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BACKGROUND: Osteoporosis prevalence is increased in Crohn's disease (CD). Its pathogenesis in these patients is incompletely understood. OBJECTIVES: To identify factors associated with decreased bone mineral density (BMD) status in CD patients on a time-line course. METHODS: A retrospective study was performed that followed CD patients who underwent at least two bone mineral density scans (DEXAs). Follow-up began one year prior to the first DEXA test and lasted at least one year after a second test. Possible correlations between baseline and follow-up variables and changes in BMD status were examined. Change in BMD was defined as a transition from one bone density category to another (normal vs. osteopenia vs. osteoporosis). Binary variables were assessed using the Cochrane-Armitage test. Categorical variables were assessed using the chi-squared test. A multivariate analysis was performed. RESULTS: The study included 141 patients. At baseline, 33 patients (23.4%) had normal BMD, 75 (53.2%) had osteopenia, and 33 (23.4%) had osteoporosis. Patients with low BMD had a lower baseline BMI compared to those with normal BMD (p < 0.0001). After a median follow-up of 48 months (IQR 29-71), BMD status worsened in 19 (13.5%) patients, whereas in 95 (67.3%) and 27 (19.1%) patients, BMD remained unchanged or improved, respectively. On the multivariate analysis, elevated median CRP throughout follow-up (OR = 0.8, 95% CI: 0.68-0.93) and low baseline BMI (OR = 0.9, 95% CI: 0.83-0.98) were associated with a lack of BMD status improvement. CONCLUSIONS: Persistently elevated CRP and low BMI are associated with a lack of improvement in BMD. These findings underscore the importance of effective inflammation control and nutritional support to maintain and improve bone health.

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Background: Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland, with lymph node metastasis significantly affecting patient prognosis. In recent years, body mass index (BMI) has garnered widespread attention as a potential factor influencing cancer development. This study aimed to explore the relationship between BMI and lymph node metastasis in patients with PTC, particularly focusing on the risk of metastasis in the lateral and central neck compartments. Methods: This retrospective study comprised 993 patients who underwent surgical treatment and were pathologically confirmed to have PTC. Patient BMI data were collected, and their relationship with lymph node metastasis in the lateral and central neck compartments was analyzed. Logistic regression models were employed to analyze the correlation between BMI and lymph node metastasis. Results: The study found a significant correlation between BMI and the risk of lateral neck lymph node metastasis in patients (P=0.008), along with a corresponding increase in extrathyroidal extension risk (P=0.02). While elevated BMI did not directly increase the risk of central compartment metastasis, a significant increase was observed in the number of central compartment lymph node metastases (P=0.009) and their proportion among the total central compartment lymph nodes (P=0.01) in patients with higher BMI. Additionally, multifocality, age, and gender were identified as risk factors for lateral neck lymph node metastasis, whereas Hashimoto's thyroiditis did not exhibit a similar impact. Conclusions: This study highlights that higher BMI is an important risk factor for lateral neck lymph node metastasis in patients with PTC and may exacerbate the severity of central compartment lymph node metastasis. These findings underscore the importance of considering BMI in the management of thyroid cancer and provide data support for future prevention and intervention strategies.

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Background: The aging spine often presents multifaceted surgical challenges for the surgeon because it can directly and indirectly impact a patient's spinal alignment and quality of life. Elderly and osteoporotic patients are predisposed to progressive spinal deformities and potential neurologic compromise and surgical management can be difficult because these patients often present with greater frailty. Methods: This was a literature review of spinal alignment changes, preoperative considerations, and spinal alignment considerations for surgical strategies. Results: Many factors impact spinal alignment as we age including lumbar lordosis flexibility, hip flexion, deformity, and osteoporosis. Preoperative considerations are required to assess the patient's overall health, bone mineral density, and osteoporosis medications. Careful radiographic assessment of the spinopelvic parameters using various classification/scoring systems provide the surgeon with goals for surgical treatment. An individualized surgical strategy can be planned for the patient including extent of surgery, surgical approach, extent of the constructs, fixation techniques, vertebral augmentation, ligamentous augmentation, and staging surgery. Conclusions: Surgical treatment should only be considered after a thorough assessment of the patient's health, deformity, bone quality and corresponding age matched alignment goals. An individualized treatment approach is often required to tackle the deformity and minimize the risk of hardware related complications and pseudarthrosis. Anabolic agents offer a promising benefit in this patient population by directly addressing and improving their bone quality and mineral density preoperatively and postoperatively.

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INTRODUCTION: The Maternal-Fetal Medicine Units Network calculator for vaginal birth after cesarean (VBAC) probability was updated to exclude a race and ethnicity variable, but its impact on marginalized groups is unknown. We assessed the tool with attention to birth history and body mass index (BMI) in a predominately Hispanic cohort and examined the possible effect of discouraging labor after cesarean (LAC) with a low score. METHODS: We conducted a retrospective cohort study of LACs by patients who entered spontaneous or induced labor with a live, nonanomalous fetus in cephalic presentation between 2012 and 2022. Observed VBAC rates were compared with the mean predicted VBAC probability derived from the calculator. Areas under the curve (AUCs) were calculated for the entire cohort and for individuals with LAC with and without prior vaginal birth. A z-test was used to determine the significance between VBAC rates in 4 BMI categories. The impact of discouraging LAC with VBAC probability below 70% was examined. RESULTS: A total of 400 people experienced 507 LACs, with 417 (82.2%) resulting in VBAC compared with a mean predicted probability of 71.2%. The AUC for all LACs was 0.76 (95% CI, 0.71-0.81), whereas the AUC for LACs with prior vaginal birth was 0.70 (95% CI, 0.56-0.85) and without was 0.60 (95% CI, 0.52-0.67). Observed VBAC rates exceeded predicted rates for individuals with overweight and obese BMIs: <25 (79.6% vs 75.6%; P = .520), 25 to 30 (83.2% vs 71.9%; P = .007), 30 to 40 (82.7% vs 70.0%; P = .004), and ≥40 (82.8% vs 58.3%; P = .040). Discouraging LAC below 70% probability might have prevented 71 unsuccessful LACs, 160 initial VBACs, and 57 subsequent VBACs, decreasing the VBAC rate to 39.4% (200/507). DISCUSSION: In a predominately Hispanic cohort, the updated calculator underestimated VBAC potential for people with no vaginal birth history and/or an elevated BMI. Discouraging LAC based on low VBAC probability may prevent both initial and subsequent VBACs.

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BACKGROUND: Intraperitoneal pressure measurement offers therapeutic and prognostic benefits in predicting leak risks and gastrointestinal symptoms in Peritoneal Dialysis (PD) patients. This systematic review aims to evaluate the prognostic utility of intraperitoneal pressure measurements and different estimated intraperitoneal pressure equations in predicting the risk of non-infectious complications in PD patients. METHODS: Databases including MEDLINE, EMBASE and Cochrane were searched up to July 2023. Randomised and non-randomised trials were included, focusing on End-Stage Kidney Disease (ESKD) patients undergoing PD. Primary outcomes were variables associated with intraperitoneal pressure, while secondary outcomes included PD-related non-infectious complications and gastrointestinal symptoms. Data synthesis combined meta-analysis with narrative synthesis. This review has been registered on PROSPERO (CRD42023475138). RESULTS: Out of 1828 identified studies, 12 were included for systematic review and 10 for meta-analysis. Body Mass Index (BMI) and Body Surface Area (BSA) showed a consistent positive correlation with intraperitoneal pressure (BMI: r = 0.49, 95% CI 0.35-0.61, I2 = 67.39%, p = 0.003; BSA: r = 0.2, 95% CI 0.08-0.31, I2 = 14.10%, p = 0.324). Conversely, the association between intraperitoneal pressure and age, intraperitoneal volume, and Charlson Comorbidity Index were less consistent. Subgroup analysis demonstrated an association between higher intraperitoneal pressure in patients with increased BMI and BSA. However, the relationship between intraperitoneal pressure and non-infectious mechanical complications remained inconclusive. DISCUSSION: This review underscores a significant association between intraperitoneal pressure and anthropometric measures (BMI and BSA). The majority of the studies identified included a small sample and considerable bias. However, the association between intraperitoneal pressure and clinically relevant outcomes was not clear. CONCLUSIONS: While increasing body mass index and body surface areas are associated with increasing intraperitoneal pressure, the clinical relevance of measuring intraperitoneal pressure in an adult population remains unclear, particularly given the absence of an association with clinically relevant non-infectious outcomes.

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Background Pancreatitis, marked by sterile inflammation of the pancreas, can present as either acute or chronic. It involves the premature activation of proteolytic enzymes, leading to autodigestion, inflammation, and potential systemic effects. This study investigates the impact of obesity on the severity of acute pancreatitis, given its role in systemic inflammation and its association with severe morbidity and mortality. Methods A retrospective analysis was conducted on patients treated for acute pancreatitis over a five-month period at the Royal Albert Edward Infirmary, Wrightington, Wigan and Leigh (WLL) NHS Foundation Trust, Wigan, United Kingdom. Patients were evaluated using diagnostic criteria such as abdominal pain, elevated serum enzyme levels, and imaging results. The study explored correlations between BMI and pancreatitis severity, hospital length of stay, and complications, applying the Atlanta severity classification. Results The analysis revealed a weak, statistically insignificant correlation between BMI and the severity of acute pancreatitis, hospital stay length, and complications. This was consistent across various statistical methods, including Pearson correlation coefficients and multiple linear regression. These findings suggest that, while obesity may influence the inflammatory response in acute pancreatitis, it does not have a significant impact on clinical outcomes within this cohort. Conclusions The study highlights the complex role of obesity in exacerbating pancreatic inflammation but also emphasizes the need for larger, more definitive studies to explore this relationship further. It underscores the importance of early recognition and intervention in managing acute pancreatitis, regardless of BMI status.

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Background: Obesity represents a significant risk factor for the development of metabolic abnormalities. However, it is not inevitable that all individuals with obesity will develop these disorders. Selenium has been demonstrated to play a role in maintaining metabolic homeostasis in vivo, with the ability to regulate relevant signaling pathways involved in glucose and lipid metabolism processes. Previous studies have indicated that selenium concentrations in obese individuals are higher than those reported in the general population. These findings the question of whether altered selenium concentrations may act as important triggers for accelerating metabolic imbalances in the obese population. The aim of this study was to examine the potential correlation between serum selenium concentrations and the risk of developing metabolic abnormalities in individuals with obesity. Methods: The present study included 6,125 participants from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) who were aged between 20 and 80 years, with a body mass index (BMI) of 30 kg/m2 or greater, and met the inclusion and exclusion criteria. Weighted generalized linear regression analyses were conducted to evaluate the associations between serum selenium concentrations and the conversion of metabolically healthy obesity (MHO) to metabolically unhealthy obesity (MUO). A generalized additive model (GAM) and a two-piecewise linear regression model were employed to investigate the saturation threshold effect between selenium and MUO. The correlation between different selenium concentration intervals and metabolic diseases was evaluated by categorizing selenium concentrations according to the saturation threshold. Furthermore, this study investigated the correlation between serum selenium and lipid concentrations in obese females and between serum selenium and blood pressure in obese males. Results: The weighted prevalence of MUO in the study population was 48.35%. After rigorous adjustment for sociodemographic, physical, and laboratory test covariates, the weighted odds ratio (OR) of MUO increased by 44% for every 1 µM increase (approximately 78.74 µg) in the serum selenium concentration (weighted OR=1.44; 95% CI=1.09 - 1.91; P=0.018). Second, GAM analysis and saturation threshold analyses revealed an inverted U-shaped relationship between serum selenium and metabolic abnormalities in males, with a corresponding inflection point (K) of 2.82 µM. When the serum selenium concentration was below the K-value, the effects of serum selenium were mainly on blood pressure, especially diastolic blood pressure (DBP) (weighted ß: 3.34; 95% CI= 0.25 - 6.44; P=0.038). Conversely, the correlation between the serum selenium concentrations and metabolic homeostasis imbalance in females was linear. When the selenium concentration exceeded 2.12 µM, the increase in selenium content was accompanied by increases in total cholesterol (TC, weighted ß=0.54, 95% CI=0.32 - 0.76; P=0.000) and triglyceride (TG, weighted ß=0.51, 95% CI=0.27 - 0.75; P=0.000) concentrations. Conclusions: The findings of our study indicate that selenium supplementation strategies for individuals with obesity should be tailored to the sex of the individual. In females, serum selenium concentration above the saturation threshold primarily facilitates the transition from MHO to MUO by influencing alterations in serum lipid metabolism. Maintaining selenium concentrations below the threshold levels is highly important for preventing the conversion of MHO to MUO. In males, serum selenium concentrations above the threshold were found to be effective in preventing an elevation in blood pressure, particularly in improving systolic blood pressure (SBP). Nevertheless, serum selenium concentrations below the threshold are linked to an increased risk of hypertension in obese individuals, particularly those with elevated diastolic blood pressure (DBP). Further research is needed to elucidate the optimal serum selenium concentration that exerts deleterious effects on blood pressure.

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PURPOSE: Ultrasound and multi-slice spiral computed tomography (CT) are frequently used to assist the diagnosis of acute appendicitis (AA), and the examination results may vary among different demographics. This study aimed to compare the diagnostic accuracy of ultrasound and CT for AA. METHODS: We performed a retrospective analysis of patients diagnosed with AA who underwent emergency surgery at our hospital from March 2021 to August 2023, with postoperative pathological results as the gold standard. Differences in the diagnostic accuracy of ultrasound and CT for different types of AA, age groups, and body mass index (BMI) values were then analyzed. RESULTS: The overall sample comprised 279 confirmed cases of AA, with 64 cases of simple appendicitis, 127 cases of suppurative appendicitis, and 88 cases of gangrenous appendicitis. For these three pathological classifications, the diagnostic accuracy of ultrasound was 68.75% (44/64), 73.22% (93/127), and 81.81% (72/88), respectively, while the diagnostic accuracy of CT was 71.87% (46/64), 82.67% (105/127), and 90.90% (80/88), respectively. There was no statistically significant difference in the overall diagnostic accuracy between the two methods (P > 0.05). Subgroup analysis showed no difference in diagnostic accuracy between the two methods for patients with normal BMI (P > 0.05). However, for overweight, obese, and elderly patients, CT provided significantly better diagnostic accuracy than ultrasound (P < 0.05). CONCLUSION: While ultrasound and CT have similar diagnostic accuracy for different pathological types of AA, CT is more accurate for overweight, obese, and elderly patients.

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BACKGROUND: Glioma is the second most common type of brain tumor, representing 24% of all brain tumor cases. The role of body mass index (BMI) on glioma remains unclear, with conflicting findings regarding the association between higher BMI and the risk of developing certain brain tumors. Glioblastoma, an aggressive and malignant form of glioma with limited treatment options and a poor prognosis, has been linked to BMI in some studies, suggesting that individuals with higher BMIs may have an elevated risk of glioblastoma development. However, a comprehensive understanding of the mechanisms underlying this relationship and its extent is still needed. The study aimed to investigate the correlation between BMI and the grading and survival of glioma patients. METHODS: A retrospective cross-sectional analysis was conducted on 117 histologically confirmed glioma patients at Dr. Sardjito General Hospital in Yogyakarta, Indonesia. Clinical data were collected from medical records. BMI was calculated by measuring weights (kg) and dividing it by squared heights (m2). The statistical analysis focused on assessing the association between BMI, tumor grade, and patient survival. RESULTS: Among 117 glioma patients, glioblastoma was the most prevalent tumor type (48.7%; n=57/117), followed by diffuse astrocytoma (22%; n=26/117). The remaining cases included anaplastic ependymoma, anaplastic oligodendroglioma, and pilocytic astrocytoma. Most patients were male (61%), with an average age of 47.5 years, age ranges between 20 and 79 years. The majority had grade IV of World Health Organization (WHO) classification (58%, n=68/117), while only two patients were classified as grade I. The average BMI was 23.5 kg/m2, indicating overweight status for the Asian population, with more than half of the patients being overweight or obese (54%, n=63/117). Additionally, ten patients were underweight. There was a trend of higher BMI being associated with higher grading and survival. However, no significant association between BMI and tumor grade (P=0.23) or survival (P=0.26) was found. CONCLUSIONS: Although no significant associations were found between BMI, tumor grade, and survival in glioma patients, further studies are warranted. The high prevalence of overweight and obesity among patients should be further investigated to provide valuable insights for patient management and care.

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BACKGROUND: Unhealthy weight control behaviors (UWCBs) involve weight control strategies to reduce or maintain weight, such as fasting, taking diet pills, and vomiting or taking laxatives. UWCBs in teenagers can escalate into severe health issues such as eating disorders. Understanding the trends of UWCBs and their association with risk behaviors in teenagers is crucial, as early intervention and prevention strategies are pivotal. METHODS: This study utilized eight waves of the youth risk behavior surveillance system (YRBSS) data from 1999 to 2013. Our primary outcome was UWCBs engagement. We used multinomial logistic models to analyze the association between UWCBs and risk behaviors among adolescents including driving after alcohol consumption, suicide attempts, smoking, alcohol use, and sexual intercourse. RESULTS: Among 109,023 participants, UWCBs prevalence was 16.64%. Body Mass Index (BMI) was significantly associated with UWCBs risk. In addition, we found the intention of weight management confounded the relationship between BMI and UWCBs. The unadjusted logistic regression indicated a monotone-increasing association between BMI and the risk of UWCBs. In contrast, the adjusted logistic regression indicated a U-shaped curve with the lowest (BMI < 17 kg/m2) and highest (BMI > 30 kg/m2) BMI groups having significantly higher odds of engaging in UWCBs compared to the reference BMI group (18.5 ≤ BMI ≤ 24.9 kg/m2). CONCLUSIONS: The intention of weight management confounded the relationship between Body Mass Index (BMI) and the risk of UWCBs. These findings suggest that healthcare interventions for weight management behaviors should be tailored to adolescents with BMI ≥ 25 and BMI < 18.5.

This study looked at unhealthy weight control behaviors (UWCBs) in American teenagers, such as fasting, taking diet pills, or vomiting to control weight. These behaviors can lead to serious health problems, including eating disorders. The research analyzed data from over 100,000 teenagers between 1999 and 2013 to understand the connection between UWCBs and other risky behaviors like drinking alcohol, smoking, and attempting suicide. While previous research suggested that teens with higher body weight were more likely to engage in UWCBs, our findings showed a shift in this relationship after considering the teens' intentions to manage weight. Specifically, teens with very low body weight (BMI < 17) and a strong desire to lose weight had an increased risk of UWCBs. This highlights the need for healthcare providers to focus on the mental health and weight management goals of these teens to prevent harmful behaviors. Additionally, reconsidering the removal of UWCB-related questions from national surveys like YRBSS is important to continue monitoring these behaviors.

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Background This study aims to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with metastatic colorectal cancer (mCRC). Methodology A retrospective analysis was conducted among 65 patients diagnosed with stage IV colorectal cancer who received treatment and follow-up at the Oncology Department of Elias Emergency University Hospital in Bucharest, Romania, from January 2016 to January 2024. Patient data were collected, including demographic information, tumor characteristics, and laboratory parameters. The mGPS was calculated based on serum albumin and C-reactive protein (CRP) levels. Patients were stratified into the following three mGPS categories: 0 (normal CRP and albumin), 1 (elevated CRP or hypoalbuminemia), and 2 (elevated CRP and hypoalbuminemia). Results Of the 65 patients included, 33 (50.8%) were male and 32 (49.2%) were female, with a mean age of 63.7 years. According to mGPS, 25 (38.5%) patients scored 0, 30 (46.2%) scored 1, and 10 (15.4%) scored 2. The median overall survival (OS) was 53 months (95% confidence interval (CI) = 23.512-82.488), and the median progression-free survival (PFS) was 23 months (95% CI = 19.244-26.756). Although numerical differences in the median PFS and OS were observed between treatment groups, these differences were not statistically significant (PFS: p = 0.292; OS: p = 0.5). Conclusions The mGPS is a useful prognostic tool in mCRC, providing insights into patient survival outcomes. However, further studies with larger sample sizes are needed to validate these findings and clarify the role of mGPS in guiding clinical decision-making for mCRC patients.

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Objective: The objective of this study is to independently assess skeletal muscle index (SMI) and body mass index (BMI) as prognostic determinants for renal cell carcinoma (RCC) and investigate their correlation with surgical outcomes. Patients and methods: A retrospective cohort study of 524 RCC patients diagnosed between August 2010 and July 2018 was conducted using data from the Zealand University Hospital Renal Cancer Database in Denmark. Patient information was extracted from electronic patient records and the National Cancer Registry and encompassed demographics, clinical factors, tumour characteristics and surgical details. SMI was calculated from a single third lumbar vertebra (L3) axial computed tomography (CT) image via CoreSlicer software and classified into high using gender-specific thresholds. Primary outcomes focused on complications within 90 days as well as survival outcomes, and their relation with both SMI and BMI. Multivariable analysis assessed SMI's independent prognostic significance in RCC. Results: Among 524 patients, 18.5% experienced complications, with high SMI correlating significantly (p = 0.018) with a 72% higher complication risk. High SMI patients had a 22.7% complication rate compared to 14.5% in the low SMI group. High SMI was also linked to prolonged survival (110.95 vs. 94.87 months; p = 0.001), whereas BMI showed no significant survival differences (p = 0.326). Multivariable analysis (n = 522) revealed high SMI associated with improved survival (hazard ratio [HR] = 0.738; 95% CI, 0.548-0.994; p = 0.046). Advanced T-stage significantly impacted mortality (T2: HR = 2.057; T3: HR = 4.361; p < 0.001), and each additional year of age raised mortality risk by 4.3% (HR = 1.043; p < 0.001). Conclusions: Higher SMI increases the risk of postoperative complications, yet it significantly improves overall survival rates. Different BMI categories lack RCC prognostic significance. The increasing incidence in RCC calls for the use of CT scan to assess SMI and aid treatment planning in patients who might benefit from preoperative interventions.

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Background: Walkable neighborhoods are closely related to an increase in walking frequency and the strengthening of social cohesion. These factors, in turn, contribute to lower BMI and other positive health-related outcomes. However, with a rapid increase in aging populations in China and the fact that women are facing more challenges than men as they age, especially mobility challenges because they tend to live longer leading to probabilities to become widowed. Nevertheless, less attention has been paid to understanding the gender difference between these relationships. Methods: Based on a survey of 533 older adults in Dalian, China, this study tried to investigate the intertwined relationship between perceived walkability, social cohesion, walking frequency, and BMI. A Structural Equation Model (SEM) and multiple-group analysis were applied to test the proposed framework. Results: First, results show that gender differences existed among the above interrelationships, and the most substantial gender gap was found in effects of social cohesion on BMI. Second, perceived walkability only has a direct effect (0.149) on walking frequencies for female seniors. Third, although the relationships between perceived walkability and BMI are not directly related in both male and female models, the indirect connection (-0.053) is substituted for female seniors. Besides, the inhibiting effect of walking on BMI, which is -0.511, is also valid for female seniors. Finally, in terms of the role of social cohesion, both the positive impacts of perceived walkability on it (0.225 for males and 0.325 for females) and its promoting effects on walking have been confirmed in male (0.142) and female models (0.103). The negative direct effect of social cohesion on BMI (-0.083) is only confirmed in male seniors. Conclusion: Insights derived from this analysis can help bring forward gender-specific interventions to build a more inclusive walkable and social environment to improve the mobility and physical health of older adults.

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Background: Dupilumab is a monoclonal antibody used for the treatment of moderate/severe atopic dermatitis (AD). In recent years, several studies have confirmed the positive association between AD and overweight/obesity, and a report demonstrated the effect of weight reduction on the improvement of AD symptoms. Methods: The weight of 170 patients under treatment with dupilumab was recorded at baseline and after 48 weeks (T48). Clinical monitoring was mainly conducted using the Eczema Area and Severity Index (EASI). The study aimed to assess a possible correlation between the clinical outcome of dupilumab therapy and BMI. Results: Although not statistically significant, patients with a BMI < 25 have a higher EASI percentage improvement than patients with a BMI ≥ 25 at any time point, and the percentage of overweight and obese patients that does not reach EASI-75 at T48 is higher compared to normal-weight patients (13.5% vs. 5.9%). Despite this, in the multivariate regression analysis, no baseline characteristic, including BMI, appears to increase the risk of not reaching EASI-75. In addition, the results show no differences in BMI between baseline and T48 in any age/sex group. Conclusions: The results suggest that overweight and obese patients have a lower response to dupilumab when considering the EASI score, but this difference does not appear to be clinically significant. Furthermore, dupilumab treatment does not seem to impact weight.

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Background: At present, there is a dearth of comprehensive data at the global, national, and regional levels regarding the adult non-alcoholic fatty liver disease (NAFLD) prevalence. This cross-sectional study aims at ascertaining the prevalence of NAFLD and non-alcoholic steatohepatitis (NASH), utilizing body mass index (BMI) as a determining factor. Methods: Based on the NHANES database, sigmoidal fitting curves were generated to establish the relationship between BMI and the risk of NAFLD/NASH. Utilizing BMI data from the NCD Risk Factor Collaboration (NCD-RisC) database at both global and regional levels, the prevalence of NAFLD/NASH among adults was estimated from 1975 to 2016, encompassing global, regional, and national perspectives. Additionally, projections were made to forecast the prevalence of adult NAFLD/NASH from 2017 to 2030. Results: In 2016, the global prevalence of NAFLD was 41.12% for males and 37.32% for females, while the global prevalence of NASH was 15.79% for males and 16.48% for females. The prevalence of NAFLD/NASH increased with higher BMI in both genders. Over the period from 1975 to 2016, there has been a gradual increase in the global prevalence of NAFLD/NASH in adults, and this trend is expected to continue between 2017 and 2030. In males, the prevalence of adult NAFLD/NASH was found to be highest in High-income Western countries, while it was highest in Central Asia, Middle East, and North African countries after 1995. Conclusions: The prevalence of adult NAFLD/NASH has been observed to increase annually, with significant variations in burden across different countries and regions.

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BACKGROUND & AIMS: Pregnancy and lactation are associated with metabolic changes, including alterations in energy metabolism, which are closely linked to body mass and composition due to hormonal status. Therefore, the objective of this study was to investigate the energy metabolism in exclusively or predominantly breastfeeding mothers with normal weight (NW) and overweight/obesity (OW/OB) and evaluate its associations with fasting serum leptin. METHODS: This cross-sectional BLOOM study was conducted among 39 mothers (n = 19 NW, n = 20 OW/OB) in 15.5 ± 1.2 weeks of lactation. The leptin was analyzed in a blood sample using an enzyme-linked immunosorbent assay, body composition was analyzed by dual-energy X-ray absorptiometry, and resting metabolic rate (RMR) was measured by indirect calorimetry method. RESULTS: The average RMR for all groups was 1747.5 ± 281.9 kcal/d, with a statistically significant difference between groups (1932.7 ± 222.6 vs. 1550.5 ± 190.6, p < 0.001, respectively in the OW/OB and NW group). The OW/OB mothers had higher oxygen uptake (VO2) and exhaled carbon dioxide (VCO2), but not respiratory quotient (RQ), carbohydrate (CHO%) and lipid oxidation (FAT%). When analyzing correlations stratified by BMI category, we found that serum leptin was correlated with CHO% negatively, and with FAT% positively in the NW but not in OW/OB mothers. Additionally, serum leptin was a significant predictor of RMR, VCO2, VO2, CHO%, and RMR/kg of total body weight. However, after adjusting for confounders, the observed associations were no longer statistically significant (RMR: ß = 0.113, 95% CI -0.354-0.319; VO2: ß = 0.141, 95% CI -0.462-0.744; VCO2: ß = 0.238, 95% CI -0.411-0.888; CHO%: ß = -0.146, 95% CI -0.151-0.444; RMR/kg of total body weight: ß = -0.294, 95% CI -0.831-0.244). CONCLUSIONS: Our results did not support the hypothesis that leptin plays a role in regulating energy homeostasis during lactation.

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Introduction Obesity can develop from childhood through adulthood and is influenced by genetics, family, and environmental factors. Parenting educational style is believed to contribute to an individual's future weight status. This study aims to assess the connection between parenting educational style and weight-related issues. Methods The study involved 487 participants, including either the mother and/or father and their school-age child, aged 6-11, at a primary care unit in Mexico. Fifty-two records were excluded due to incomplete questionnaires, electronic records, and refusal of informed consent. The study group consisted of 435 adults and children who completed an adapted version of the Parenting Styles and Dimensions Questionnaire (PSDQ) tailored for the Mexican population. The researchers also gathered anthropometric measurements of the primary caregiver (parent) and the child from the electronic record to calculate their BMI and nutritional status. We used IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA) to analyze the data. The Pearson Chi-square and Fisher's exact test were applied to examine interaction terms between variables, revealing a statistically significant p-value of <0.05. Results Out of the 435 patients examined, there were 229 (52.6%) children and 206 (47.3%) adult patients. Grade 2 obesity was present in 90 (39.3%) school-age children and 104 (50.5%) adult patients. The family's parenting educational style, as determined by the PSDQ questionnaire, was found to be permissive in 143 (69.4%) patients, authoritarian in 33 (16.0%) patients, and authoritative in 30 (14.6%) patients. Conclusions Parenting educational style and the PSDQ tool can be used to assess how parents influence the development of obesogenic home environments. We observed that a permissive parenting educational style was linked to a more obesogenic environment, whereas an authoritative parenting educational style was linked to a less obesogenic environment.

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BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery procedure in China. However, its cost-effectiveness in Chinese patients is currently unknown. OBJECTIVES: This study aims to assess the cost-effectiveness of LSG vs no surgery in Chinese patients with severe and complex obesity, taking into account both healthcare expenses and the potential improvement in health-related quality of life (HRQoL). METHODS: A retrospective cohort study was conducted, encompassing 135 Chinese patients who underwent LSG between January 3, 2022 and December 29, 2022, at a major bariatric center. The study evaluated the cost-effectiveness from a healthcare service perspective, employing the incremental cost-effectiveness ratio (ICER) for quality-adjusted life years (QALYs) gained. The analyses compared LSG with the alternative of not undergoing surgery over a 1-year period, using actual data, and extended to a lifetime horizon by projecting costs and utilities at an annual discount rate of 3.0%. Subgroup analyses were undertaken to explore cost-effectiveness variations across different sex, age and BMI categories, and diabetes status, employing a one-way analysis of variance (ANOVA). To ensure the reliability of the findings, one-way and probabilistic sensitivity analyses were executed. RESULTS: The results indicated that 1-year post-LSG, patients achieved an average total weight loss (TWL) of (32.7 ± 7.3)% and an excess weight loss (EWL) of (97.8 ± 23.1)%. The ICER for LSG compared to no surgery over a lifetime was $4,327/QALY, significantly below the willingness-to-pay (WTP) threshold for Chinese patients with severe and complex obesity. From a lifetime perspective, LSG proved to be cost-effective for all sex and age groups, across all BMI categories, and for both patients with and without diabetes. Notably, it was more cost-effective for younger patients, patients with higher BMI, and patients with diabetes. CONCLUSIONS: LSG is a highly cost-effective intervention for managing obesity in Chinese patients, delivering substantial benefits in terms of HRQoL improvement at a low cost. Its cost-effectiveness is particularly pronounced among younger individuals, those with higher BMI, and patients with diabetes.

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AIM:  To determine the correlation between body mass index (BMI), bone mineral density (BMD), and residual ridge resorption (RRR) in postmenopausal females and the effect of osteoporosis on RRR. MATERIALS AND METHODS:  A study was conducted with 60 postmenopausal female individuals. BMI was calculated using the weight and height of the patient using a formula. BMD was assessed and graded using a T-score. RRR was determined using the Tallgren method. RESULTS: Most individuals showed a higher BMI (63.33%), which is in the overweight or obese category. BMD was lower in approximately 68.33% of patients, and RRR was significantly higher in about 60% of total patients. CONCLUSION: The higher the BMI values, the lesser the BMD and the higher the RRR.

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BACKGROUND: The global rise in obesity and related health complications has cast a spotlight on the urgent need for initiatives that promote informed dietary decisions. This cross-sectional study investigates the knowledge, attitudes, and practices of university students at Jazan University, Saudi Arabia, regarding menu calorie labeling. The study examines how these variables may affect dietary decisions, body mass index (BMI), and support for proposed legislative measures requiring calorie disclosure on restaurant menus. METHODS: The study included 581 Saudi university students who were 18 years of age or older as a convenience sample. A three-part questionnaire that asked about demographics, anthropometric measurements, and attitudes and behaviors related to calorie counting was completed by the participants. Using the Statistical Product and Service Solutions (SPSS, version 25.0; IBM SPSS Statistics for Windows, Armonk, NY) program, chi-square, t-tests, and ANOVA tests were used to evaluate the data. Both informed consent and ethical approval were obtained. RESULTS: The study finds that, even while more than half of the participants knew their recommended daily calorie intake and exhibited curiosity about calorie information on menus, this knowledge did not always result in healthy eating habits. Participants' opinions and behaviors regarding calorie labeling were significantly correlated with their BMI levels, indicating the importance of education in promoting nutritional awareness and healthy eating habits. New calorie labeling regulations received higher approval from people who regularly ate out. CONCLUSION: This study emphasizes the necessity of comprehensive nutritional education initiatives to raise calorie knowledge and encourage Saudi Arabian university students to make healthier eating choices. It also emphasizes the possible effects of legislative measures requiring calorie information on menus, particularly among regular diners. However, while evaluating the results, it is important to take into account the study's limitations, including self-reported data and convenience sample. To support menu calorie labeling legislation and inform targeted public health interventions for university students' eating behaviors, more research that takes cultural quirks and regional settings into account is necessary.