体重指数、高脂血症、脂肪肝3者的相关性调查分析

目的:探讨体重指数(BMI)、高脂血症、脂肪肝3者的相关性。方法:以2008～2009年在上海中医药大学附属曙光医院健康体检人群4586例为研究对象,统计分析其体检中体重指数、血脂、脂肪肝情况。结果:超重及肥胖总检出率为45.42%,随年龄增长,BMI随之增长,高脂血症、脂肪肝的检出率增加,其组间差异有统计学意义(P<0.01);高脂血症组脂肪肝的检出率高于无高脂血症组,其差异有统计学意义(P<0.01);脂肪肝的检出率与血脂成分有关,高甘油三酯血症组脂肪肝的检出率较高胆固醇血症组增加,其组间差异有统计学意义(P<0.01)。结论:体重指数与高脂血症、脂肪肝的发生呈正相关,脂肪肝的形成与甘油三酯关系密切。

腰臀比和体重指数对不同性别急性冠脉综合征发病的预测价值

目的:探讨陕西人群不同性别腰臀比和体重指数与急性冠脉综合征(ACS)的关系。方法:收集因ACS年龄、性别、民族匹配的非ACS患者165例,测量腰臀比(WHR)和体重指数(BMI);Logistic回归分析WHR和BMI与ACS的关系。结果:与正常对照者相比,女性ACS患者的BMI、WHR明显升高。与正常对照者相比,男性ACS患者的BMI、TG、hsCRP明显升高。多变量Logistic回归分析发现,在女性研究对象中,WHR与ACS的回归系数为17.895(P<0.001),BMI并未进入回归方程。在男性研究对象中,WHR未进入回归方程,而BMI与ACS发生的回归系数为2.62(P=0.001)。结论:BMI与男性ACS的关系更为密切,WHR与女性ACS的发生关系更为密切。

单纯性肥胖患儿BMI相关危险因素多元线性回归分析

目的:研究单纯性肥胖患儿BMI相关危险因素,为预防肥胖相关疾病在儿童中的流行提供一定的指导。方法:对68例单纯性肥胖儿童测量身高、体重,留空腹血并检测血脂、肝功、血糖、胰岛素、C反应蛋白、单核细胞趋化因子、内脂素。结果:线性相关分析显示,BMI与C反应蛋白、单核细胞趋化因子、谷草转氨酶、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、胰岛素等具有简单线性相关;多元线性回归显示,甘油三酯、胰岛素、C反应蛋白、低密度脂蛋白与BMI密切相关。结论:甘油三酯、胰岛素、C反应蛋白、低密度脂蛋白与肥胖相关疾病密切相关,肥胖儿童通过降低其BMI水平,对于预防血脂紊乱、炎症性疾病及2型糖尿病的发生有重要意义。

超重育龄妇女孕前BMI与巨大儿发生相关性的研究

目的:探讨孕前体重对新生儿出生体重的影响,为降低巨大儿发生率、减少妊娠并发症提供临床资料。方法:收集进行产检和生产的515例足月产妇的孕前体重、身高等各项资料,记录其新生儿出生体重、身长等新生儿信息。根据孕前BMI分为超重组和正常组。运用SPSS软件分析孕前BMI与新生儿出生体重等的关系。结果:超重组巨大儿发生率16.7%,正常组发生率8.5%,两组的发生率存在显著的统计学差异(χ~2=6.004,P<0.05),孕前BMI超重组巨大儿发生率明显高于孕前BMI正常组;BMI≥25是巨大儿发生的危险因素(RR=1.943,95%CI 1.135–3.326)。结论:孕产妇孕前BMI超重是巨大儿发生的危险因素,具有显著的相关性,孕产妇及医护人员应当就此做好巨大儿的早期干预和预防措施,以获得更好的预期和结果。

Prevalence of and risk factors for postprandial hypotension in older Chinese men

Objective To assess the prevalence of and risk factors for postprandial hypotension （PPH） among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age categories： group 1 （old） included 163 men aged 65 to 80 years; group 2 （very old） included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use Results The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 （63.4% vs. 54.6%, P 〈 0.05）. In group 2, the prevalence of PPH after breakfast （33.8%） and lunch （32.1%） were higher than that after supper （20.9%）, P 〈 0.05. Hypertension and age were significant risk factors for PPH （OR = 2.188, 95% CI： 1.134-4.223, P = 0.02; OR = 1.86, 95% CI： 1.112-3.11, P = 0.018, respectively）. In contrast, acarbose use was protective against PPH （OR = 0.4, 95% CI： 0.189-0.847, P = 0.017）. The decrease in blood pres- sure during PPH was 20-40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30-60 min after a meal and lasted 30-120 rnin. Conclusions These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.

Impact of obesity on the surgical outcome following repeat hepatic resection in Japanese patients with recurrent hepatocellular carcinoma

AIM: To evaluate the impact of obesity on the posto- perative outcome after hepatic resection in patients with hepatocellular carcinoma (HCC). METHODS: Data from 328 consecutive patients with primary HCC and 60 patients with recurrent HCC were studied. We compared the surgical outcomes between the non-obese group (body mass index: BMI < 25 kg/m2) and the obese group (BMI ≥ 25 kg/m2). RESULTS: Following curative hepatectomy in patients with primary HCC, the incidence of postoperative complications and the long-term prognosis in the non- obese group (n = 240) were comparable to those in the obese group (n = 88). Among patients with recurrent HCC, the incidence of postoperative complications after repeat hepatectomy was not significantly different between the non-obese group (n = 44) and the obese group (n = 16). However, patients in the obese group showed a significantly poorer long-term prognosis than those in the non-obese group (P < 0.05, five-yearsurvival rate; 51.9% and 92.0%, respectively). CONCLUSION: Obesity alone may not have an adverse effect on the surgical outcomes of patients with primary HCC. However, greater caution seems to be required when planning a repeat hepatectomy for obese patients with recurrent HCC.

Is obesity associated with gastropharyngeal reflux disease?

AIM: To examine the association between obesity and gastropharyngeal reflux disease (GPRD) as well as gastroesophageal reflux disease (GERD) METHODS: We conducted a cross-sectional study of consecutive patients undergoing ambulatory 24-h dual-probe pH monitoring from July 2003 to December 2006. The association between body mass index (BMI) and parameters about gastroesophageal or gastropharyngeal reflux was examined in univariate and multivariate analyses.RESULTS: A total of 769 patients (307 men and 462 women; mean age 50.7 years) were finally enrolled. Most variables showing gastroesophageal reflux was higher in the obese patients than the patients with normal BMI. There was no difference in all the variables showing gastropharyngeal reflux according to the BMI. After adjustment for age, sex, alcohol intake and smoking, obese patients demonstrated an about 2-fold increase in risk of GERD compared with patients with normal BMI (OR, 1.9; 95 CI, 1.3-2.9), but overweight patients did not demonstrate increased risk of GERD (OR, 1.2; 95 CI, 0.8-1.7). Both obese patients and overweight patients did not demonstrated increased risk of GPRD compared with patients with normal BMI (OR, 1.1; 95 CI, 0.8-1.7; and OR, 0.9; 95 CI, 0.6-1.3, respectively).CONCLUSION: Obesity is not associated with GPRD reflux while it is associated with GERD.

Gut bacteria alteration in obese people and its relationshipwith gene polymorphism

AIM:To investigate the differences in cultivable gut bacteria and peroxisome proliferator-activated receptor γ2(PPAR-γ2) gene Pro12Ala variation in obese and normal-weight Chinese people.METHODS:Using culture methods,the amounts of Escherichia coli,Enterococci,Bacteroides,Lactobacilli,Bif idobacteria and Clostridium perfringens(C.perfringens) in the feces of 52 obese participants [body mass index(BMI):≥ 28 kg/m2] and 52 participants of normalweight(BMI:18.5-24 kg/m2) were obtained.Study participants completed comprehensive questionnaires and underwent clinical laboratory tests.The polymerase chain reaction-restriction fragment length polymorphism(PCR-PFLP) assay was used to analyze PPAR-γ2 gene Pro12Ala variation.RESULTS:The obese group exhibited a lower amount of C.perfringens(6.54 ± 0.65 vs 6.94 ± 0.57,P = 0.001)and Bacteroides(9.81 ± 0.58 vs 10.06 ± 0.39,P = 0.012) than their normal-weight counterparts.No major differences were observed in Pro12Ala genotype distribution between the two groups;however,obese individuals with a Pro/Ala genotype had a signif icantly lower level of Bacteroides(9.45 ± 0.62 vs 9.93 ± 0.51,P = 0.027) than those with a Pro/Pro genotype.In addition,the obese group demonstrated a higher stool frequency(U = 975,P < 0.001) and a looser stool(U = 1062,P = 0.015) than the normal-weight group.CONCLUSION:Our results indicated interactions among cultivable gut flora,host genetic factors and obese phenotype and this might be helpful for obesity prevention.

Influences of different time intervals between loop electrosurgical excision and abdominal hysterectomy or radical hysterectomy on postoperative complications: a retrospective analysis

Objective： To study the influences of different time intervals between loop electrosurgical excision （LEEP） and abdominal hysterectomy or radical hysterectomy on postoperative complications. Methods： Sixty-eight patients, who received subsequent abdominal hysterectomy or radical hysterectomy after LEEP due to C1N III and cervical cancer （IA1, IA2 and IB1）, were included in the present study. The hospital and clinic records of these patients were reviewed. The patients were divided into three groups according to the time intervals between LEEP and hysterectomy or radical hysterectomy： group l（within 48 h）, group 2 （between 48 h to 6 weeks）, and group 3（〉 6 weeks ）.Results： General characteristics of patients, including the mean age, delivery history, BMI, menopausal status, clinical stage and HPV infection, were comparable between patients of different groups. There were no significant differences in the mean transfusion amount, posthysterectomy hospital stay or operation time between different groups. The frequencies and spectrum of complications were not significantly affected by the time interval between LEEP and hysterectomy or radical hysterectomy. Conclusion： It is concluded that whenever the LEEP is done, the operation including hysterectomy or radical hysterectomy can be conducted at any time as it is necessary for the patients.

Natural history of heartburn:A 10-year population-based study

AIM： To study the natural history and prevalence of heartburn at a 10-year interval, and to study the effect of heartburn on various symptoms and activities. METHODS： A population-based postal study was carried out. Questionnaires were mailed to the same age- and gender-stratified random sample of the Icelandic population （aged 18-75 years） in 1996 and again in 2006. Subjects were classified with heartburn if they reported heartburn in the preceding year and/or week, based on the definition of heartburn. RESULTS： Heartburn in the preceding year was reported in 42.8% （1996） and 44.2% （2006） of subjects, with a strong relationship between those who experienced heartburn in both years. Heartburn in the precedingweek was diagnosed in 20.8%. There was a significant relationship between heartburn, dyspepsia and irritable bowel syndrome. IndMduals with a body mass index （BMI） below or higher than normal weight were more likely to have heartburn. Heartburn caused by food or beverages was reported very often by 20.0% of subjects. CONCLUSION： Heartburn is a common and chronic condition. Subjects with a BMI below or higher than normal weight are more likely to experience heartburn. Heartburn has a great impact on daily activities, sleep and quality of life.

Correlates of subjectively and objectively measured physical activity in young adolescents

Background： Many studies examining individual-level correlates in youth utilize self-report rather than objective measures of physical activity （PA）. This utilization of self-report may result in associations that are not present when examining objectively measured PA. The present study investigates the relationship between hypothesized correlates of PA with objectively and subjectively measured PA. Methods： Participating children （n 232, 101 males, mean age - 12.3 years） provided a minimum of four monitored days of PA （via accelerometer） and completed a survey assessing moderate-to-vigorous physical activity （MVPA）, sport competence, appearance, enjoyment, and self-efficacy. Height and weight were measured and body mass index （BMI） was calculated. Results： Hierarchical regression models controlling for sex, race, and BMI Z-score showed that only sex and BMI Z-score were significant correlates of objective MVPA while only sex was a significant correlate of objective total PA. However, in a separate model examining the relationship with subjective MVPA, enjoyment of PA and self-efficacy for PA were the only significant correlates of self-reported PA. Conclusion： Measuring MVPA via self-report versus accelerometry produces considerably different results in a sample of young adolescents. Future studies should use caution when selecting outcome measures if the intent is to identify modifiable correlates of MVPA in youth.

Prevalence of Abnormity of Blood Lipid and Associated Factors in Health Examination Population in Beijing

Objective To investigate the prevalence of abnormity of blood lipid and associated factors in healthy population in Beijing. Methods Totally, 38 462 individuals who received health examination were enrolled in our study. We divided them into eight groups according to their ages. The levels of serum total cholesterol, triglyceride, high density lipoprotein cholesterol, and low density lipoprotein cholesterol were tested, and the relationship of blood lipid abnormity with body mass index (BMI) and fasting blood glucose was analyzed. Results The incidences of hypercholesterolemia, hyperglyceridemia, low high-density lipoprotein cholesterolemia, and hyper low-density lipoprotein cholesterolemia presented increasing trend in this population. The incidence rate of abnormity of blood lipid in health examination population increased with BMI increase. The incidence of abnormity of blood lipid in overweight and obesity population was significantly higher than that in low weight and normal weight populations (P<0.05). Meanwhile, the trend of abnormal blood lipid incidence coincided with that of abnormal fasting blood glucose. Conclusions The prevalence of overweight, obesity, and abnormity of blood lipid in Beijing presents increasing trend. The incidence of abnormity of blood lipid increases with BMI increase, in coincidence with that of fasting blood glucose.

Advanced wasting in peritoneal dialysis patients

AIM To identify patients with end-stage renal disease treated by peritoneal dialysis(PD) who had zero body fat(BF) as determined by analysis of body composition using anthropometric formulas estimating body water(V) and to compare nutritional parameters between these patients and PD patients whose BF was above zero.METHODS Body weight(W) consists of fat-free mass(FFM) andBF.Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73,where 0.73 is the water fraction of FFM at normal hydration.Wasting from loss of BF has adverse survival outcomes in PD.Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W.This study,which analyzed 439 PD patients at their first clearance study,used the Watson formulas estimating V to identify patients with V_(Watson)/0.73 ≥ W and compared their nutritional indices with those of PD patients with V_(Watson)/0.73 < W.RESULTS The study identified at the first clearance study two male patients with V_(Watson)/0.73 ≥ W among 439 patients on PD.Compared to 260 other male patients on PD,the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration.The first of the two subjects also had very low values for serum creatinine concentration and total(in urine and spent peritoneal dialysate) creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due,most probably,to non-compliance with the PD prescription.CONCLUSION Advanced wasting(zero BF) in PD patients,identified by the anthropometric formulas that estimate V,while rare,is associated with indices of poor somatic and visceral nutrition.

Severe chronic diarrhea and weight loss in cholesteryl ester storage disease: A case report

AIM: An inherited deficiency of human lysosomal acid lipase (LAL)results in the rare conditions of Wolman disease and cholesteryl ester storage disease (CESD). We want to present the rare case of CESD in an adult.METHODS: We report about an adult female patient with severe chronic diarrhea and weight loss as a consequence of CESD. Clinical examination revealed signs of malabsorption and slightly elevated liver enzymes.RESULTS: Histopathologic changes in the liver tissue and DNA sequence analysis confirmed the diagnosis of CESD due to homozygosity for the most common CESD mutation,a G934A splice site defect encoded by exon 8 of the lysosomal acid lipase (LIPA) gene.CONCLUSION: It is the first case in the literature with diarrhea as a putative symptom of CESD in adult patients.

Female waist-to-hip ratio,body mass index and sexual attractiveness in China

Men and women at Northwest University （n=751）, Xi＇an, China were asked to judge the attractiveness of photographs of female patients who had undergone micrograft surgery to reduce their waist-to-hip ratios （WHR）. Micrograft surgery involves harvesting adipose tissue from the waist and reshaping the buttocks to produce a low WHR and an ‘hourglass＇ female figure. This gynoid distribution of female body fat has been shown to correlate with measures of fertility and health. Significantly larger numbers of subjects, of both sexes, chose post-operative photographs, with lower WHRs, as more attractive than pre-operative photographs of the same women. Some patients had gained, and some had lost weight, post-operatively, with resultant changes in body mass index （BMI）. However, these changes in BMI were not related to judgments of attractiveness. These results show that the hourglass female figure is rated as attractive in China, and that WHR, rather than BMI, plays a crucial role in such attractiveness judgments.

Risk factors for prehypertension in Xinjiang Uygur population

Objective To assess the risk factors for prehypertension in Xinjiang Uygur population. Methods A cross-section study was conducted in a Xinjiang Uygur population（438 males and 716 females,aged 30 to 70 years）.The fasting lipid profiles,serum glucose,insulin,and uric acid were determined.Homeostasis model assessment of insulin resistance（HOMA-IR）index was used to assess insulin resistance（IR）.Binary logistic regression analysis was performed to determine risk factors for prehypertension.Blood pressure levels ofnormotensives and prehypertensives in different body mass index（BMI）categories were compared. Results Binary logistic regression analysis performed after adjustment for gender,lipids profiles,waist-to-hip ratio,uric acid,HOMA-IR,and lifestyle（alcohol drinking and smoking）showed a significantly increasing prevalence of prehypertension with BMI.The odds ratios for prehypertension against the lowest BMI group（separated by 24 and 28）were 1.934 and 2.490（95% confidence interval：1.435-2.606 and 1.825-3.399,respectively）.Age was independently correlated to the increasing prevalence of prehypertension.HOMA-IR was not associated with prehypertensive.The mean diastolic blood pressure（DBP）was significantly increased with BMI categories in either normotensives or prehypertensives（P〈0.001）while the mean systolic blood pressure（SBP）was significantly increased with BMI only in normotensives（P〈0.001）. Conclusions In Xinjiang Uygurs,BMI and age was the risk factors for prehypertension.DBP is significantly increased with BMI.IR is not associated with prehypertension.These findings emphasize the importance of management of obesity for the control of blood pressure and other cardiovascular complications.

Long-term treatment with proton pump inhibitor is associated with undesired weight gain

AIM:To examine the effects of long-term proton pump inhibitor (PPI) therapy on body weight (BW) and body mass index (BMI) in patients with gastroesophageal reflux disease (GERD).METHODS: The subjects were 52 patients with GERD and 58 sex-and age-matched healthy controls. GERD patients were treated with PPI for a mean of 2.2 years (range, 0.8-5.7 years), and also advised on lifestyle modifications (e.g. selective diet, weight management). BW, BMI and other parameters were measured at baseline and end of study.RESULTS: Twenty-four GERD patients were treated daily with 10 mg omeprazole, 12 with 20 mg omeprazole, 8 with 10 mg rabeprazole, 5 with 15 mg lansoprazole, and 3 patients with 30 mg lansoprazole. At baseline, there were no differences in BW and BMI between reflux patients and controls. Patients with GERD showed increases in BW (baseline: 56.4±10.4 kg, end: 58.6±10.8 kg, mean±SD, P<0.0001) and BMI (baseline: 23.1±3.1 kg/m2, end: 24.0±3.1 kg/m2, P<0.001), but no such changes were noted in the control group. Mean BW increased by 3.5 kg (6.2% of baseline) in 37 (71%) reflux patients but decreased in only 6 (12%) patients during treatment.CONCLUSION: Long-term PPI treatment was associated with BW gain in patients with GERD. Reflux patients receiving PPI should be encouraged to manage BW through lifestyle modifi cations.

The Effect of Age and Markers of Obesity on Bone Density in Iraqi Postmenopausal Women

Osteoporosis is a disease characterized by a low bone mineral density and structural deterioration of bone tissue. Leptin is considered to play a role in the maintenance of energy balance and body weight. Weight and body mass index are associated with low bone mineral density with high serum leptin concentration in older women. The study is designed to elucidate the impact of age and BMI （Body Mass Index） on osteoporotic patients （Iraqi postmenopausal women） and the functional role of leptin in those patients. A total of 72 patients divided into three groups according to BMI and two groups according to age： BMD （bone mineral density）, T-score and serum leptin concentration increased as BMI increased, while with increased age, BMD and T-score deceased and serum leptin concentration increased. There is a significant difference of BMD and T-score in BMI （25-30） group and BMI （〉 30） group from that in BMI （〈 25） group. In conclusions： Both age and BMI have an impact on osteoporosis although age shows more impact on the severity of the disease than does BMI. Studying the direct impact of leptin on BMD may open the way in using new methods in treating and preventing the osteoporosis in patients with risk factors.

Effects of body mass index on the outcomes of in vitro fertilization in Chinese patients with polycystic ovary syndrome: a retrospective cohort study

Objective: To investigate the effects of body mass index(BMI) on the outcomes of in vitro fertilization(IVF) in Chinese patients with polycystic ovary syndrome(PCOS). Methods: In the retrospective cohort study, a total of 1074 patients with PCOS undergoing IVF between April 2010 and May 2017 in two reproductive medicine centers, respectively in eastern China(Women's Hospital, School of Medicine, Zhejiang University, Zhejiang Province) and in southern China(Maternal and Child Health Care Hospital of Liuzhou, Guangxi Province), were included. The patients were divided into four groups according to the recommended Chinese BMI cut-off points: underweight(BMI<18.5kg/m^2), normal weight(18.5kg/m^2≤BMI<24.0kg/m^2), overweight(24.0kg/m^2≤BMI<28.0kg/m^2), and obese(BMI≥28.0kg/m2). The basic characteristics of the PCOS patients, the details of IVF treatment, and the pregnancy outcomes were collected. Main results: There were no significant differences among the normal weight, overweight, and obese PCOS patients undergoing IVF on the biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, or term delivery rate(P>0.05), although the overweight and obese PCOS patients required more gonadotropin(Gn)(P<0.001) as well as longer stimulation period(P<0.001), and got less retrieved oocytes(P<0.05) and fertilized oocytes(P<0.05). The underweight PCOS patients required less Gn(P<0.05) and achieved higher live birth rate and term delivery rate(P<0.05), compared with the normal weight PCOS patients. Conclusions: High BMI had no negative effects on the outcomes of IVF in Chinese patients with PCOS; however, the conclusion may seem a little limited due to the retrospective design and the potential bias.

Factors affecting cerebrospinal fluid opening pressure in patients with spontaneous intracranial hypotension

Objective： Spontaneous intracranial hypotension （SIH） is recognized far more commonly than ever before. Though usually characterized by low cerebrospinal fluid （CSF） pressure, some patients with SIH are observed to have normal pressure values. In this study, we aimed to confirm the proportion of patients with normal CSF opening pressure （CSF OP） and explore the factors affecting CSF OP in SIH patients. Methods： We retrospectively reviewed 206 consecutive SIH patients and analyzed their clinical and imaging variables （including demographic data, body mass index （BMI）, duration of symptoms, and brain imaging findings）. Univariate and multiVariate analyses were performed to identify the potential factors affecting CSF OP. Results： In a total of 114 （55.3%） cases the CSF OP was 〈60 mmH2O （1 mmH2O=9.80665 Pa）, in 90 （43.7%） cases it was between 60 and 200 mmH2O, and in 2 （1.0%） cases it was 〉200 mmH2O. Univadate analysis showed that the duration of symptoms （P〈0.001）, BMI （P〈0.001）, and age （P=0.024） were positively correlated with CSF OP. However, multivariate analysis suggested that only the duration of symptoms （P〈0.001） and BMI （P〈0.001） were strongly correlated with CSF OP. A relatively high R2 of 0.681 was obtained for the multivariate model. Conclusions： Our study indicated that in patients without a low CSF OP, a diagnosis of SIH should not be excluded. BMI and the duration of symptoms can influence CSF OP in SIH patients, and other potential factors need further investigation.