight gain and obesity are sensitive indicators of high hepatic fat content.

Influence of overweight and obesity on the mortality of hospitalized patients with community-acquired pneumonia

BACKGROUND Obesity is associated with a better prognosis in patients with community-acquired pneumonia(the so-called obesity survival paradox),but conflicting results have been found.AIM To investigate the relationship between all-cause mortality and body mass index in patients with community-acquired pneumonia.METHODS This retrospective study included patients with community-acquired pneumonia hospitalized in the First Hospital of Qinhuangdao from June 2013 to November 2018.The patients were grouped as underweight(<18.5 kg/m^(2)),normal weight(18.5-23.9 kg/m^(2)),and overweight/obesity(≥24 kg/m^(2)).The primary outcome was all-cause hospital mortality.RESULTS Among 2327 patients,297(12.8%)were underweight,1013(43.5%)normal weight,and 1017(43.7%)overweight/obesity.The all-cause hospital mortality was 4.6%(106/2327).Mortality was lowest in the overweight/obesity group and highest in the underweight group(2.8%,vs 5.0%,vs 9.1%,P<0.001).All-cause mortality of overweight/obesity patients was lower than normal-weight patients[odds ratio(OR)=0.535,95%confidence interval(CI)=0.334-0.855,P=0.009],while the allcause mortality of underweight patients was higher than that of normal-weight patients(OR=1.886,95%CI:1.161-3.066,P=0.010).Multivariable analysis showed that abnormal neutrophil counts(OR=2.38,95%CI:1.55-3.65,P<0.001),abnormal albumin levels(OR=0.20,95%CI:0.06-0.72,P=0.014),high-risk Confusion-Urea-Respiration-Blood pressure-65 score(OR=2.89,95%CI:1.48-5.64,P=0.002),and intensive care unit admission(OR=3.11,95%CI:1.77-5.49,P<0.001)were independently associated with mortality.CONCLUSION All-cause mortality of normal-weight patients was higher than overweight/obesity patients,lower than that of underweight patients.Neutrophil counts,albumin levels,Confusion-Urea-Respiration-Blood pressure-65 score,and intensive care unit admission were independently associated with mortality in patients with community-acquired pneumonia.

Replacement Meal: Effectiveness of a Soluble Powder Rich in Fibers and at Low Glycemic Index in Overweight but Not in Obese Patients

Active lifestyle and qualitative and quantitative diets are the best way to lose weight. In our study we have assessed the effectiveness and tolerability of a soluble powder rich in fibers and at low glycemic index and used, with a portion of fresh fruit, as replacement meal (for a total calorie intake ranging from a minimum of about 130 kcal to a maximum of 260 kcal) in 52 overweight/obese subjects of the outpatient clinic of the Italian National Research Council (CNR) of Rome already in treatment with a low-fat low-carbohydrates qualitative diet. The study was a parallel, prospective trial of two randomized sample groups, “intervention” (26 subjects) and “control” (26 subjects). After 8 weeks, the treatment based on the replacement meal has improved the results obtained through the qualitative diet alone above all in the overweight subjects: 11/16, versus only 2/16 in the control group, became ranged within normal weight. On the contrary, the majority of obese subjects didn’t change their BMI classification suggesting that, in case of obesity, a controlled quantitative correction with weighing food portions could be a better strategy than low-calorie replacement meal.