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1.
International Journal of Molecular Sciences ; 23(18):10846, 2022.
Article in English | ProQuest Central | ID: covidwho-2039873

ABSTRACT

Obesity is increasing at epidemic rates across the US and worldwide, as are its co-morbidities, including type-2 diabetes and cardiovascular disease. Thus, targeted interventions to reduce the prevalence of obesity are of the utmost importance. The sigma-1 receptor (S1R) and sigma-2 receptor (S2R;encoded by Tmem97) belong to the same class of drug-binding sites, yet they are genetically distinct. There are multiple ongoing clinical trials focused on sigma receptors, targeting diseases ranging from Alzheimer’s disease through chronic pain to COVID-19. However, little is known regarding their gene-specific role in obesity. In this study, we measured body composition, used a comprehensive laboratory-animal monitoring system, and determined the glucose and insulin tolerance in mice fed a high-fat diet. Compared to Sigmar1+/+ mice of the same sex, the male and female Sigmar1−/− mice had lower fat mass (17% and 12% lower, respectively), and elevated lean mass (16% and 10% higher, respectively), but S1R ablation had no effect on their metabolism. The male Tmem97−/− mice exhibited 7% lower fat mass, 8% higher lean mass, increased volumes of O2 and CO2, a decreased respiratory exchange ratio indicating elevated fatty-acid oxidation, and improved insulin tolerance, compared to the male Tmem97+/+ mice. There were no changes in any of these parameters in the female Tmem97−/− mice. Together, these data indicate that the S1R ablation in male and female mice or the S2R ablation in male mice protects against diet-induced adiposity, and that S2R ablation, but not S1R deletion, improves insulin tolerance and enhances fatty-acid oxidation in male mice. Further mechanistic investigations may lead to translational strategies to target differential S1R/S2R regulations and sexual dimorphism for precision treatments of obesity.

2.
Boletin de Malariologia y Salud Ambiental ; 62(2):233-240, 2022.
Article in Spanish | CAB Abstracts | ID: covidwho-2033888

ABSTRACT

The objective of the study was to determine the factors associated with hospital mortality in patients with coronavirus disease 2019 (COVID-19). An observational, analytical, case-control study was conducted. Hospitalized patients diagnosed with COVID-19 by serological test and/or molecular test between March and August 2020 were included. The Mann Whitney test was used for statistical analysis and logistic regression was used for the analysis of associated factors. The significance of p-value was < 0.05. A total of 814 patients were included, 556 (68.3%) were men and 246 (30.2%) were older than 60 years. The presence of some comorbidity was evidenced in 29.6% (241 patients);35.8% (292) died. The median age of the deceased was higher compared to the survivors (59 vs. 49;p >0.01). The comorbidities associated with COVID-19 were: obesity (OR= 2.14;95% CI: 1.38-3.32) and arterial hypertension (OR=1.86;95% CI: 1.06- 3.24). Likewise, oxygen saturation levels less than 85% at hospital admission (OR= 3.58;95% CI: 2.82-4.53);age over 60 years (OR=1.96;95% CI: 1.54-2.50) and male gender (OR= 1.64;95% CI: 1.12-2.39) were associated with greater mortality. Finally, the factors associated with hospital mortality were oxygen saturation less than 85% at hospital admission, older than 60 years of age, obesity, and arterial hypertension.

3.
Medicina de Familia. SEMERGEN ; : 101840, 2022.
Article in English | ScienceDirect | ID: covidwho-2031683

ABSTRACT

Resumen Introducción: La obesidad es considerada un factor de riesgo en casos graves de la COVID-19, habiendo sido analizada mediante el índice de masa corporal (IMC), estimador que no correlaciona adecuadamente con el porcentaje de grasa corporal (GC). El objetivo de este estudio ha sido analizar la fracción atribuible poblacional a la GC en formas graves de COVID-19 atendiendo al IMC y al CUN-BAE. Material y métodos: Estudio multicéntrico observacional de prevalencia. Se recogió información sociodemográfica, antecedentes personales, IMC y CUN-BAE, de casos positivos SARS-CoV-2, de las provincias de León y La Rioja. Mediante modelos de regresión logística se calcularon odds ratio con sus respectivos intervalos de confianza del 95% ajustando por edad y antecedentes personales, así como la fracción atribuible poblacional a la GC. Resultados: Participaron 785 pacientes, 123 (15,7%) fueron graves. Se detectaron como factores de riesgo la edad, la obesidad (tanto por IMC como por CUN-BAE) y los antecedentes personales. Un 51,6% de casos graves podrían ser atribuidos a un exceso de IMC y un 61,4% a exceso GC estimada según CUN-BAE, observándose una mayor infraestimación del riesgo en mujeres. Conclusiones: El exceso de GC, es un factor de riesgo para formas graves de la COVID-19 junto con la edad avanzada y la presencia de enfermedades cardiovasculares, respiratorias crónicas u oncohematológicas. El IMC infraestima el riesgo, especialmente en mujeres, siendo el CUN-BAE el predictor seleccionado por su mejor estimación del porcentaje de GC. Introduction: Obesity is considered a risk factor in severe cases of COVID-19, which has been analysed using body mass index (BMI), an estimator that does not correlate adequately with body fat (BF) percentage. The aim of this study was to analyse the population attributable fraction to BF in severe forms of COVID-19 based on BMI and CUN-BAE. Material and methods: Multicentre observational prevalence study. Sociodemographic information, personal history, BMI and CUN-BAE were collected in SARS-CoV-2 positive cases from the provinces of León and La Rioja. Logistic regression models were used to calculate odds ratios with their respective 95% confidence intervals adjusting for age and personal history, as well as the population attributable fraction to BF. Results: 785 patients participated, 123 (15.7%) were severe. Age, obesity (both by BMI and CUN-BAE) and personal history were detected as risk factors. 51.6% of severe cases could be attributed to excess BMI and 61.4% to excess BF estimated according to CUN-BAE, with a higher underestimation of risk in women. Conclusions: Excess BF is a risk factor for severe forms of COVID-19 together with advanced age and the presence of cardiovascular, chronic respiratory or oncohematological diseases. BMI underestimates the risk especially in women, being CUN-BAE the predictor selected for its better estimation of the percentage of BF.

4.
Viruses ; 14(8):1687, 2022.
Article in English | ProQuest Central | ID: covidwho-2024271

ABSTRACT

Mesenchymal stem cells (MSCs) have excellent anti-inflammatory and immunomodulatory capabilities and therapeutic effects in some viral diseases. The therapeutic impact of MSCs mainly relies on the paracrine effects of various secreted substances. Feline calicivirus (FCV) and feline herpesvirus type 1 (FHV1) are common and highly prevalent pathogens causing upper respiratory diseases, and FCV is associated with gingivostomatitis in cats. Recently, feline MSC treatment has been reported to improve the clinical symptoms of feline chronic gingivostomatitis, but the antiviral effects of feline MSCs on FCV and FHV1 are not known. In this study, we evaluated the antiviral efficacy of using feline MSC secretome as a conditioned medium on FCV and FHV1 viral replication in Crandell–Reese feline kidney (CRFK) cells, and RNA sequencing was used to analyze how the CRFK cells were altered by the MSC secretomes. The feline MSC secretome did not inhibit FCV or FHV1 viral entry into the CRFK cells but had antiviral effects on the replication of both FCV and FHV1 in a dose-dependent manner.

5.
International Journal of Molecular Sciences ; 23(16):9319, 2022.
Article in English | ProQuest Central | ID: covidwho-2023739

ABSTRACT

The European mink (Mustela lutreola) is one of Europe’s most endangered species, and it is on the brink of extinction in the Iberian Peninsula. The species’ precarious situation requires the application of new ex situ conservation methodologies that complement the existing ex situ and in situ conservation measures. Here, we report for the first time the establishment of a biobank for European mink mesenchymal stem cells (emMSC) and oocytes from specimens found dead in the Iberian Peninsula, either free or in captivity. New emMSC lines were isolated from different tissues: bone marrow (emBM-MSC), oral mucosa (emOM-MSc), dermal skin (emDS-MSC), oviduct (emO-MSc), endometrium (emE-MSC), testicular (emT-MSC), and adipose tissue from two different adipose depots: subcutaneous (emSCA-MSC) and ovarian (emOA-MSC). All eight emMSC lines showed plastic adhesion, a detectable expression of characteristic markers of MSCs, and, when cultured under osteogenic and adipogenic conditions, differentiation capacity to these lineages. Additionally, we were able to keep 227 Cumulus-oocyte complexes (COCs) in the biobank, 97 of which are grade I or II. The European mink MSC and oocyte biobank will allow for the conservation of the species’ genetic variability, the application of assisted reproduction techniques, and the development of in vitro models for studying the molecular mechanisms of infectious diseases that threaten the species’ precarious situation.

6.
International Journal of Molecular Sciences ; 23(16):8984, 2022.
Article in English | ProQuest Central | ID: covidwho-2023733

ABSTRACT

Glucocorticoids (GCs), which are secreted by the adrenal cortex, are important regulators in the metabolism of carbohydrates, lipids, and proteins. For the proper functioning of the body, strict control of their release is necessary, as increased GCs levels may contribute to the development of obesity, type 2 diabetes mellitus, hypertension, cardiovascular diseases, and other pathological conditions contributing to the development of metabolic syndrome. 11β-hydroxysteroid dehydrogenase type I (11β-HSD1) locally controls the availability of the active glucocorticoid, namely cortisol and corticosterone, for the glucocorticoid receptor. Therefore, the participation of 11β-HSD1 in the development of metabolic diseases makes both this enzyme and its inhibitors attractive targets in the pharmacotherapy of the above-mentioned diseases.

7.
International Journal of Environmental Research and Public Health ; 19(17):10797, 2022.
Article in English | ProQuest Central | ID: covidwho-2023705

ABSTRACT

The practice of physical activity during adolescence is essential for the proper development of the population. In recent decades, the relevance of physical activity has been increasing, due to the development of the “fat but fit” paradigm. This paradigm shows that adolescents with a high level of physical fitness are healthier than adolescents with poorer physical fitness, regardless of their weight, giving importance to sports practice over other aspects. However, few previous studies have analyzed the differences in physical and body composition between active and sedentary adolescents in this paradigm. For this reason, the objectives of the present study were to establish the differences in body composition, physical performance, and adherence to the Mediterranean diet between active and sedentary adolescents;and to analyze the differences between active and sedentary adolescents according to the “fat but fit” paradigm. The sample consisted of 791 adolescent whose body composition, level of physical activity, adherence to the Mediterranean diet, and physical fitness were measured. It was found significant between active and sedentary adolescents in most of the anthropometric, AMD, and physical fitness variables, with a significant effect of the covariates gender, age, BMI, and biological maturation on the model. The binary logistic regression analysis performed shows that anthropometric variables, AMD, and VO2 max can be considered as primary outcomes to distinguish between active and sedentary groups of adolescents. Furthermore, the results showed that the active adolescents, regardless of their weight status, had lower fat mass and greater muscle mass, as well as a higher performance in the physical fitness tests, and greater adherence to the Mediterranean diet than the sedentary adolescents. To conclude, the practice of physical activity is a determinant for the improvement of body composition, physical performance, and adherence to the Mediterranean diet of the adolescent population, regardless of their gender, age, weight, or maturity status.

8.
Children ; 9(8):1199, 2022.
Article in English | ProQuest Central | ID: covidwho-2023218

ABSTRACT

According to the findings of this study, the consumption of various core food groups (dairy products, fruit, vegetables, legumes, and fish) was lower than the national recommendations, while the consumption of meat/poultry exceeded them. [...]a high number of the participants were found to consume unhealthy foods and beverages (e.g., regular soft drinks, sweets, salty snacks, etc.) regularly. According to the results of this study, a large proportion of the participants (18.7% of children and 24.5% of adolescents) exceeded the recommendation of 10% of total energy intake from added sugars, which may be attributed to their high consumption of foods rich in sugar, such as sweets and processed/refined grains and cereals in the case of children, or sugar-sweetened beverages in the case of adolescents. The results of this study showed that children with higher BMIs tended to have higher percentages of body fat, while younger children had lower percentages of body fat. [...]girls experienced a greater increase in adipose tissue (both in the total and segmental body composition analyses), and boys in lean mass, muscle mass, and total body water. The obese participants were found to have higher levels of white blood cells, red blood cells, and platelets compared to their normal-weight peers. [...]positive associations were observed between BMI standard deviation scores and white blood cells, red blood cells, hemoglobin, hematocrit, and platelets.

9.
Frontiers in Nutrition ; 9, 2022.
Article in English | Web of Science | ID: covidwho-2022810

ABSTRACT

Metabolic diseases are major public health issues worldwide and are responsible for disproportionately higher healthcare costs and increased complications of many diseases including SARS-CoV-2 infection. The Western Diet (WD) specifically is believed to be a major contributor to the global metabolic disease epidemic. In contrast, the Mediterranean diet (MeD), Ketogenic diet (KD), and Japanese diet (JD) are often considered beneficial for metabolic health. Yet, there is a growing appreciation that the effect of diet on metabolic health varies depending on several factors including host genetics. Additionally, poor metabolic health has also been attributed to altered gut microbial composition and/or function. To understand the complex relationship between host genetics, gut microbiota, and dietary patterns, we treated four widely used metabolically diverse inbred mouse strains (A/J, C57BL/6J, FVB/NJ, and NOD/ShiLtJ) with four human-relevant diets (MeD, JD, KD, WD), and a control mouse chow from 6 weeks to 30 weeks of age. We found that diet-induced alteration of gut microbiota (alpha-diversity, beta-diversity, and abundance of several bacteria including Bifidobacterium, Ruminococcus, Turicibacter, Faecalibaculum, and Akkermansia) is significantly modified by host genetics. In addition, depending on the gut microbiota, the same diet could have different metabolic health effects. Our study also revealed that C57BL/6J mice are more susceptible to altered gut microbiota compared to other strains in this study indicating that host genetics is an important modulator of the diet-microbiota-metabolic health axis. Overall, our study demonstrated complex interactions between host genetics, gut microbiota, and diet on metabolic health;indicating the need to consider both host genetics and the gut microbiota in the development of new and more effective precision nutrition strategies to improve metabolic health.

10.
Archives of Disease in Childhood ; 107(Suppl 2):A62, 2022.
Article in English | ProQuest Central | ID: covidwho-2019831

ABSTRACT

Aims• Explore international literature published in the years 2020-2021 to determine the prevalence of adolescent obesity and identify any changes following the introduction of COVID-19 lockdown measures.• Determine changes in weight and anthropometric measurements in adolescents during this period (2020-2021).• Consider correlations between changes in physical activity, eating habits and screen-time following COVID-19 lockdowns and changes in anthropometric measures.• Explore the impact of economic and environmental inequalities on weight gain and obesity.MethodsPeer-reviewed publications published between 1st January 2020 - 1st December 2021 were identified via systematic searching of three electronic databases, CINAHL, PubMed and OVID. Designated medical subject headings (MeSH) terms and free text search terms relating to the research question including ’COVID-19’, ‘obesity’, and ‘adolescents’ were used to identify relevant articles for inclusion. Those executed in all global settings, published in the English language, and with participants aged 10-18-years-old were included. Any anthropometric measure of obesity, including body mass index, body weight and body fat index were considered. Grey literature searches were also conducted using Goggle Scholar. Data was extracted onto a pre piloted data collection form capturing population, intervention/exposure, comparators, and outcomes (PICO). A narrative analysis was produced based around identified themes.ResultsOverall nine studies were deemed suitable for inclusion. No UK based studies were identified, but global findings were captured including those conducted in the USA, China, South Korea, Germany, India, and Italy. Two studies compared anthropometric measures before and after school closures due to COVID-19. Six reported anthropometric changes before and after/during COVID-19 lockdowns, and one reported pre-pandemic versus pandemic changes in anthropometry. COVID-19 resulted in increased screen times, reduced physical activity and changes in nutritional habits. Key themes included gender- weight gain was higher in adolescent males than females, ethnicity- those from Hispanic backgrounds showed higher levels of obesity, parental factors- obese parents increased the likelihood of adolescent obesity (70%), lower socioeconomic status presented with 2.5 times increase in body weight, and behavioural changes- this included reduced physical activity, increased sedentary behaviour and dietary changes with increased snacking reported.ConclusionOur findings show that there was an increase in the prevalence of adiposity, obesity prevalence and weight gain alongside changes in eating habits and activity levels across several regions between 2020-2021. COVID-19 infection control measures such as school closures increased sedentary behaviours e.g. screen-time for both education and leisure, and negatively influenced nutrition. There is a need for ongoing surveillance and intervention in particular for those identified at risk groups from our included articles. All healthcare professionals and governmental bodies have a role to play in addressing this issue. Further work will be required in order to explore the long-term effects of COVID-19 and its true impact on adolescent obesity.

11.
Health Science Journal ; 16(7):1-5, 2022.
Article in English | ProQuest Central | ID: covidwho-2002882

ABSTRACT

Keywords: Core Muscles;Functional Capacity;Peak Cough Flow;Hospitalized Patients;Case Report Introduction The "core" has been used to refer a three-dimensional space, the lumbopelvic-hip complex, which involves deeper muscles, such as the internal oblique, transverses abdominals, transversospinalis (multifidus, rotators, semispinalis), quadratus lumborum, and psoas major and minor, and superficial muscles, such as the rectus abdominis, external oblique, erector spinae (iliocostalis, spinalis, longissimus) latissimus dorsi, gluteus maximus and medius, hamstrings, and rectus femoris [1, 2]. At the beginning of the session HR, respiratory rate (RR), SpO2, Blood pressure (BP), dyspnea (using the MBS) was monitored for all patients and for those who have diabetes was also monitored glucose levels. Personal history (PH) of SARS-CoV2 pneumonia in March 2021 (hospitalized for 1 month in the Intensive Care Unit (ICU) using mechanically invasive ventilation), type 2 diabetes mellitus (DM) treated with premixed insulin, polyneuropathy for more than 10 years, arterial hypertension (AH), chronic kidney disease (CKD), coronary heart disease (placement stent in 2010), dyslipidaemia, chronic gastritis, lithiasis and renal cysts.

12.
Working Paper Series National Bureau of Economic Research ; 16, 2022.
Article in English | GIM | ID: covidwho-2002488

ABSTRACT

From April 2020 through at least the end of 2021, Americans died from non-Covid causes at an average annual rate 97,000 in excess of previous trends. Hypertension and heart disease deaths combined were elevated 32,000. Diabetes or obesity, drug-induced causes, and alcohol-induced causes were each elevated 12,000 to 15,000 above previous (upward) trends. Drug deaths especially followed an alarming trend, only to significantly exceed it during the pandemic to reach 108,000 for calendar year 2021. Homicide and motor-vehicle fatalities combined were elevated almost 10,000. Various other causes combined to add 18,000. While Covid deaths overwhelmingly afflict senior citizens, absolute numbers of non-Covid excess deaths are similar for each of the 18-44, 45-64, and over-65 age groups, with essentially no aggregate excess deaths of children. Mortality from all causes during the pandemic was elevated 26 percent for working-age adults (18-64), as compared to 18 percent for the elderly. Other data on drug addictions, non-fatal shootings, weight gain, and cancer screenings point to a historic, yet largely unacknowledged, health emergency.

13.
Res Pract Thromb Haemost ; 6(4): e12722, 2022 May.
Article in English | MEDLINE | ID: covidwho-1976781

ABSTRACT

Men seem to have a higher intrinsic risk of venous thromboembolism (VTE) than women, regardless of age. To date, this difference has not been explained. By integrating state-of-the-art research presented at the International Society on Thrombosis and Haemostasis Congress of 2021 with the available literature, we address potential explanations for this intriguing risk difference between men and women. We discuss the role of exogenous and endogenous sex hormones as the most important known sex-specific determinants of VTE risk. In addition, we highlight clues on the role of sex hormones and VTE risk from clinical scenarios such as pregnancy and the polycystic ovary syndrome. Furthermore, we address new potential sex-specific risk factors and unanswered research questions, which could provide more insight in the intrinsic risk difference between men and women, such as body height and differences in body fat distribution, leading to dysregulation of metabolism and inflammation.

14.
Gastroenterology ; 162(7):S-836, 2022.
Article in English | EMBASE | ID: covidwho-1967372

ABSTRACT

Background and Aims: In patients with COVID-19, obesity may increase risk of hospitalisation, use of mechanical ventilation and patient mortality. High liver fat, body mass index (BMI) and male sex are significant predictors of hospitalisation risk following COVID-19. However, BMI is a poor indicator of body fat distribution. Here, we studied ectopic fat accumulation within the liver and pancreas and body composition through multiparametric magnetic resonance (mpMR) and compared participants with and without hospitalisation for COVID-19. Method: Participants with laboratory-confirmed or clinically suspected SARSCoV- 2 infection were recruited to the COVERSCAN study (NCT04369807;median time from initial symptoms = 177 days) and underwent a multi-organ mpMR scan (CoverScan®, Perspectum Ltd). Measures of liver and pancreatic fat (PDFF), liver fibroinflammation (cT1) and body composition [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), skeletal muscle index (SMI)] were analysed. Differences between participants hospitalised (n = 59) and not hospitalised (n = 348) for COVID-19 were assessed using Wilcoxon signedrank tests. Univariate and multivariate analyses were performed on all biomarkers to assess the hospitalisation risk. Data presented are median values. Results: Approximately 6-months after initial symptoms, participants hospitalised following COVID-19 had significantly elevated pancreatic fat (3.8 % vs 2.8 %, p < 0.01), liver fat (3.8 % vs 2.4 %, p < 0.01) and liver cT1 (735ms vs 706ms, p < 0.01) compared to those who convalesced at home. Though hospitalised participants had a significantly elevated BMI (27 kg/m2 vs 25 kg/m2, p = 0.014), it was VAT, but not SAT, that was significantly elevated (132 cm2 vs 86 cm2, p < 0.01). Univariate analysis revealed that male sex, advanced age and elevated BMI, VAT, pancreatic fat, liver fat, and liver cT1 were all significantly predictive of hospitalisation following COVID- 19. In multivariate analysis, only age remained significantly predictive of hospitalisation. In hospitalised people with obesity (³ 30 kg/m2), VAT, liver cT1 and liver fat, but not BMI nor pancreatic fat, remained significantly elevated [VAT: 220 cm2 vs 152cm2, p = 0.01 (Figure 1);liver fat: 9.9 % vs 4.2 %, p = 0.003;liver cT1: 782ms vs 742ms, p = 0.012]. Conclusion: mpMR revealed significantly elevated visceral and ectopic fat deposition within the liver and pancreas in hospitalised participants following COVID-19. In obese participants, BMI was not significantly different in hospitalised, and non-hospitalised patients, whereas visceral fat, liver fibroinflammation and liver fat were significantly elevated. Our work highlights body fat distribution an important consideration for COVID-19 risk profiling, which cannot be sufficiently evaluated based on BMI alone. (Figure Presented) Figure 1. Comparison of liver fat (left), pancreatic fat (middle) and visceral adipose tissue (right) between participants hospitalised and not hospitalised following COVID-19.

15.
Front Nutr ; 9: 906659, 2022.
Article in English | MEDLINE | ID: covidwho-1963500

ABSTRACT

Background: Published data regarding the impact of obesity on COVID-19 outcomes are inconsistent. However, in most studies, body composition was assessed using body mass index (BMI) alone, thus neglecting the presence and distribution of adipose tissue. Therefore, we aimed to investigate the impact of body and visceral fat on COVID-19 outcomes. Methods: Observational, prospective cohort study included 216 consecutive COVID-19 patients hospitalized at University Clinical Center Kragujevac (Serbia) from October to December 2021. Body composition was assessed using the BMI, body fat percentage (%BF), and visceral fat (VF) via bioelectrical impedance analysis (BIA). In addition to anthropometric measurements, variables in the research were socio-demographic and medical history data, as well as admission inflammatory biomarkers. Primary end-points were fatal outcomes and intensive care unit (ICU) admission. Results: The overall prevalence of obesity was 39.3% according to BMI and 50.9% according to % BF, while 38.4% of patients had very high VF levels. After adjusting odds ratio values for cofounding variables and obesity-related conditions, all three anthropometric parameters were significant predictors of primary end-points. However, we note that % BF and VF, compared to BMI, were stronger predictors of both mortality (aOR 3.353, aOR 3.05, and aOR 2.387, respectively) and ICU admission [adjusted odds ratio (aOR) 7.141, aOR 3.424, and aOR 3.133, respectively]. Conclusion: Obesity is linked with COVID-19 mortality and ICU admission, with BIA measurements being stronger predictors of outcome compared to BMI use alone.

16.
Diabetes ; 71, 2022.
Article in English | ProQuest Central | ID: covidwho-1952109

ABSTRACT

Background: Recent evidence suggests a bidirectional relationship between COVID-infection and new-onset diabetes (NOD) presenting with DKA. Methodology: This one-year prospective study comprised of 29 COVID-negative DKA (controls) and 52 COVID-positive-DKA patients (18 NOD, 15 T1DM ,T2DM) . NOD were previously normoglycemic and negative for GAD/IA-2/ZnT8 autoantibodies. After 75g- OGTT with estimation of glucose, C-peptide, FFA and insulin at 0,15, 30,45, 60,90 ,120, 150 and 180minutes, Insulin secretion rate (ISR) [C-peptide-deconvolution] , Hepatic insulin sensitivity [AUC-glucose × AUC-insulin during first 30-minutes of OGTT ], Peripheral insulin sensitivity [ dG/dt ÷ mean plasma insulin concentration;dG/dt rate of decline in plasma glucose concentration]were calculated alongwith Metabolomics and Adipose tissue gene expression. All tests were performed at admission and 4, 8, and 12-months of followup. Results: At baseline, ISR in NOD was significantly reduced than controls (p=0.001) but similar to T1DM (p=0.15) . Nearly 83% (n=17) of NOD with DKA had near-complete recovery of ISR on follow-up compared to T1DM (all p<0.01) ,with non-remitters (n=3) having significantly worse admission Hba1c and IL-6 (all p<0.01) . NOD had significantly increased hepatic and peripheral insulin resistance compared to T1DM (all p<0.05) ,but similar to T2DM (all p>0.05) . Their Metabolomics revealed increased inflammatory phosphatidylcholines, that correlated with peripheral glucose uptake (p<0.01) ,while RNA sequencing showed significantly enhanced WNT5A , TLR4 (Toll-like Receptor-4) and RETN (resistin) than T1DM and T2DM (both p=0.001) . Conclusion: Our study provides novel insights into COVID-associated NOD with DKA. Majority have near-complete recovery of insulin secretion while simultaneous multi-tissue insulin resistance and inflammatory adipose tissue profiles persist as drivers of hyperglycemia.

17.
Journal of Adolescent Health ; 70(4):S88, 2022.
Article in English | EMBASE | ID: covidwho-1936639

ABSTRACT

Purpose: Adolescent obesity continues to rise, with body mass index (BMI) commonly used as an adiposity surrogate. While obesity correlates with metabolic syndrome risk, individuals with the same BMI do not have equivalent health risks. In 2018, the first pediatric consensus definition for metabolically healthy obesity (MHO) was proposed. Identifying MHO patients is clinically relevant for personalizing interventions by cardiometabolic phenotype. The objective of this study was to examine baseline MHO and metabolically unhealthy obesity (MUO) prevalence and identify metabolic and anthropomorphic predictors among adolescents enrolled in weight management. Methods: This study uses baseline data from 1,316 patients ≥ 11 years of age enrolled in a weight management program for obese adolescents in Baltimore, Maryland between 2005-2018. Anthropometric measures (including body fat by bioimpedance (%fat)), vital signs, and fasting labs were performed at intake. MHO definition was: glucose <100, HDL > 40, triglycerides < 150, systolic blood pressure < 120, diastolic blood pressure < 80. MUO was defined as ≥ 1 abnormal value among MHO variables. Independent samples t-tests were used to compare mean %fat and BMI z-score of MHO and MUO groups. Bivariate logistic regression was performed to determine effects of age, sex, %fat, BMI, and BMI z-score on likelihood of MHO. Results: Mean age in the MHO group was 13.48 years (SD 1.88);mean age in the MUO group was 13.98 years (SD 2.03). 444 (33.7%) patients met criteria for MHO;872 patients had MUO. MHO teens had statistically significantly lower mean %fat (46.7% +/- 8.0% SD) vs. MUO (47.8% +/- 8.2% SD) (p = 0.034) and lower BMI z-score (2.37 +/- 0.33 SD vs 2.51 +/- 0.34 SD;p < 0.001) vs MUO. The MHO group was 66.9% female vs 54.5% females in MUO, with 38.9% lower odds of MHO for males vs. females (OR 0.611;CI 0.467 - 0.800). For every 1% increase in %fat, odds of MHO increased by 3.1%, (OR 1.031;CI 1.008 - 1.053). Each 1-year age increase led to 10.9% decrease in MHO odds (OR 0.891;CI 0.823 - 0.965). In addition, each 1 unit increase in BMI z-score was associated with a 64.5% decrease in odds of MHO (OR 0.355;CI 0.166 - 0.759). BMI change did not significantly change MHO odds. Conclusions: Among this cohort of obese adolescents enrolled in weight management, one-third had MHO. Factors associated with higher likelihood of MHO include: female sex, younger age, and lower BMI z-score. Notably, BMI was not predictive of metabolic phenotype. These findings suggest potential for risk prediction for MUO profile to tailor interventions and resources accordingly. Next, we will evaluate metabolic profiles of patients enrolled during the COVID-19 pandemic. Sources of Support: NICHD T32HD052459 (PI: Trent), The Mount Washington Foundation.

18.
European Journal of Preventive Cardiology ; 29(SUPPL 1):i354-i355, 2022.
Article in English | EMBASE | ID: covidwho-1915599

ABSTRACT

Background: Cardiorespiratory fitness (CRF) is a powerful predictor of all-cause mortality among individuals with coronary artery disease (CAD). A structured community-based phase III cardiac rehabilitation (CR) is very important in lifelong maintenance of phase II CRF and health gains. During the COVID-19 pandemic, CR programs had to adapt, mainly using new technologies and remote follow-up. The CRF impact in patients (Ps) who kept going their phase III program, during this troubled era is still unknown. Purpose: Assess the variation in CRF and prognostic parameters in Ps with CAD who maintain high adherence levels in their phase III CR before and during the COVID-19 pandemic. Methods: A cohort of Ps enrolled in a community-based phase 3 CR program, with active participation at the end of 2019, was included in this retrospective study. The inclusion criteria for this study were high levels of attendance (>80%) to the CR program before and during COVID-19 and high levels of physical activity with more than 150 mins of moderate to vigorous physical activity (MVPA). All Ps were evaluated with transthoracic echocardiography (TTE) and a cardiorespiratory exercise test (CPET) in a cycloergometer in 2019 and between october and november of 2021. All Ps had used accelerometers to measure their physical activity levels and dual-energy absorptiometry (DEXA) scan to evaluate their body composition. Between 2020 and 2021, Ps had online (in lockdown periods) and face to face exercise training sessions, 3xtimes per week, 60 mins each exercise session. A t-test paired two sample for means was used to compare CPET variables before the beginning of the first COVID lockdown (end of 2019) and after the removal of the majority of restrictions (end of 2021). Results: A total of 30 Ps with high levels of adherence were included (99.6% male, 65 ± 9 years old). In this cohort, the majority had history of an ACS before the referral to the CR program (73.3%) and 55.6 ± 10.4% of left ventricular ejection fraction. There was no significant difference in body mass index (27.9 ± 3.2 kg/m2 vs 28.1 ± 3.6 kg/m2, p=0.493 but there was a significant increase in the percentage of body fat mass (30.1 ± 5.7% vs 31.0 ± 6.6%, p= 0.042). There was a maintenance on MVPA levels (352 ± 137 minutes/week vs 313 ± 194 minutes/week, p = 0.106) during this period. When comparing the 2 CPET results, Ps achieved higher exercise loads in the 2021 test (175 ± 51W vs 185 ± 52W, p=0.005), higher VO2 peak (25.3 ± 6.9 ml/kg/min vs 21.5 ± 6.3 ml/kg/min, p =0.001) and higher percentage of predicted VO2max (78.8 ± 16.8% vs 95.27 ± 20.8%, p = 0.001). Conclusion: In spite of all the difficulties in maintaining a phase III CR program during the COVID-19 pandemic, we observed that in physically active CAD Ps, with the aid of new technologies and remote follow-up (during the lockdown periods) and face to face exercise sessions, it is still possible to have functional gains and improvements in CRF. (Figure Presented).

19.
JMIR Form Res ; 6(6): e30630, 2022 Jun 08.
Article in English | MEDLINE | ID: covidwho-1910854

ABSTRACT

BACKGROUND: There has been an increase in personal health records with the increased use of wearable devices and smartphone apps to improve health. Traditional health promotion programs by human professionals have limitations in terms of cost and reach. Due to labor shortages and to save costs, there has been a growing emphasis in the medical field on building health guidance systems using artificial intelligence (AI). AI will replace advanced human tasks to some extent in the future. However, it is difficult to sustain behavioral change through technology alone at present. OBJECTIVE: This study investigates whether AI alone can effectively encourage healthy behaviors or whether human interventions are needed to achieve and sustain health-related behavioral change. We examined the effectiveness of AI and human interventions to encourage dietary management behaviors. In addition, we elucidated the conditions for maximizing the effect of AI on health improvement. We hypothesized that the combination of AI and human interventions will maximize their effectiveness. METHODS: We conducted a 3-month experiment by recruiting participants who were users of a smartphone diet management app. We recruited 102 participants and divided them into 3 groups. Treatment group I received text messages using the standard features of the app (AI-based text message intervention). Treatment group II received video messages from a companion, in addition to the text messages (combined text message and human video message intervention by AI). The control group used the app to keep a dietary record, but no feedback was provided (no intervention). We examine the participants' continuity and the effects on physical indicators. RESULTS: Combined AI and video messaging (treatment group II) led to a lower dropout rate from the program compared to the control group, and the Cox proportional-hazards model estimate showed a hazard ratio (HR) of 0.078, which was statistically significant at the 5% level. Further, human intervention with AI and video messaging significantly reduced the body fat percentage (BFP) of participants after 3 months compared to the control group, and the rate of reduction was greater in the group with more individualized intervention. The AI-based text messages affected the BMI but had no significant effect on the BFP. CONCLUSIONS: This experiment shows that it is challenging to sustain participants' healthy behavior with AI intervention alone. The results also suggest that even if the health information conveyed is the same, the information conveyed by humans and AI is more effective in improving health than the information sent by AI alone. The support received from the companion in the form of video messages may have promoted voluntary health behaviors. It is noteworthy that companions were competent, even though they were nonexperts. This means that person-to-person communication is crucial for health interventions.

20.
Nutrition and Food Science ; 52(5):765-777, 2022.
Article in English | ProQuest Central | ID: covidwho-1909161

ABSTRACT

Purpose>This study aims at determining the risk of physical inactivity and sedentary behaviors on overweight and obesity among primary school children aged 10–13 years in Tanzania.Design/methodology/approach>A case-control study was conducted from January to March 2020 involving 69 overweight/obese children as cases and 138 normal weight children as controls. Cases were identified as having body mass index-for-age ≥ +1 standard deviation (SD) and controls as those having BMI-for-age range between −2 SD to <+1 SD. A validated questionnaire was used for data collection on daily physical activities and sedentary behavior types, frequency duration and activity score. An independent sample t-test was used to compare means of activity score between cases and controls. Binary logistic regression was used to predict risk factors for overweight/obesity.Findings>Risk factors for overweight/obesity were listening to music and/or radio for >2 h/week (OR 2.7, 95% CI 1.2–6.1) and walking for exercise <2 h/week (OR 2.1, 95% confidence interval [CI] 1.1–4.1). On the other hand, rope skipping for >2 h/week (OR 0.14, 95% CI 0.03–0.7) was a protective factor against overweight/obesity. Controls had a significantly higher mean score of being active during lunch breaks compared to cases (p = 0.012). Cases had higher weight, height and percentage body fat than controls (p < 0.001). The home environment provided more avenues for physical activity than the school environment.Originality/value>To the best of the authors’ knowledge, this is original research work and the first case-control study to predict physical activity and sedentary behaviors as risk factors for overweight and obesity in Tanzanian school children.

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